| 1. |
- Andersson, Ann-Christine, et al.
(författare)
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Erfarenheter från lärandeseminarier : Barn som anhöriga: Reflektioner från följeforskning
- 2016
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Under 2015 genomfördes nationella lärandeseminarier för att stärka implementeringen av den lag som ger barn rätt till information, råd och stöd när en förälder plötsligt avlider, är svårt sjuk eller skadad (HSL 2g §). Satsningen var ett förbättringsarbete som omfattade sex landsting som med hjälp av en projektledning träffades vid fyra tillfällen från januari till september. Två av träffarna skedde i Stockholm och två var digitala. Under våren 2015 knöts följeforskning till arbetet med frågeställningar om vilka resultat förbättringsarbetet gav och hur deltagarna upplevde arbetssättet. Syftet var att lyfta fram vad satsningen gav samt att lära inför framtida satsningar – är lärandeseminarier ett användbart arbetssätt för nationella implementeringssatsningar?Rapporten visar att lärandeseminarier tycks vara en användbar form. Teamen kan redovisa att de uppnått många av de mål som de föresatte sig under projekttiden. Det handlade om kartläggning av kunskapsläge och strukturer, kompetensutveckling samt utveckling av rutiner och material. Teamen uppskattade också att få delta i ett nationellt sammanhang som gav inspiration. Samtidigt framkom det önskemål om fortsatt och ännu mer handfast stöd i fortsatt implementering i klinisk verksamhet.
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| 2. |
- Andersson, Ann-Christine, 1968-, et al.
(författare)
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Identification of children as relatives with a systematic approach: a prerequisite in order to offer advice and support
- 2018
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Ingår i: Quality Management in Health Care. - : Wolters Kluwer. - 1063-8628 .- 1550-5154. ; 27:3, s. 172-177
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Tidskriftsartikel (refereegranskat)abstract
- The purpose of this study was to elucidate conditions at all system levels in a specific health care service to develop practices for identification of children as relatives. An interactive research approach with the intention to create mutual learning between practice and research was used. The participating health care service cared for both clinic in- and outpatients with psychiatric disorders. Health care professionals from different system levels (micro, meso, macro) participated, representing different professions. At the first project meeting, it was obvious that there was no systematic approach to identify children as relatives. At the micro level, activities such as a pilot survey and an open house activity were carried out. At the meso level, it was discussed how to better support collaboration between units. At the management (macro) level, it was decided that all units should appoint at least one child agent, with the aim to increase collaboration throughout the whole health care service. To change focus, in this case from only parents to inclusion of children, is an important challenge faced by health care services when forced to incorporate new policies and regulations. The new regulations contribute to increased complexity in already complex organizations. This study highlights that such challenges are underestimated.
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| 3. |
- Andersson, Ann-Christine, 1968-, et al.
(författare)
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Learning through networking in healthcare and welfare : The use of a breakthrough collaborative in the Swedish context
- 2020
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Ingår i: International Journal of Healthcare Management. - : Maney Publishing. - 2047-9700 .- 2047-9719. ; 13:3, s. 236-244
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Tidskriftsartikel (refereegranskat)abstract
- Breakthrough Collaborative (BC) aims at learning through networking, mainly at micro level, and is used as a tool to improve care and welfare organizations. The aim of this study was to explore and illuminate the challenges when applying BC model at meso and macro level. In 2010, the Swedish Health and Medical Services Act stated the responsibility of healthcare professionals to consider children’s needs as relatives. This study uses an interactive collaborative research model. To support healthcare organizations in the implementation of the regulation, county councils/regions in Sweden were invited to take part in a BC during 2015. Six teams from different county councils/regions participated. Team members were interviewed several times during the project time. Data were analyzed with an explorative and descriptive qualitative content analysis. The result illuminates the challenges faced when applying BC at meso and macro level. Most challenges concern preparation, support structures and system connections. There are similarities with the challenges met at micro level when BC is used at meso and macro level. But it seems even more important to consider how the team is constituted at meso and macro level to make use of the learnings and achieve long-term impact in the home organization.
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| 4. |
- Avby, Gunilla, et al.
(författare)
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Social Services as a sustainable knowledge organization: from vision to reality?
- 2023
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Ingår i: Socialvetenskaplig tidskrift. - : Linkoping University Electronic Press. - 1104-1420 .- 2003-5624. ; 29:2, s. 195-207
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- The imminent Social Services Act is expected to stipulate that decision-making should be "in accordance with scientific evidence and proven experience". If the proposal is fulfilled, the Act will contain requirements similar to existing acts in other welfare sectors, such as requirements for increased systematic follow-ups, developmental work and the use of knowledge from various knowledge sources. These are characteristics that symbolize a practice that both uses verified knowledge and develops new knowledge by testing, documenting and evaluating new ideas and working methods in a systematic process in everyday life. In this article, we argue that the goal presupposes an aspiration towards a knowledge organization; therefore we want to contribute with an analysis of what this means for social services.The “knowledge-seeking social worker” is a key actor in the transition towards a knowledge organization, because it is in the everyday social work practice, that is, the interactions between the social worker and the client, that the knowledge organization largely becomes visible. However, a large-scale transition towards a sustainable knowledge organization cannot depend on only professionals and their ability to engage clients in work processes, it will require changes at a system level, where actors in politics, academia and practice take responsibility for future investments. This article highlights four areas of importance: 1) co-ordination of research and practice, 2) continuing education to build expert knowledge and broaden career paths, 3) development of political ownership for quality and direction, and 4) organization and management for knowledge use and knowledge development.
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| 5. |
- Henningsson, Susanne, 1977, et al.
(författare)
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Association between polymorphisms in NOS3 and KCNH2 and social memory
- 2015
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Ingår i: Frontiers in Neuroscience. - : Frontiers Media SA. - 1662-4548 .- 1662-453X. ; 9
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Tidskriftsartikel (refereegranskat)abstract
- Social memory, including the ability to recognize faces and voices, is essential for social relationships. It has a large heritable component, but the knowledge about the contributing genes is sparse. The genetic variation underlying inter-individual differences in social memory was investigated in an exploratory sample (n = 55), genotyped with a chip comprising approximately 200,000 single nucleotide polymorphisms (SNPs), and in a validation sample (n = 582), where 30 SNPs were targeted. In the exploratory study face identity recognition was measured. The validation study also measured vocal sound recognition, as well as recognition of faces and vocal sounds combined (multimodal condition). In the exploratory study, the 30 SNPs that were associated with face recognition at puncorrected < 0.001 and located in genes, were chosen for further study. In the validation study two of these SNPs showed significant associations with recognition of faces, vocal sounds, and multimodal stimuli: rs1800779 in the gene encoding nitric oxide synthase 3 (NOS3) and rs3807370 in the gene encoding the voltage-gated channel, subfamily H, member 2 (KCNH2), in strong linkage disequilibrium with each other. The uncommon alleles were associated with superior performance, and the effects were present for men only (p < 0.0002). The exploratory study also showed a weaker but significant association with (non-emotional) word recognition, an effect that was independent of the effect on face recognition. This study demonstrates evidence for an association between NOS3 and KCNH2SNPs and social memory.
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| 6. |
- Hovey, Daniel, et al.
(författare)
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Antisocial behavior and polymorphisms in the oxytocin receptor gene: findings in two independent samples.
- 2016
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Ingår i: Molecular psychiatry. - Stockholm : Springer Science and Business Media LLC. - 1476-5578 .- 1359-4184. ; 16, s. 983-988
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Tidskriftsartikel (refereegranskat)abstract
- The quantitative genetic contribution to antisocial behavior is well established, but few, if any, genetic variants are established as risk factors. Emerging evidence suggests that the neuropeptide oxytocin (OXT) may modulate interpersonal aggression. We here investigated whether single-nucleotide polymorphisms (SNPs) in the OXT receptor gene (OXTR) are associated with the expression of antisocial behavior. A discovery sample, including both sexes, was drawn from the Child and Adolescent Twin Study in Sweden (CATSS; n=2372), and a sample from the Twin Study of Child and Adolescent Development (TCHAD; n=1232) was used for replication. Eight SNPs in OXTR, selected on previous associations with social and antisocial behavior, were genotyped in the participants of CATSS. Significant polymorphisms were subsequently genotyped in TCHAD for replication. Participants completed self-assessment questionnaires-Life History of Aggression (LHA; available only in CATSS), and Self-Reported Delinquency (SRD; available in both samples)-designed to capture antisocial behavior as continuous traits. In the discovery sample, the rs7632287 AA genotype was associated with higher frequency of antisocial behavior in boys, and this was then replicated in the second sample. In particular, overt aggression (directly targeting another individual) was strongly associated with this genotype in boys (P=6.2 × 10(-7) in the discovery sample). Meta-analysis of the results for antisocial behavior from both samples yielded P=2.5 × 10(-5). Furthermore, an association between rs4564970 and LHA (P=0.00013) survived correction in the discovery sample, but there was no association with the SRD in the replication sample. We conclude that the rs7632287 and rs4564970 polymorphisms in OXTR may independently influence antisocial behavior in adolescent boys. Further replication of our results will be crucial to understanding how aberrant social behavior arises, and would support the OXT receptor as one potential target in the treatment of aggressive antisocial behavior.Molecular Psychiatry advance online publication, 22 September 2015; doi:10.1038/mp.2015.144.
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| 7. |
- Hovey, Daniel, et al.
(författare)
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Emotion recognition associated with polymorphism in oxytocinergic pathway gene ARNT2
- 2018
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Ingår i: Social Cognitive & Affective Neuroscience. - : Oxford University Press (OUP). - 1749-5024 .- 1749-5016. ; 13:2, s. 173-181
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Tidskriftsartikel (refereegranskat)abstract
- The ability to correctly understand the emotional expression of another person is essential for social relationships and appears to be a partly inherited trait. The neuropeptides oxytocin and vasopressin have been shown to influence this ability as well as face processing in humans. Here, recognition of the emotional content of faces and voices, separately and combined, was investigated in 492 subjects, genotyped for 25 single nucleotide polymorphisms (SNPs) in eight genes encoding proteins important for oxytocin and vasopressin neurotransmission. The SNP rs4778599 in the gene encoding aryl hydrocarbon receptor nuclear translocator 2 (ARNT2), a transcription factor that participates in the development of hypothalamic oxytocin and vasopressin neurons, showed an association that survived correction for multiple testing with emotion recognition of audio-visual stimuli in women (). This study demonstrates evidence for an association that further expands previous findings of oxytocin and vasopressin involvement in emotion recognition.
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| 8. |
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| 9. |
- Johansson, Daniel, et al.
(författare)
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Associations between oxytocin-related genes and autistic-like traits
- 2014
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Ingår i: Social Neuroscience. - Stockholm : Karolinska Institutet, Dept of Medical Epidemiology and Biostatistics. - 1747-0919 .- 1747-0927.
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Tidskriftsartikel (refereegranskat)abstract
- Oxytocin has repeatedly been shown to influence human behavior in social contexts; also, a relationship between oxytocin and the pathophysiology of autism spectrum disorder (ASD) has been suggested. In the present study, we investigated single-nucleotide polymorphisms (SNPs) in the oxytocin gene (OXT) and the genes for single-minded 1 (SIM1), aryl hydrocarbon receptor nuclear translocator 2 (ARNT2) and cluster of differentiation 38 (CD38) in a population of 1771 children from the Child and Adolescent Twin Study in Sweden (CATSS). Statistical analyses were performed to investigate any association between SNPs and autistic-like traits (ALTs), measured through ASD scores in the Autism-Tics, ADHD and other Co-morbidities inventory. Firstly, we found a statistically significant association between the SIM1 SNP rs3734354 (Pro352Thr) and scores for language impairment (p = .0004), but due to low statistical power this should be interpreted cautiously. Furthermore, nominal associations were found between ASD scores and SNPs in OXT, ARNT2 and CD38. In summary, the present study lends support to the hypothesis that oxytocin and oxytocin neuron development may have an influence on the development of ALTs and suggests a new candidate gene in the search for the pathophysiology of ASD.
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| 10. |
- Jonsson, Lina, 1982, et al.
(författare)
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Association between ASMT and autistic-like traits in children from a Swedish nationwide cohort
- 2014
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Ingår i: Psychiatric Genetics. - Stockholm : Lippincott Williams & Wilkins. - 0955-8829 .- 1473-5873. ; 24:1, s. 21-27
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Tidskriftsartikel (refereegranskat)abstract
- Individuals with autism spectrum disorders often show low levels of melatonin, and it has been suggested that this decrease may be because of the low activity of the acetylserotonin O-methyltransferase (ASMT), the last enzyme in the melatonin-synthesis pathway. Also, genetic variants in ASMT have been associated with autism, as well as with low ASMT activity and melatonin levels, suggesting that the low ASMT activity observed in autism may partly be because of variations within the ASMT gene. In this study, we present a symptom-based approach to investigate possible associations between ASMT and autistic-like traits in the general population. To this end, continuous measures of autistic-like traits were assessed in a nationally representative twin cohort (n=1771) from Sweden and six single nucleotide polymorphisms (SNPs), and a duplication of exons 2-8 in ASMT were genotyped. Our results show a nominally significant association, in girls, between one single nucleotide polymorphism (rs5949028) in the last intron of ASMT and social interaction impairments. No significant association, however, was observed with traits related to language impairment or restricted and repetitive behavior. In conclusion, our results support the possible involvement of the ASMT gene in autism spectrum disorders, and our finding that only one of the three traits shows association suggests that genetic research may benefit from adopting a symptom-specific approach to identify genes involved in autism psychopathology.
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| 11. |
- Jonsson, Lina, 1982, et al.
(författare)
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Association study between autistic-like traits and polymorphisms in the autism candidate regions RELN, CNTNAP2, SHANK3, and CDH9/10
- 2014
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Ingår i: Molecular Autism. - Stockholm : Karolinska Institutet, Dept of Medical Epidemiology and Biostatistics. - 2040-2392.
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Tidskriftsartikel (refereegranskat)abstract
- Background: Autistic-like traits (ALTs) are continuously distributed in the general population, with the autism spectrum disorder (ASD) at the upper extreme end. A genetic overlap has been shown between ALTs and ASD, indicating that common variation in ASD candidate genes may also influence ALTs. In our study, we have investigated the SNP rs4307059 that has been associated with both ALTs and ASD. In addition, we genotyped polymorphisms in a selection of genes involved in synaptic functioning, that is, SHANK3, RELN, and CNTNAP2, which repeatedly have been associated with ASD. The possible associations of these polymorphisms with ALTs, as well as genetic factors for neurodevelopmental problems (NDPs), were investigated in a large cohort from the general population: The Child and Adolescent Twin Study in Sweden. For analyses of ALTs and NDPs, 12,319 subjects (including 2,268 monozygotic (MZ) and 3,805 dizygotic (DZ) twin pairs) and 8,671 subjects (including 2,243 MZ and 2,044 DZ twin pairs), respectively, were included in the analyses. Findings: We could not replicate the previous association between rs4307059 and social communication impairment. Moreover, common variations in CNTNAP2 (rs7794745 and rs2710102), RELN (rs362691), and SHANK3 (rs9616915) were not significantly associated with ALTs in our study. Conclusions: Our results do not suggest that the investigated genes, which previously has been found associated with ASD diagnosis, have any major influence on ALTs in children from the general population.
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| 12. |
- Jonsson, Lina, 1982, et al.
(författare)
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Mutation screening of melatonin-related genes in patients with autism spectrum disorders.
- 2010
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Ingår i: BMC medical genomics. - : Springer Science and Business Media LLC. - 1755-8794. ; 3
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: One consistent finding in autism spectrum disorders (ASD) is a decreased level of the pineal gland hormone melatonin and it has recently been demonstrated that this decrease to a large extent is due to low activity of the acetylserotonin O-methyltransferase (ASMT), the last enzyme in the melatonin synthesis pathway. Moreover, mutations in the ASMT gene have been identified, including a splice site mutation, that were associated with low ASMT activity and melatonin secretion, suggesting that the low ASMT activity observed in autism is, at least partly, due to variation within the ASMT gene. METHODS: In the present study, we have investigated all the genes involved in the melatonin pathway by mutation screening of AA-NAT (arylalkylamine N-acetyltransferase), ASMT, MTNR1A, MTNR1B (melatonin receptor 1A and 1B) and GPR50 (G protein-coupled receptor 50), encoding both synthesis enzymes and the three main receptors of melatonin, in 109 patients with autism spectrum disorders (ASD). A cohort of 188 subjects from the general population was used as a comparison group and was genotyped for the variants identified in the patient sample. RESULTS: Several rare variants were identified in patients with ASD, including the previously reported splice site mutation in ASMT (IVS5+2T>C). Of the variants affecting protein sequence, only the V124I in the MTNR1B gene was absent in our comparison group. However, mutations were found in upstream regulatory regions in three of the genes investigated, ASMT, MTNR1A, and MTNR1B. CONCLUSIONS: Our report of another ASD patient carrying the splice site mutation IVS5+2T>C, in ASMT further supports an involvement of this gene in autism. Moreover, our results also suggest that other melatonin related genes might be interesting candidates for further investigation in the search for genes involved in autism spectrum disorders and related neurobehavioral phenotypes. However, further studies of the novel variants identified in this study are warranted to shed light on their potential role in the pathophysiology of these disorders.
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| 13. |
- Karlsson, Sara, 1980, et al.
(författare)
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Social memory associated with estrogen receptor polymorphisms in women
- 2016
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Ingår i: Social Cognitive & Affective Neuroscience. - : Oxford University Press (OUP). - 1749-5016 .- 1749-5024. ; 11:6, s. 877-883
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Tidskriftsartikel (refereegranskat)abstract
- The ability to recognize the identity of faces and voices is essential for social relationships. Although the heritability of social memory is high, knowledge about the contributing genes is sparse. Since sex differences and rodent studies support an influence of estrogens and androgens on social memory, polymorphisms in the estrogen and androgen receptor genes (ESR1, ESR2, AR) are candidates for this trait. Recognition of faces and vocal sounds, separately and combined, was investigated in 490 subjects, genotyped for 10 single nucleotide polymorphisms (SNPs) in ESR1, four in ESR2 and one in the AR. Four of the associations survived correction for multiple testing: women carrying rare alleles of the three ESR2 SNPs, rs928554, rs1271572 and rs1256030, in linkage disequilibrium with each other, displayed superior face recognition compared with non-carriers. Furthermore, the uncommon genotype of the ESR1 SNP rs2504063 was associated with better recognition of identity through vocal sounds, also specifically in women. This study demonstrates evidence for associations in women between face recognition and variation in ESR2, and recognition of identity through vocal sounds and variation in ESR1. These results suggest that estrogen receptors may regulate social memory function in humans, in line with what has previously been established in mice.
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| 14. |
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| 15. |
- Melke, Anna, 1974
(författare)
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Country report Sweden in Allin et al "Measuring inequalities in access to health care. A review of the indices"
- 2007
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Equity in health care is a goal embraced by most industrialized countries. Although universal coverage of health care services does not eliminate inequalities, it represents the first step towards a more equitable health care system. This paper explores the main methodological issues involved in defining and measuring equity in access to health care. Access, equity and need are complicated concepts which are difficult to define and to measure. The definition of equity most appropriate for policy makers is that of equal access for equal need. There is no consensus about the definition of need, although most commonly ill-health is used to indicate need for health care, because of relative ease of measurement. Access is a multi-dimensional concept influenced by both supply and demand factors; however it is commonly approximated by utilization which is easily observed. Methodological issues arise in the simplification of these complex terms; for instance, the measurement of utilization alone to define access leaves out other important factors such as quality of care, and cultural and financial barriers, which are necessary in understanding inequalities. Most countries use surveys and/or administrative sources to measure access and need. However, each of these methods faces inherent limitations. Surveys collecting data on utilization or self-assessed health are subject to bias based on questionnaire design, question wording and psychosocial and cultural factors. Administrative sources on the other hand are less able to collect information on health status, and might be limited in their coverage of other important indicators. Generally, there are three main approaches to calculating equity in access to health care, these are: 1) odds ratios, 2) rates of access and use-needs ratios, and 3) horizontal inequity index. Although increasingly surveys are available at EU-level, more work is needed to improve these surveys and collect more comprehensive and reliable information on both health and access to health care.
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| 16. |
- Melke, Anna, 1974
(författare)
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Country report Sweden in Masseria C. "What are the methodological issues related to measuring health"
- 2007
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Measuring population health is vital for creating effective health interventions and policies, informing resource allocation, guiding health impact assessment, and identifying the determinants of health across diverse settings. The aim of this brief is to review the methodological issues related to measuring health within and across countries and outline recommendations for improving health measurement. Population health can be measured using macro-level and micro-level indicators. While macro- or population-level data provides a broad picture or summary of health, (e.g. life expectancy, infant mortality and health-adjusted life expectancy), micro- or individual-level data comprise a variety of objective and self-assessed indicators on specific aspects or dimensions of health. Population summary measures although useful for estimating the overall population health and the global burden of disease, may provide minimal indication of the underlying factors that may be influencing health attainment in a country. While efforts have been made to combine mortality and morbidity, e.g. in healthy- and disability-adjusted life expectancy, these methods have been criticized on the grounds of methodological limitations. Avoidable mortality – or causes of death that should be avoided in the presence of timely and effective health care – represents an alternative measure of population health that can be better attributed to the health system, broader public health policies and also changes in lifestyles. On the micro-level, objective health measures such as blood pressure and body mass index are important both clinically and from a health system perspective, but they are often more expensive to collect and may be subject to measurement error. Conversely, self-assessed measures such as general health (usually ranging from excellent to poor) and limitations in daily activities although commonly available, are sensitive to variations in socio-economic conditions, individual expectations as well as wording and meaning of assessment questions. Developing an index of health on the basis of several indicators, or including vignettes in surveys are two possible methods of reducing systematic bias associated with general measures of self-assessed health. Significant advances have been made at EU-level to systematically measure health status. However improved longitudinal data is needed to make robust causal determinations about health. In addition, while extensive information is collected at national level, better international coordination of survey design and implementation would help facilitate and improve cross-country comparisons. These efforts will help to provide decision-makers with more accurate and meaningful information necessary to develop policies and programmes that most effectively address health needs and inequalities within limited resources.
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| 17. |
- Melke, Anna, 1974
(författare)
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Country report Sweden in Mladovsky, P. "Migration and health in the EU"
- 2007
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- From both the perspectives of European integration and human rights, migrant health and access to health care are important elements of national health policy. However, many EU Member States have not addressed, or have only recently begun to address this issue. Relatively little is known about the health of migrants. Measurement is challenging for a variety of technical and political reasons. The data that is available gives rise to a complex picture; the health of migrants and access issues vary across space, time, age, gender, across different countries of origin and type of migration. Disease specific mortality rates for certain conditions are higher for immigrants. Despite the fact that most migrants originate from countries with a substantially higher mortality rate than Europe, many studies have found that immigrant groups have similar or more favourable total mortality rates than native Europeans. However, the health advantage is confined to specific diseases. Furthermore, in many contexts the advantage disappears in the second generation and with increased duration of stay. The possible reasons for inequalities in health care use between migrants and autochthonous populations are complicated. Data in some countries suggests that utilization of health services among migrants tends to be relatively low, with a greater reliance on emergency services. Particularly worrisome are the low rates of utilization of antenatal and paediatric care. Barriers to access are thought to include education, cultural differences, language difficulties, lack of complimentary voluntary health insurance and legal issues. The other major issue is quality of care and whether it is lower for migrants. Across EU countries, attempts to incorporate the needs of migrant workers, in particular from non-EU Member States, into welfare systems have remained scattered and uncoordinated, although to some extent diversity in policy is to be expected. A country’s approach to migrant health issues will depend on the type of migration and the overall welfare regime. Nevertheless, it seems there are many opportunities for learning across countries. In some countries (notably France), social analyses by ethnic origin are not routinely carried out both for cultural and administrative reasons. In others (such as Spain, Germany and Ireland), migrant health policy has only recently started to be proactively developed. In others (notably the Netherlands, UK and Sweden), policy regarding the health of migrants is already relatively developed. The EU could play an important role in facilitating the development and transfer of evidence and information on migrant health policy. Topics identified as theoretically central and/or under-researched include: methodological problems of migrant health research; children and youth, particularly in terms of psychosocial health; sexuality, reproduction and family life; older migrants; access of illegal/undocumented migrants to health services; user involvement in the design and provision of services; ‘linkages’ between sender countries and receiver countries; preserving the health ‘advantage’ of some newly arrived migrants; analysis approaches to preventing and controlling TB and HIV/AIDS among migrants; multi-sectoral policy; and sharing of knowledge and data, and the improvement of data collection.
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| 18. |
- Melke, Anna, 1974
(författare)
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Country report Sweden in Sorenson, C & Mossialos, E "Measuring quality and standards of long-term care for older people"
- 2007
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Measuring the quality of long-term care is important for establishing standards of care and monitoring the performance of service providers, in addition to enhancing consumer choice and competition. Information on quality allows both purchasers and consumers to make informed decisions on providers based on performance, and to ascertain whether standards are achieved. Further, public reporting of provider performance across quality indicators spurs greater participation of providers in national and regional quality improvement initiatives. Quality measurement involves collecting information on a variety of accepted quality indicators to assess the care given to older people across a variety of care settings, but most commonly in nursing homes and home health services. Quality of care is measured by using structure, process, or outcome indicators at both patient and provider-levels. Several countries, most notably the U.S., collect these measures using standardised and mandatory patient assessment systems. While existing evidence suggests that the adoption of such systems has lead to quality improvement, there are a number of important methodological challenges that limit the effectiveness and benefits of quality measurement. To advance toward better quality assurance, various initiatives and reforms have been developed. The majority of improvements in this area have occurred in the U.S., with the European experience demonstrating limited efforts to measure quality and set performance standards. Although a number of Member States are increasingly introducing more formalised quality measurement and assurance programmes and policies, many are in the initial stages of implementation. To guide these new and future efforts toward effective quality measurement, further research is needed to improve quality measures and data collection processes. Several actions to enhance the accuracy and completeness of data collection activities could be undertaken, such as better training of facility staff on good patient assessment practices, further exploration of the information needs of consumers and purchasers, and how such information is actually employed to make decisions. More broadly, long-term care should be better coordinated with acute health services to ensure a consistent continuum of care for older persons. A focus on coordination should be extended to the various entities involved in quality improvement initiatives.
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| 19. |
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| 20. |
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| 21. |
- Melke, Anna, et al.
(författare)
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Vår offentliga förvaltning : Samverkan i välfärdspolitiken
- 2024. - 3
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Bok (populärvet., debatt m.m.)abstract
- Politik och förvaltning är två sidor av demokratin. Den politiska makten används för att styra samhällsutvecklingen utifrån ett ideologiskt synsätt, medan den offentliga förvaltningens uppgift är att tjäna andra, ytterst medborgarna. I detta ligger en unik utmaning: å ena sidan ska folket genom sina valda representanter styra och kontrollera förvaltningen, å andra sidan ska myndigheter och tjänstemän vara självständiga nog att hävda saklighet, opartiskhet och ett etiskt förhållningssätt. Denna bok ger en bild av dessa utmaningar. Den ger också en överblick som gör det lättare att navigera bland alla aktörer. Att hitta rätt bland internationella, statliga, regionala och lokala nivåer är nämligen inte självklart. Detta är en karta som dessutom blivit alltmer splittrad i takt med decentralisering, specialisering och privatisering. I den tredje upplagan av VÅR OFFENTLIGA FÖRVALTNING har lagar och förordningar inom välfärdssektorn uppdaterats, liksom andra viktiga förändringar inom offentlig förvaltning. Även den ökade digitaliseringen och betydelsen av medlemskapet i Nato behandlas. Boken vänder sig till högskolestuderande vid utbildningar i offentlig förvaltning, men också till den som redan arbetar inom sådana verksamheter. Det inkluderar så skilda yrken som kommunikatör, utredare, socionom, arbetsvetare, lärare, arbetsförmedlare, sjukvårdspersonal, polis och miljöinspektör. Boken vänder sig också till förtroendevalda politiker och andra som är intresserade av området. Anna Melke är journalist, fil. dr i offentlig förvaltning och verksam som forskare vid Göteborgsregionen, FoU i Väst. Hon har även medverkat i tidigare upplagor, som initialt författades av Hans Bengtsson. I denna upplaga medverkar två nya författare: Petra Svensson och Sara Svensson, docenter i statsvetenskap och verksamma som lektorer vid Högskolan i Halmstad.
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| 22. |
- Paulsen, Veronika, et al.
(författare)
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Editorial "leaving care in the Nordic countries"
- 2018
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Ingår i: Nordic Social Work Research. - 2156-857X .- 2156-8588. ; 8:Suppl 1
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Editorial for special issue of Nordic Social Work Research which aims to explore the field of young people exiting out from care in the Nordic Countries, both from foster care, residential care and young people that have received assistant measures from the child welfare services. The special issue is initiated from the Nordic Research Network on Care Leavers´ Transition to Adulthood (NRT) and is funded by NTNU Social Research
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| 23. |
- Shahabi, H Niazi, et al.
(författare)
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Cytochrome P450 2E1 gene polymorphisms/haplotypes and Parkinson's disease in a Swedish population.
- 2009
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Ingår i: Journal of neural transmission (Vienna, Austria : 1996). - : Springer Science and Business Media LLC. - 1435-1463 .- 0300-9564. ; 116:5, s. 567-73
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Tidskriftsartikel (refereegranskat)abstract
- Cytochrome P450 2E1 (CYP2E1), which inter alia is located in dopamine containing neurons in the substantia nigra, has been hypothesized to be of importance for the pathophysiology of Parkinson's disease (PD), either by its production of reactive oxygen species (ROS) or by its capability to detoxify putative neurotoxins. Numerous polymorphisms in the coding and non-coding regions of the gene for this enzyme have been reported. Different variants may account for inter-individual differences in the activity of the enzyme or production of ROS. In this study, the CYP2E1 gene was examined in a control population (n = 272) and a population with PD (n = 347), using a tag-single nucleotide polymorphism (tSNP) approach founded on HapMap Data. Six tSNPs were used in the analysis and haplotype block data were obtained. In case of significance, the SNP was further examined regarding early/late age of disease onset and presence of relatives with PD. We found an association between allele and genotype frequencies of the C/G polymorphism at intron 7 (rs2070676) of this gene and PD (P value of 0.026 and 0.027, respectively). Furthermore, analysis of the rs2070676 polymorphism in subgroups of patients with age of disease onset higher than 50 years and those not having a relative with PD also demonstrated a significant difference with controls. This was seen in both genotype (corresponding to P value = 0.039 and 0.032) and allele (P = 0.027 and 0.017 respectively) frequency. As a representative of many polymorphisms or in possible linkage disequilibrium with other functional variants, it is possible that rs2070676 could influence the regulation of the enzyme. In conclusion, our results display an association between the rs2070676 polymorphism and PD. Additional investigations are needed to elucidate the importance of this polymorphism for the activity of CYP2E1 and PD susceptibility.
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| 24. |
- Westberg, Lars, 1973, et al.
(författare)
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Association between the estrogen receptor beta gene and age of onset of Parkinson's disease.
- 2004
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Ingår i: Psychoneuroendocrinology. - : Elsevier BV. - 0306-4530. ; 29:8, s. 993-8
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Tidskriftsartikel (refereegranskat)abstract
- The purpose of this study was to investigate the potential contribution of genetic variants in the estrogen receptor beta gene to the aetiology of Parkinson's disease (PD). Several lines of evidence from human and animal studies suggest a protective role for estrogen in PD. Recently the estrogen receptor beta subtype was reported to be an important mediator of estrogen actions in the nigrostriatal dopamine system. Two single nucleotide polymorphisms at position 1730 and 1082 in the ER beta gene were genotyped, using pyrosequencing, in 260 patients with PD and 308 controls recruited from the Swedish population. Neither of the two estrogen receptor beta polymorphisms was associated with an increased risk for PD. However, the G allele of the A1730G polymorphism was more frequent in patients with an early age of onset than in patients with a late age of onset of PD (P = 0.006). Patients carrying the GG genotype had an odds ratio of 2.2 for having an early onset of PD compared to non-carriers. In conclusion, our results indicate that genetic variation in the estrogen receptor beta gene may influence the age of onset of PD.
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| 25. |
- Wissö, Therese, et al.
(författare)
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Exploring moral injury among parents with children in out-of-home care
- 2024
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Ingår i: Child & Family Social Work. - : John Wiley & Sons. - 1356-7500 .- 1365-2206.
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Tidskriftsartikel (refereegranskat)abstract
- This article brings together the experiences of parents whose children are placed in out-of-home care (OHC) with the theoretical concept of moral injury. The findings are based on empirical data from a research and development project conducted in seven Swedish municipalities with the aim of developing support for such parents. This article draws on a data set of qualitative interviews with 40 parents, 30 mothers and 10 fathers, with children in OHC. The interview transcripts were analysed thematically, with an abductive approach to theories and the empirical data. The findings illustrate how parents of children in OHC experience moral injury in relation to seven aspects: professionals' morally problematic and distressing behaviour, problematic services, an adversarial system, systemic bias, parent's actions, children's withdrawal and feeling excluded. The injuries are related to events in several periods—prior to the child's removal, during the execution of removal and during OHC—and tend to last for many years. These findings stress that the social services must be aware of the injuries parents experience and must minimize the possible harm and moral injury. We also suggest that parents of children in OHC should have an appointed social worker as a means of support.
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| 26. |
- Wissö, Therese, et al.
(författare)
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Social workers’ constructions of parents to children in foster care
- 2022
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Ingår i: Qualitative Social Work. - : SAGE Publications. - 1473-3250 .- 1741-3117. ; 21:4
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Tidskriftsartikel (refereegranskat)abstract
- Parents of children in out-of-home care receive little support from social services. Drawing on qualitative data collected in the project ‘Parent at a distance’, in which social services in seven municipalities in Sweden aimed to improve support to parents whose children are placed in foster care, this paper explores social workers’ discourses about parents to children in care. The analysis is based on focus group data in which a total of 52 social workers reflected on parents to children in care and how they can be supported by social services. The concept of interpretive repertoires was used to analyse how social workers in interaction construct parents and their support needs. The identified repertoires of change, acceptance, permanency, biology and non-biology may contribute to the understanding of why so few parents receive support, even though legislation stipulates that placements should be temporary. The paper concluded that discourses may shape support practices and thus it is crucial that social workers reflect on and develop their awareness about their constructions of parents and their role for children in out-of-home care.
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| 27. |
- Zettergren, Anna, 1978, et al.
(författare)
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Associations between polymorphisms in sex steroid related genes and autistic-like traits.
- 2013
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Ingår i: Psychoneuroendocrinology. - : Elsevier BV. - 1873-3360 .- 0306-4530. ; 38:11, s. 2575-2584
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Tidskriftsartikel (refereegranskat)abstract
- Sex differences in psychiatric disorders are common, which is particularly striking in autism spectrum disorders (ASDs) that are four times more prevalent in boys. High levels of testosterone during early development have been hypothesized to be a risk factor for ASDs, supported by several studies showing fetal testosterone levels, as well as indirect measures of prenatal androgenization, to be associated with ASDs and autistic-like traits (ALTs). Further, the importance of sex steroid related genes in ASDs is supported by studies reporting associations between polymorphisms in genes involved in sex steroid synthesis/metabolism and ASDs and ALTs. The aim of the present study was to investigate possible associations between 29 single nucleotide polymorphisms (SNPs) in eight genes related to sex steroids and autistic features. Individuals included in the study belong to a subset (n=1771) from The Child and Adolescent Twin Study in Sweden (CATSS), which are all assessed for ALTs. For two SNPs, rs2747648 located in the 3'-UTR of ESR1 encoding the estrogen receptor alpha and rs523349 (Leu89Val) located in SRD5A2 encoding 5-alpha-reductase, type 2, highly significant associations with ALTs were found in boys and girls, respectively. The results of the present study suggest that SNPs in sex steroid related genes, known to affect gene expression (rs2747648 in ESR1) and enzymatic activity (Leu89Val in SRD5A2), seem to be associated with ALTs in a general population. In conclusion, the current findings provide further support for a role of sex steroids in the pathophysiology of ASDs.
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| 28. |
- Zettergren, Anna, 1978, et al.
(författare)
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Further investigations of the relation between polymorphisms in sex steroid related genes and autistic-like traits.
- 2016
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Ingår i: Psychoneuroendocrinology. - Stockholm : Elsevier BV. - 1873-3360 .- 0306-4530. ; 68, s. 1-5
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Tidskriftsartikel (refereegranskat)abstract
- Autism spectrum disorders (ASDs) are more prevalent in boys than in girls, indicating that high levels of testosterone during early development may be a risk factor. Evidence for this hypothesis comes from studies showing associations between fetal testosterone levels, as well as indirect measures of prenatal androgenization, and ASDs and autistic-like traits (ALTs). In a recent study we reported associations between ALTs and single nucleotide polymorphisms (SNPs) in the genes encoding estrogen receptor 1 (ESR1), steroid-5-alpha-reductase, type 2 (SRD5A2) and sex hormone-binding globulin (SHBG) in a subset (n=1771) from the Child and Adolescent Twin Study in Sweden (CATSS). The aim of the present study was to try to replicate these findings in an additional, larger, sample of individuals from the CATSS (n=10,654), as well as to analyze additional SNPs of functional importance in SHBG and SRD5A2. No associations between the previously associated SNPs in the genes ESR1 and SRD5A2 and ALTs could be seen in the large replication sample. Still, our results show that two non-linked SNPs (rs6259 and rs9901675) at the SHBG gene locus might be of importance for language impairment problems in boys. The results of the present study do not point toward a major role for the investigated SNPs in the genes ESR1 and SRD5A2 in ALTs, but a possible influence of genetic variation in SHBG, especially for language impairment problems in boys, cannot be ruled out.
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