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1.
  • Andersson, Gunnel, 1958- (författare)
  • Urinary incontinence : prevalence, treatment seeking behaviour, experiences, and perceptions among persons with and without urinary leakage
  • 2009
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • The overall aim of this thesis is to describe urinary incontinence (UI) from a population perspective and to describe experiences and perceptions of UI from an individual perspective. This includes assessing the prevalence of urinary incontinence as well as describing treatment seeking and experiences of living with UI. A secondary aim was to describe the perception of UI among cultures other than the Swedish mainstream, exemplified in this case by Syrian women living in Sweden. Both quantitative and qualitative methods were used, including questionnaires and interviews. Studies I and II were quantitative studies based on a population-based study. Together with a postal survey on general health and living conditions “Life & Health”, a questionnaire on urinary incontinence was sent out to 15 360 randomly-selected residents aged 18-79 in Orebro County, Sweden. In Study I, UI was found to affect 19%. The majority of the respondents experienced minor problems, and only 18% of those reporting UI wanted treatment. However, there was also a group who reported severe problems, but despite this 42% of them did not want treatment. Study II investigated why people with UI refrain from seeking care and treatment. It was found that the desire for treatment was regulated by the frequency of UI, being restricted from participating in various activities, the degree of inconvenience, and the type of UI. Studies III and IV were both qualitative interview studies, describing older women’s experiences of living with UI (Study III) and Syrian women’s perceptions of UI (Study IV). There were similarities between the results of these two studies; the women described UI as a normal and expected problem, and they knew that the district nurse could prescribe incontinence protections and that treatments existed. In both studies, the women expressed difficulties in making contact with the health care service, while the women who did not speak Swedish (Study IV) also had difficulties due to different communication problems. In conclusion, it is important that health care resources are optimized to identify and meet the needs of those who experience major problems with UI, and that there is awareness of the communication difficulties that can be present in meeting with people who speak other languages. However it is also important not to medicalize those who experience minor problems and who have the desire to manage on their own.
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2.
  • Björk, Anna-Bell, et al. (författare)
  • Women's Experiences of Internet-Based or Postal Treatment for Stress Urinary Incontinence
  • 2014
  • Ingår i: Qualitative Health Research. - : SAGE Publications. - 1049-7323 .- 1552-7557. ; 24:4, s. 484-493
  • Tidskriftsartikel (refereegranskat)abstract
    • Stress urinary incontinence is common and sometimes embarrassing. New, simple, and easily accessible treatments are needed. We telephone interviewed 21 women who participated in a randomized controlled study comparing two treatment programs based on instructions for pelvic floor muscle training. One program was Internet-based and included email support by a urotherapist; the other was sent by post. There was no face-to-face contact in either program. Our main aim was to explore the women's experiences of the Internet-based treatment. Grounded theory analysis revealed three categories: hidden but present, at a distance but close, and by myself but not alone. These were incorporated in a core category: acknowledged but not exposed. The leakage was often a well-hidden secret, but the study treatments lowered the barrier for seeking care. In the Internet group, a supportive patient-provider relationship developed despite the lack of face-to-face contact. Internet-based treatment programs can increase access to care and empower women.
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3.
  • Danielsson, Ulla EB, 1947-, et al. (författare)
  • "My greatest dream is to be normal" : the impact of gender on depression narratives of young Swedish women and men
  • 2011
  • Ingår i: Qualitative Health Research. - : Sage Publications. - 1049-7323 .- 1552-7557. ; 21:5, s. 612-624
  • Tidskriftsartikel (refereegranskat)abstract
    • Depression is common among young people. Gender differences in diagnosing depression appear during adolescence. The study aim was to explore the impact of gender on depression in young Swedish men and women. Grounded theory was used to analyze interviews with 23 young people aged 17 to 25 years who had been diagnosed with depression. Their narratives were marked by a striving to be normal and disclosed strong gender stereotypes, constructed in interaction with parents, friends, and the media. Gender norms were upheld by feelings of shame, and restricted the acting space of our informants. However, we also found transgressions of these gender norms. Primary health care workers could encourage young men to open up emotionally and communicate their personal distress, and young women to be daring and assertive of their own strengths, so that both genders might gain access to the positive coping strategies practiced respectively by each.
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4.
  • Danielsson, Ulla EB, 1947- (författare)
  • Träffad av blixten eller långsam kvävning : genuskodade uttryck för depression i en primärvårdskontext
  • 2010
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • Depression is a common mental health problem in primary health care. One third of the Swedish population is expected to experience depression at some point in their lives. The understanding of depression has expanded, both from a lay and primary health care perspective. The number of persons considering themselves as depressed, receiving the diagnosis, and getting treatment for it has increased steadily over the last decades. Unchanged, however, is that depression is diagnosed twice as often in women as in men, while twice as many men as women commit suicide. These gender differences appear in adolescence. In earlier research biomedical, psychological, and social-cultural explanations of gender differences have been discussed. Patient’s own perspectives have more seldom stood in focus, and men’s narratives in particular are still scarce. In this thesis, gender, i.e. how to be a woman or a man, is considered as a construct, formed and negotiated in social interaction. The aim of the study is to explore the gendered face of depression from a patient perspective: How is depression expressed and explained by patients in primary health care, by women and men, adults and adolescents? How are depressed women and men portrayed in the media? How do patient and media accounts of depression compare with the perspective offered in medical research articles? Method and material The analyses are based on data from three different sources: patient narratives, newspaper portrayals and scientific medical articles. – 37 in-depth interviews were undertaken with primary health care patients diagnosed with depression. Informants were chosen to include both men and women, grown-ups (Studies I + II) and young adults (Study V) of varying occupational and social class backgrounds. Data were analyzed according to grounded theory. – 26 articles portraying lay informants with depression (Study III) were drawn from three major Swedish daily newspapers by a search of database Mediearkivet 2002. The articles were analyzed by qualitative content analysis. –82 scientific articles concerning depression in relation to gender were identified in a PubMed search 2002. The understanding of depression in these articles was explored and compared with findings in the grown-up patient narratives and in the media portrayals by means of discourse analysis (Study IV). Findings Study I captured women’s and men’s formulations of their experiences of depression. To be marked with demands constituted a central experience for both women and men, but the outward manifestations differed in relation to gender as well as to class. Home and work had different priority. Men talked more about physical distress (often chest pain) than about emotions. Women readily verbalized emotional distress – shame and guilt – while physical symptoms were vague and secondary (often about the stomach). Men dealt with insecurity by aggrandizing their previous competence, women by self-effacement. Study II disclosed gendered trajectories into depression. Four symbolic illness narratives were identified: struck by lightning, nagging darkness, blackout and slowly suffocating. Most of the men considered their bodies suddenly “struck” by external circumstances beyond their control. The stories of women in the study were more diverse, reflecting all four illness narratives. However, the women had a tendency to blame their own personality and to describe depression as insidious and originating from the inside. The women expressed feelings of guilt and shame but also conveyed a personal responsibility and concern with relationships. Study III identified four themes in media portrayals of depression: displaying a successful facade, experiencing a cracking facade, losing and regaining control and explaining the illness. The mediated image of depression both upheld and challenged traditional gender stereotypes. The women’s stories were more detailed, relational, emotionally oriented and embodied. The portrayal of men was less emotional and expressive, and described a more dramatic onset of depression. Study IV revealed gaps in how depression in relation to gender is understood by the patients, the media, and the medical research establishment. There were differences in recognition, in understanding of the reasons, and in contextualization of depression. Although women and men described different symptoms and reasons for falling ill, in scientific articles these gendered differences were conceptualized mainly in terms of hormones and other biological markers. Study V elucidated the impact of gender on adolescent depression. The young women and men were all striving to be normal, influenced by demanding media images, confronted by identity trouble, and overwhelmed by feelings. They had dreams of an ordinary family and described normative expectations. Getting a safety net of friends and other adults was a way out. Both the young women and men were eager to communicate their distress when given the opportunity. This seemed especially important to some of the young men, who in talking about their emotional problems transgressed gender norms. Conclusions Patient perspectives enrich the understanding of gendered expressions of depression by making visible transgressions of and breaks with stereotype gender norms. Gender awareness is an important key in clinical consultation. To recognize gendered narratives of illness might have a salutary potential, making depression more visible among men, and relieving self-blame among women. By re-evaluating restrictive gender patterns, the clinician might encourage development of healthier practices of how to be a man or a woman, a development especially important for adolescents. An integrated model for understanding biological, gender and cultural aspects of depression has yet to be developed. As general practitioners we have a unique possibility to see and to study the whole individual in her social and cultural context.
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6.
  • Fredriksson, Karolina, et al. (författare)
  • Klassrumsdialog i matematikundervisningen : matematiska samtal i helklass i grundskolan
  • 2017
  • Rapport (övrigt vetenskapligt/konstnärligt)abstract
    • Denna systematiska översikt ger en bild av vad forskningen sammantaget säger om hur lärare kan leda samtal i helklass för att få elever att delta i gemensamma matematiska resonemang. Det handlar om diskussioner i vilka eleverna använder och analyserar matematiska begrepp och argumenterar matematiskt. Detta är förmågor som kursplanen i matematik anger att undervisningen ska ge eleverna förutsättningar att utveckla, och som forskning lyfter fram att elever i svensk skola behöver förstärka. Översikten rör också frågor om hur lärare kan möta och ta tillvara elevers olikheter i undervisningen, närmare bestämt hur lärare kan få med elever som inte är så benägna att delta i gemensamma resonemang, och hur elevers olika idéer kan bli en del av de matematiska samtalen och berika dem. Översikten utgår från följande frågeställning:Vad kännetecknar klassrumsdialoger som engagerar elever i matematiskaresonemang och som möter och tar tillvara elevers olikheter, och vad kännetecknarlärarens ledning av sådana dialoger?Översikten är en sammanställning av arton forskningsstudier som systematiskt har valts ut av forskare efter omfattande litteratursökningar i internationella forskningsdatabaser. Sökningarna resulterade i 10 528 studier.Studierna bygger på ingående observationer och analyser av dialoger i helklass mellan lärare och elever. Det är klassrumssituationer som lärare skulle kunna känna igen sig i. Analyserna sätter ord på det som sker och ger förståelse i form av olika begrepp och strukturer. Denna vetenskapligt grundade kunskap kan utgöra stöd för lärare när de planerar och leder klassrumsdialoger i matematikundervisningen.
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7.
  • Halldén, Gunilla, et al. (författare)
  • Omsorgsbegreppet i förskolan : Olika infallsvinklar på ett begrepp och dess relation till en verksamhet. Rapport från nätverk för barnomsorgsforskning, Göteborg 20-21 novemberg 2000
  • 2001
  • Rapport (övrigt vetenskapligt/konstnärligt)abstract
    • Denna rapport innehåller texter som presenterats vid en konferens arrangerad inom ramen för Nätverk för barnomsorgsforskningi . Syftet med konferensen var att lyfta upp begreppet omsorg, diskutera dess innebörd, rädda det från retorisk förflackning och samtidigt via dess koppling till verksamheter belysa ett vidare sammanhang. När bamforskning diskuteras har jag på senare tid funnit det väsentligt att peka på att den har en kapacitet att kasta ljus över centrala samhällsfrågor. Forskning om barn bör inte bara vara en forskning om en viss grupp i samhället. Den nyare bamdomsforskningen söker tillämpa ett bamperspektiv. Detta innebär att fenomen studeras såsom de framstår från barnens perspektiv och att inverkan av olika sociala reformer, politiska förändringar och produktion av varor på barns liv belyses. Det handlar alltså både om att söka efter barnens perspektiv och att söka efter konsekvenserna för barnen av olika samhälleliga förändringar. Nya fålt som t.ex. barndomshistoria, barndomssociologi och barndomsantropologi har uppstått och begreppet generation har införts för att markera vikten av att anlägga ett generationsperspektiv på frågor som vanligtvis grupperats på annat sätt.
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8.
  • Högberg, Cecilia, et al. (författare)
  • Could it be colorectal cancer? : general practitioners' use of the faecal occult blood test and decision making - a qualitative study
  • 2015
  • Ingår i: BMC Family Practice. - : BioMed Central. - 1471-2296. ; 16:1, s. 153-161
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Abdominal complaints are common reasons for contacting primary care physicians, and it can be challenging for general practitioners (GPs) to identify patients with suspected colorectal cancer (CRC) for referral to secondary care. The immunochemical faecal occult blood test (iFOBT) is used as a diagnostic aid in primary care, but it is unclear how test results are interpreted. Studies show that negative tests are associated with a risk of delayed diagnosis of CRC and that some patients with positive tests are not investigated further. The aim of this study was to explore what makes GPs suspect CRC and to investigate their practices regarding investigation and referral, with special attention on the use of iFOBTs.METHOD: Semi-structured individual interviews were conducted with eleven purposely selected GPs and registrars in Region Jämtland Härjedalen, Sweden, and subjected to qualitative content analysis.RESULTS: In the analysis of the interviews four categories were identified that described what made the physicians suspect CRC and their practices. Careful listening-with awareness of the pitfalls: Attentive listening was described as essential, but there was a risk of being misled by, for example, the patient's own explanations. Tests can help-the iFOBT can also complicate the diagnosis: All physicians used iFOBTs to various extents. In the absence of guidelines, all found their own ways to interpret and act on the test results. To refer or not to refer-safety margins are necessary: Uncertainty was described as a part of everyday work and was handled in different ways. Common vague symptoms could be CRC and thus justified referral with safety margins. Growing more confident-but also more humble: With increasing experience, the GPs described becoming more confident in their decisions but they were also more cautious.CONCLUSIONS: Listening carefully to the patient's history was essential. The iFOBT was frequently used as support, but there were considerable variations in the interpretation and handling of the results. The diagnostic process can be described as navigating uncertain waters with safety margins, while striving to keep the patient's best interests in mind. The iFOBT may be useful as a diagnostic aid in primary care, but more research and evidence-based guidelines are needed.
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10.
  • Nilsson-Ehle, Herman, et al. (författare)
  • Quality of life, physical function and MRI T2*in elderly low-risk MDS patients treated to a haemoglobin level of andgt;= 120 g/L with darbepoetin alfa +/- filgrastim or erythrocyte transfusions
  • 2011
  • Ingår i: European Journal of Haematology. - : John Wiley and Sons. - 0902-4441 .- 1600-0609. ; 87:3, s. 244-252
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective: Anaemia in low-risk myelodysplastic syndromes (MDS) is associated with reduced quality of life (QoL). Response to treatment with erythropoietin +/- granulocyte colony-stimulating factor (G-CSF) is associated with improved QoL, but whether transfusion therapy with higher haemoglobin (Hb) target levels has similar effects is unknown. The objective for this prospective phase II Nordic multicentre trial was to assess QoL, response rate and physical function in elderly anaemic MDS patients treated to a target Hb level of andgt; 120 g /L. Methods: Thirty-six elderly patients with low-and intermediate-1 risk MDS received darbepoetin (DA) 300 mu g/wk, with the addition of G-CSF if no response. If the Hb target was reached at 16 wk, treatment was maintained until week 26. Remaining patients were transfused to reach the target level for at least 8 wk. Results: Twenty-seven patients completed the study. Response rate to DA +/- G-CSF was 67% in evaluable patients and 56% according to intention to treat. Eighteen patients reached the target Hb level according to protocol. QoL scores for fatigue, dyspnoea, constipation, and physical, role and social functioning improved significantly during study, with similar results for transfused and untransfused patients. Maintaining Hb andgt; 120 g /L did not confer a higher transfusion rate, once the target was reached. In two of fourteen patients, magnetic resonance imaging T2* indicated cardiac iron overload, however, without association with ferritin levels. Conclusions: In elderly anaemic MDS patients, an increment in haemoglobin is associated with improved QoL, whether induced by growth factor treatment or transfusion therapy.
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11.
  • Pramling Samuelsson, Ingrid, et al. (författare)
  • 27 forskare i upprop mot skärmfri förskola
  • 2024
  • Ingår i: Förskolan. - Stockholm : Sveriges Lärare.
  • Tidskriftsartikel (populärvet., debatt m.m.)abstract
    • VI LÄRARE DEBATT: Regeringens uppdrag till Skolverket – att göra utbildningen i förskolan skärmfri – riskerar att ge negativa och allvarliga konsekvenser, särskilt för barn som är i störst behov av att möta en digitaliserad värld med stöd av utbildade förskollärare och barnskötare. Det skriver 27 barn- och förskoleforskare i ett gemensamt upprop.
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12.
  • Samuelsson, Andreas, 1977, et al. (författare)
  • Functional Outcomes of Emergency Surgery for Perforated Diverticulitis, Hinchey Grade III
  • 2023
  • Ingår i: World Journal of Surgery. - : Springer Science and Business Media LLC. - 0364-2313 .- 1432-2323. ; 47:6, s. 1570-1582
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Laparoscopic lavage as a treatment for perforated diverticulitis, Hinchey III, has been found safe and feasible in randomized trials. A few studies have reported functional outcomes and quality of life as secondary outcomes. This study investigated distress associated with dysfunction of the bowel or stoma, functional outcomes, and quality of life 2–3years after surgery in a national unselected cohort. Methods: All patients in Sweden who underwent emergency surgery for perforated diverticulitis with purulent peritonitis (2016–2018) were invited to answer a comprehensive, study-specific questionnaire 2–3years after the index surgery. Results: Out of 499 potential patients, 226 returned the questionnaire, and 209 were included in the analysis. There was no statistically significant difference between laparoscopic lavage and resection in distress associated with dysfunction of the bowel or stoma (odds ratio [OR], 1.32 [95% CI, 0.91–1.92]; p = 0.015). Bowel dysfunction measured by the LARS score was significantly higher for the lavage group (OR, 1.65 [95% CI, 1.11–2.45]), while stoma was more frequent after resection surgery (40 vs 6%). Conclusions: Patients experienced long-term distress from bodily dysfunction after emergency surgery for perforated diverticulitis regardless of the technique used. Regular follow-up could benefit these patients.
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13.
  • Samuelsson, Andreas, 1977, et al. (författare)
  • Laparoscopic lavage for perforated diverticulitis in the LapLav study: population-based registry study.
  • 2021
  • Ingår i: The British journal of surgery. - : Oxford University Press (OUP). - 1365-2168 .- 0007-1323. ; 108:10, s. 1236-1242
  • Tidskriftsartikel (refereegranskat)abstract
    • The standard treatment for Hinchey III perforated diverticulitis with peritonitis was resection with or without a stoma, but recent trials have shown that laparoscopic lavage is a reasonable alternative. This registry-based Swedish study investigated results at a national level to assess safety in real-world scenarios.Patients in Sweden who underwent emergency surgery for perforated diverticulitis between 2016 and 2018 were studied. Inverse probability weighting by propensity score was used to adjust for confounding factors.A total of 499 patients were included in this study. Laparoscopic lavage was associated with a significantly lower 90-day Comprehensive Complication Index (20.9 versus 32.0; odds ratio 0.77, 95 per cent compatibility interval (c.i.) 0.61 to 0.97) and overall duration of hospital stay (9 versus 15days; ratio of means 0.84, 95 per cent c.i. 0.74 to 0.96) compared with resection. Patients had 82 (95 per cent c.i. 39 to 140) per cent more readmissions following lavage than resection (27.2 versus 21.0 per cent), but similar reoperation rates. More co-morbidity was noted among patients who underwent resection than those who had laparoscopic lavage.Laparoscopic lavage is safe in routine care beyond trial evaluations.
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15.
  • Al-Zaidi, Zinah, et al. (författare)
  • A mobile app as support for pelvic floor muscle training started prior to radical prostatectomy
  • 2023
  • Ingår i: BJUI Compass. - : John Wiley & Sons. - 2688-4526. ; 4:1, s. 114-122
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective: To evaluate the usefulness of a mobile app to support pelvic floor muscle training (PFMT) started prior to radical prostatectomy (RP).Materials and methods: A prospective cohort study conducted in Sweden from June 2018 to February 2021 including men for whom RP was planned within 12 months. Users responded anonymously to questionnaires at baseline, 1 and 3 months. Our primary aim was to evaluate if the app could facilitate PFMT and increase confidence in performing pelvic floor muscle (PFM) contractions correctly. Our second aim was to describe the change in urinary incontinence (UI) after RP, based on the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF).Results: Of the 3043 users at baseline, 388 met the primary inclusion criteria. Of those, 71 (18.3%) were incontinent, predominantly with slight symptoms. The most common type was urge UI, 39/71 (54.9%). Of the 388 users, 159 (41.0%) answered the questionnaire at 1 month, and 131 (33.7%) at 3 months within 89–135 days. Of those 131, 127 (96.9%) indicated that the app facilitated their training ‘a lot’ or ‘somewhat’. Confidence in performing PFM contractions correctly increased from 39.7% at baseline to 74.0% at 1 month and 87.8% at 3 months (p < 0.001). At baseline, 19.8% performed PFM contractions at least daily, which increased to 74.0% at 1 month and 77.9% at 3 months (p < 0.001). At 3 months, 115/131 (87.8%) had undergone RP, 93.6% of which were robot-assisted. Of the 115, 103 (89.6%) were incontinent, and stress UI dominated. The mean ICIQ-UI SF score increased from 1.2 (2.4 SD) at baseline to 9.6 (5.2 SD), p < 0.001, after surgery.Conclusions: The mobile app facilitated pelvic floor muscle training for men who were planned to undergo radical prostatectomy and used the app.
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16.
  • Albinsson, Anders (författare)
  • ”De va svinhögt typ 250 kilo” : Förskolebarns mätande av längd, volym och tid i legoleken
  • 2016
  • Licentiatavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • The purpose of the dissertation is to study, describe and analyses which comparative measurement activities preschool children construct and use, and how they solve problems and communicate when they use the comparative measurement activities whilst playing with Lego (“the Lego play”). The measurement activities chosen are length/height, quantity and time.The empirical material is based on data from two preschool classes with children aged 2 – 5 year, It was collected through participant observation (video captures) of the children’s Lego play. The theoretical starting points in this study are grounded in childhood sociology and the sociocultural perspective. The study assumes the childhood sociology perspective by viewing the children as competent and active in creating meaning as well as controlling and influencing their own and others’ social environment. The sociocultural perspective gives prominence to development and learning, and its related tools and concepts are used to analyses the results of the study. That is, the Lego play is studied in a social context from the child’s perspective, and the sociocultural perspective describes and analyses the child’s use of mathematics and the acquisition of knowledge in the Lego play in a sociocultural context.The results show that children measuring length/height and quantity explored a store of measurement tools in order to make comparisons, and adapted these to the context in question. These were own body, other body, artefacts, numbers and counting. The measurements were used individually and with others, and the solving of the own or shared problems constituted a large share of the time spent constructing models during Lego play. By contrast, the time concept was used mainly as a tool when the children played with their finished Lego models. Thus, a time perspective was added to the child’s finished model, which inspired thoughts and reflections about time used in the Lego play. The children used the time concepts of the present, the past and the future, and also considered the concept of velocity in the context of the timescale. The children’s communication had a large impact on the Lego play, and they expressed their ideas verbally, physically and through action. The children’s use of mathematics was prominent and meaningful during the Lego play.
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17.
  • Andersen, Christen L., et al. (författare)
  • A phase II study of vorinostat (MK-0683) in patients with polycythaemia vera and essential thrombocythaemia
  • 2013
  • Ingår i: British Journal of Haematology. - : Wiley. - 0007-1048 .- 1365-2141. ; 162:4, s. 498-508
  • Tidskriftsartikel (refereegranskat)abstract
    • Inhibition of histone deacetylases may be an important target in patients with myeloproliferative neoplasms. This investigator-initiated, non-randomized, open-label phase II multi-centre study included 63 patients (19 essential thrombocythaemia, 44 polycythaemia vera) from 15 centres. The primary objective was to evaluate if vorinostat was followed by a decline in clonal myeloproliferation as defined by European Leukaemia Net. Thirty patients (48%) completed the intervention period (24 weeks of therapy). An intention-to-treat response rate of 35% was identified. Pruritus was resolved [19% to 0% (P=0.06)] and the prevalence of splenomegaly was lowered from 50% to 27% (P=0.03). Sixty-five per cent of the patients experienced a decrease in JAK2 V617F allele burden (P=0.006). Thirty-three patients (52% of patients) discontinued study drug before end of intervention due to adverse events (28 patients) or lack of response (5 patients). In conclusion, vorinostat showed effectiveness by normalizing elevated leucocyte and platelet counts, resolving pruritus and significantly reducing splenomegaly. However, vorinostat was associated with significant side effects resulting in a high discontinuation rate. A lower dose of vorinostat in combination with conventional and/or novel targeted therapies may be warranted in future studies.
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18.
  • Andersen, Christen Lykkegaard, et al. (författare)
  • Circulating YKL-40 in patients with essential thrombocythemia and polycythemia vera treated with the novel histone deacetylase inhibitor vorinostat
  • 2014
  • Ingår i: Leukemia Research. - : Elsevier. - 0145-2126 .- 1873-5835. ; 38:7, s. 816-821
  • Tidskriftsartikel (refereegranskat)abstract
    • YKL-40 regulates vascular endothelial growth factors and induces tumor proliferation. We investigated YKL-40 before and after treatment with vorinostat in 31 polycythemia vera (PV) and 16 essential thrombocythemia (ET) patients. Baseline PV patient levels were 2 times higher than in healthy controls (P<0.0001) and 1.7 times higher than in ET (P = 0.02). A significant correlation between YKL-40 at baseline and neutrophils, CRP, LDH, JAK2V617F and platelets in PV patients was observed, as well as a significantly greater reduction of YKL-40 levels in PV patients responding to therapy. YKL-40 might be a novel marker of disease burden and progression in myeloproliferative neoplasms.
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  • Arvola, Mattias, 1975-, et al. (författare)
  • Simulated Provocations : A Hypermedia Radio Theatre for Reflection on Classroom Management
  • 2018
  • Ingår i: Journal Simulation & Gaming. - : SAGE Publications. - 1046-8781 .- 1552-826X. ; 49:2, s. 98-114
  • Tidskriftsartikel (refereegranskat)abstract
    • Background. Learning to manage a classroom is a difficult but important part of teacher education. Earlier research on simulations for learning classroom management has highlighted the difficulty of supporting reflection.Purpose. This case study explores and evaluates the design of a simulation for student teachers' reflection on classroom management.Design. The design process resulted in the scenario-based SIMPROV simulation, which was made in the form of a hypermedia radio theatre that students go through in pairs or triads. Authoritarian, authoritative, democratic, and compliant leadership styles were built into the choices student teachers made.Evaluation. The simulation was evaluated in two courses where the participants' level of reflection and perceived knowledge improvement was measured using a questionnaire. Forty-three first-year student teachers, 48 third-year student teachers, and 38 of the student teachers' mentors participated in the evaluation.Results. The results indicate that participants engaged in reflection and understanding to a high degree, and only to a low degree in critical reflection or habitual action.Conclusions. The conclusions are that the scenario-based simulation designed as a hypermedia radio theatre supported knowledge improvement, understanding, and reflection and that social interaction during and after simulation sessions was an important feature.
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22.
  • Asklund, Ina, 1978- (författare)
  • A mobile app for self-management of urinary incontinence : treatment effect and user experience
  • 2020
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • Background Urinary incontinence affects 25-45% of all women. The most common type is stress urinary incontinence, which is the leakage of urine on physical exertion. Pelvic floor muscle training is an effective first-line treatment for this condition but many women do not seek help from their ordinary health care service. There is a need to evaluate new methods to offer effective treatment, and internet-based treatment has previously been found to be effective for women with stress urinary incontinence.Aim To evaluate the mobile app Tät® which has a self-management program focused on pelvic floor muscle training for women with stress urinary incontinence, with respect to treatment effect, factors associated with successful treatment, user experience and use by pregnant and postnatal women.Methods Papers I, II and III are based on the same study population from a randomized controlled trial (RCT). We recruited adult women who had stress urinary incontinence at least weekly via our website. In total, 123 women  were randomized to the app group (n=62) or the control group (n=61). The app included information about incontinence, the pelvic floor and lifestyle factors associated with incontinence, pelvic floor muscle training exercises and functions for reminders and training statistics. Treatment outcome after three months was evaluated using validated questionnaires assessing incontinence symptoms, quality of life, subjective improvement and a leakage diary. Outcomes were compared between the two groups. Factors associated with a successful outcome in the app group were further analysed using logistic regression. We strategically selected 15 women who had used the app and interviewed them about their experiences of using the app. The interviews were analysed according to Grounded Theory. After closing the RCT we made the app freely available and continued to follow its use on a larger scale by incorporating an anonymous questionnaire that appeared within the app upon download and after three months. The data from these questionnaires is used in paper IV.  Results Participants in the RCT had a mean age of 44.7 years (range 27-72) and 120 of the 123 women had moderate/severe incontinence. The app group reported significant improvements in the primary outcomes, the incontinence symptom score (mean ICIQ-UI SF reduction 3.9, 95% CI 3.0-4.7) and the quality of life score (mean ICIQ LUTSqol reduction 4.8, 95% CI 3.4-6.2), and the difference between the groups was significant. The app group also reduced their number of leakages and use of incontinence aids compared to the control group. At follow-up 92% of women in the app group experienced subjective improvement and 56% had improved “much” or “very much” and were classified as having a successful treatment outcome.Factors associated with a successful outcome were higher expectations of treatment effect (OR 11.38, 95% CI 2.02-64.19), weight control (OR 0.44 per kg gained, 95% CI 0.24-0.79), and self-assessed improvement of pelvic floor muscle strength (OR 35.54, 95% CI 4.96-254.61).The main finding from the interviews was that women experienced that the app “enabled their independence”. They described that the app was “something new” that helped with “keeping motivation up” although they sometimes wondered whether their training efforts were “good enough”.The freely available app was downloaded by 10,456 pregnant and postnatal women during a period of ten months (41% of all users). At inclusion 51% experienced incontinence and their mean ICIQ-UI SF score was 6.7 (SD 3.45). After three months, 1,805 women answered the follow-up. The majority of women with incontinence at inclusion experienced improvement with greater improvement in the postnatal group than in the pregnant group.Conclusion The mobile app Tät® offers a new, easily accessible and effective self-management program for women with stress urinary incontinence. Women appreciated that the app enabled them to manage their pelvic floor muscle training independently. Once the app was freely released it reached a large population with many pregnant and postnatal women. We believe that the app could be useful for the prevention of urinary incontinence among pregnant women. We also believe that the app could be used both as a stand-alone treatment and as a complement to other treatments provided by the ordinary health care service.
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23.
  • Asklund, Ina, et al. (författare)
  • Mobilapp effektiv vid inkontinens
  • 2016
  • Ingår i: Läkartidningen. - : Sveriges läkarförbund. - 0023-7205 .- 1652-7518. ; 113:41
  • Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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24.
  • Asklund, Ina, et al. (författare)
  • Mobile app for treatment of stress urinary incontinence : a randomized controlled trial
  • 2017
  • Ingår i: Neurourology and Urodynamics. - : John Wiley & Sons. - 0733-2467 .- 1520-6777. ; 36:5, s. 1369-1376
  • Tidskriftsartikel (refereegranskat)abstract
    • AIMS: To evaluate the effect of a mobile app treatment for stress urinary incontinence (SUI) in women.METHODS: Randomized controlled trial, conducted 2013-2014 in Sweden. Community-dwelling adult women with ≥1 SUI episode/week recruited through our website and randomized to app treatment (n = 62) or control group (postponed treatment, n = 61). One participant from each group was lost to follow-up. Intervention was the mobile app Tät(®) with a treatment program focused on pelvic floor muscle training (PFMT), and information about SUI and lifestyle factors. Primary outcomes, 3 months after randomization: symptom severity (International Consultation on Incontinence Modular Questionnaire Urinary Incontinence Short Form [ICIQ-UI SF]); and condition-specific quality of life (ICIQ Lower Urinary Tract Symptoms Quality of Life [ICIQ-LUTSqol]).RESULTS: One hundred and twenty-three women were included (mean age 44.7), with moderate/severe SUI (97.5%, 120/123), mean ICIQ-UI SF score 11.1 (SD 2.8) and mean ICIQ-LUTSqol score 34.4 (SD 6.1) at baseline. At follow-up, the app group reported improvements in symptom severity (mean ICIQ-UI SF score reduction: 3.9, 95% confidence interval 3.0-4.7) and condition-specific quality of life (mean ICIQ-LUTSqol score reduction: 4.8, 3.4-6.2) and the groups were significantly different (mean ICIQ-UI SF score difference: -3.2, -4.3to -2.1; mean ICIQ-LUTSqol score difference: -4.6, -7.8 to -1.4). In the app group, 98.4% (60/61) performed PFMT at follow-up, and 41.0% (25/61) performed it daily.CONCLUSIONS: The mobile app treatment was effective for women with SUI and yielded clinically relevant improvements. This app may increase access to first-line treatment and adherence to PFMT.
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25.
  • Asklund, Ina, et al. (författare)
  • Pregnant and postnatal women’s usage of an app with a pelvic floor muscle training program for the prevention and treatment of urinary incontinence.
  • Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
    • Introduction: Pregnancy and childbirth are risk factors for developing urinary incontinence (UI). The prevalence of UI has been reported at 58% in late pregnancy and at around 30% in the three months after childbirth. Pelvic floor muscle training (PFMT) during pregnancy can prevent the onset of UI. We developed the mobile app Tät with a PFMT program for women with stress urinary incontinence. We evaluated its efficacy in a randomized controlled trial and found that the app group experienced fewer incontinence symptoms, fewer leakages, and better quality of life compared to the control group. The app is now freely available, and the aim of this study was to investigate the use of the app by pregnant and postnatal women.Methods: We included pregnant and postnatal (childbirth in the last three months) women who had downloaded the app between January 16 and November 15 2018 and answered the inclusion questionnaire within the app. Questions included age, gender, country, place of residence, education, reason for download, pregnancy, childbirth in the last three months, and incontinence symptoms according to the ICIQ-UI SF. After three months a follow-up questionnaire appeared in the app. All answers were sent anonymously to our research database.Results: 10 456 women were included (4 607 pregnant, 5 849 postnatal). The mean age was 31 years and 95% lived in Sweden. 47% of the pregnant women and 55% of the postnatal women reported having UI. The mean ICIQ-UI SF score of those with UI was 6.7 (SD 3.4). 1 805 women answered the follow-up and almost three quarters had used the app and performed PFMT at least weekly. Of those with incontinence, the majority experienced improvement with mean ICIQ-UI SF scores improving significantly at follow-up, except in the subgroup “pregnant both at inclusion and follow-up”.Conclusion: The Tät app is widely used by pregnant and postnatal women in Sweden for prevention and treatment of UI. Postnatal women with incontinence experienced the largest improvements and reductions in ICIQ-UI SF score. With this study design we cannot say if this effect relates to the use of the app or is the natural improvement of UI over time.
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26.
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27.
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28.
  • Asklund, Ina, et al. (författare)
  • User Experience of an App-Based Treatment for Stress Urinary Incontinence : Qualitative Interview Study
  • 2019
  • Ingår i: Journal of Medical Internet Research. - : JMIR Publications Inc.. - 1438-8871. ; 21:3
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Stress urinary incontinence (SUI) affects 10%-39% of women. Its first-line treatment consists of lifestyle interventions and pelvic floor muscle training (PFMT), which can be performed supervised or unsupervised. Health apps are increasing in number and can be used to improve adherence to treatments. We developed the Tät app, which provides a 3-month treatment program with a focus on PFMT for women with SUI. The app treatment was evaluated in a randomized controlled trial, which demonstrated efficacy for improving incontinence symptoms and quality of life. In this qualitative interview study, we investigated participant experiences of the app-based treatment.Objective: This study aimed to explore women’s experiences of using an app-based treatment program for SUI.Methods: This qualitative study is based on telephone interviews with 15 selected women, with a mean age of 47 years, who had used the app in the previous randomized controlled trial. A semistructured interview guide with open-ended questions was used, and the interviews were transcribed verbatim. Data were analyzed according to the grounded theory.Results: The results were grouped into three categories: “Something new!” “Keeping motivation up!” and “Good enough?” A core category, “Enabling my independence,” was identified. The participants appreciated having a new and modern way to access a treatment program for SUI. The use of new technology seemed to make incontinence treatment feel more prioritized and less embarrassing for the subjects. The closeness to their mobile phone and app features like reminders and visual graphs helped support and motivate the women to carry through the PFMT. The participants felt confident that they could perform the treatment program on their own, even though they expressed some uncertainty about whether they were doing the pelvic floor muscle contractions correctly. They felt that the app-based treatment increased their self-confidence and enabled them to take responsibility for their treatment.Conclusions: Use of the app-based treatment program for SUI empowered the women in this study and helped them self-manage their incontinence treatment. They appreciated the app as a new tool for supporting their motivation to carry through a slightly challenging PFMT program.Trial Registration: ClinicalTrials.gov NCT01848938; https://clinicaltrials.gov/ct2/show/NCT01848938 (Archived by WebCite at https://clinicaltrials.gov/ct2/show/NCT01848938)
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29.
  • Balciuniene, Jorune, et al. (författare)
  • Evidence for digenic inheritance of nonsyndromic hereditary hearing loss in a Swedish family
  • 1998
  • Ingår i: American Journal of Human Genetics. - : Elsevier BV. - 0002-9297 .- 1537-6605. ; 63:3, s. 786-93
  • Tidskriftsartikel (refereegranskat)abstract
    • We investigated a Swedish family with nonsyndromic progressive bilateral sensorineural hearing loss. Thirteen candidate loci for autosomal dominant nonsyndromic hearing loss were tested for linkage in this family. We found significant LOD scores (>3) for markers at candidate locus DFNA12 (11q22-q24) and suggestive LOD scores (>2) for markers at locus DFNA2 (1p32). Our results for markers on chromosome 11 narrowed down the candidate region for the DFNA12 locus. A detailed analysis of the phenotypes and haplotypes shared by the affected individuals supported the notion that two genes segregated together with hearing impairment in the family. Severely affected family members had haplotypes linked to the disease allele on both chromosomes 1 and 11, whereas individuals with milder hearing loss had haplotypes linked to the disease allele on either chromosome 1 or chromosome 11. These observations suggest an additive effect of two genes, each gene resulting in a mild and sometimes undiagnosed phenotype, but both together resulting in a more severe phenotype.
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30.
  • Barns tidiga lärande : en tvärsnittsstudie om förskolan som miljö för barns lärande
  • 2009
  • Samlingsverk (redaktörskap) (övrigt vetenskapligt/konstnärligt)abstract
    • The main aim of preschool is to promote children’s learning, implying that its quality is an important aspect to study. However, despite a long preschool tradition and a preschool system that is nearing completion, we have limited knowledge of the effect of preschool on children’s learning and knowledge formation. The overall aim of the study, Children’s early learning, is to gain knowledge of the characteristics of preschool as a learning environment by studying various preschool environments and the impact they have on children’s knowledge formation/experiences of different aspects of communication, mathematics and interplay. Questions at issue are: How does children’s knowledge formation emerge in relation to specific content areas in different preschool contexts? What quality aspects emerge as important for children’s learning in different preschool contexts according to the teachers and parents? How are these different quality aspects constituted and related to one another? A case study of bilingual children has also been conducted within the project. It is based on the question: What communicative patterns emerge in interplay among young children who have Swedish as their second language? The complexity of preschool, as a learning context, can only be grasped by adopting several research approaches, and examining it from diverse perspectives and dimensions. Therefore, the study is based on two theoretical perspectives: interactionistic theory (Ball, 2006; Bronfenbrenner, 1979, 1986; Bruner, 1996) and variation theory (Marton & Booth, 2000). The study is also based on a pedagogical perspective of quality (Sheridan, 2001, 2009). The study was conducted in Gothenburg. A stratified sample of eight districts was chosen in order to represent diverse geographical areas and living conditions as well as ethnic and socio-economic backgrounds. Within these districts a random sample of 38 preschools was selected. All the children aged 1 and 2 years (230) in these preschools, plus their parents and teachers (120) participated. The study has a cross-sectional design and is divided into eight different parts and content areas. The data production is both quantitative and qualitative. Given the theoretical framework of the study, there are few methods available to observe young children’s learning and development. Therefore, the development of methods to observe children’s knowledge related to mathematics, communication and interplay may be seen as important results of this study. The results highlight a variation in preschool quality and in the ways the teachers communicate with and approach the children. Three different learning environments of low, good and high quality emerged, showing that children do not have equal opportunities for learning in preschool. The learning environments are: Separating and limiting environments, Child-centred negotiating environments and Challenging learning environments. Teachers and parents see preschool mainly as a democratic and social arena, even though learning of mathematics and literacy are becoming important contents in preschool education. The individual child’s learning and development are primary concerns. Play is emphasised and learning is accepted as long as it is based on the initiative of the child and/or is a by-product of play. According to the teacher’s observations, the children seem to be involved in creative and reciprocal interactions, characterised by joy and interest. The preschool context seems to offer children various positions, which may be described as interactive observational, adaptive and driving. The results indicate that a significant change in knowing/learning occurs between the age of 1 and 3 years with regard to children’s ability to approach and handle different tasks related to mathematics and communication. The results show that this is an important time in children’s learning, and that much depends on the quality of the preschool. These findings should benefit research on early childhood education on both a national and international level.
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31.
  • Bergh, Christina, 1953, et al. (författare)
  • Regionalt HTA-arbete kan ge bra genomslag i vården. Goda exempel från Västra Götaland : [Regional HTA work can have a good impact on health care. Good examples form Vastra Gotaland].
  • 2010
  • Ingår i: Läkartidningen. - 0023-7205. ; 107:29-31, s. 1780-1783
  • Tidskriftsartikel (refereegranskat)abstract
    • HTA (health technology assessment) innebär en systematisk granskning av det vetenskapliga underlaget för en viss teknik. Ett väl definierat PICO (patients, intervention, comparison, outcome) är en grundförutsättning för att få fram den dokumentation som ska granskas. En fokuserad fråga är central i HTA-processen. En teknik granskas med avseende på effektivitet och risker, etiska och organisatoriska aspekter samt kostnader. I en systematisk litteraturöversikt granskas vetenskapliga artiklar med avseende på kvalitet och relevans. Slutsatserna evidensgraderas enligt GRADE. I Västra Götalandsregionen har inrättats ett HTA-centrum som arbetar med regional medicinsk utvärdering. Regionalt HTA-arbete har flera fördelar; en är att den praktiska omsättningen av de nyvunna kunskaperna troligen kan ske snabbare.
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32.
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33.
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34.
  • Björklund, Elisabeth, 1945- (författare)
  • Att erövra litteracitet : Små barns kommunikativa möten med berättande, bilder, text och tecken i förskolan
  • 2008
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • This thesis is based on an ethnographic field study among a group of monolingual children from one and a half to three years old at a pre-school in a Swedish village. The primary aim of the study has been to gain knowledge about how young children conquer and express literacy in their everyday lives. One assumption was that children are active and competent in their search for meaning when dealing with texts, signs and images. A second aim has been to investigate whether children’s literacy could have an impact on the social and cultural context of pre-school.Research questions addressed in the study focus on children’s participation in literacy events and their actions in literacy practice. An additional question was  whether children were contributing to literacy practice when interacting with other children in the group.The theoretical framework draws upon socio-cultural theory. The empirical material consists of video recordings and the focus of observation has been on children’s actions related to literacy, expressed as early literacy, including reading and writing as well as telling and retelling narratives, singing and other verbal and non verbal communication. In children’s literacy events and literacy practice the specific context was of central interest. All the material collected has been transcribed and transferred into text and constitutes the basis for analyzing what children are performing in actual events and practices. The guiding principle for description was at first to give a close reproduction of children’s verbal utterances and their acting linked to the concept of early literacy. Secondly, the aim was to describe and analyze whether the utterances and actions could be linked to the specific social and cultural context.The analysed material demonstrates how children participate and interact with each other while engaged in literacy and the material also displays the content of their communication. Two different kinds of literacy appear: one is narrative tellings and the other is reading and drawing/writing. A deeper analysis shows that children are building knowledge of telling and also creating a specific manifesto of literacy. The children also underline what they are doing through verbal expressions where they defined  themselves as both readers and writers.The result gives a contribution to new knowledge and an understanding of early literacy among very young children as something they have created in pre-school as a social and cultural environment. Literacy in the studied group of children uncovers many more expressions, including several actions with regard to written material, than we usally relate to the youngest children in pre-school.
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35.
  • Bokne, Kajsa, et al. (författare)
  • Self-management of stress urinary incontinence : effectiveness of two treatment programmes focused on pelvic floor muscle training, one booklet and one Internet-based
  • 2019
  • Ingår i: Scandinavian Journal of Primary Health Care. - : Taylor & Francis. - 0281-3432 .- 1502-7724. ; 37:3, s. 380-387
  • Tidskriftsartikel (refereegranskat)abstract
    • Objectives: In a previous study, self-management of stress urinary incontinence (SUI), via an Internet-based programme or a booklet improved symptoms and quality of life. We wanted to evaluate the effectiveness of these programmes when implemented for free use, as well as to characterize the users.Design: Pragmatic prospective cohort study.Setting and subjects: Information about the Internet programme and the booklet was provided at www.tät.nu and by nurse midwives. Both programmes included a three-month pelvic floor muscle training (PFMT) programme. Questionnaires were used at the start and after three months.Main outcome measures: Characteristics of the participants regarding age and education. Reductions in symptom severity was measured using the validated ICIQ-UI SF.Results: 109 women using the booklet, and 166 women using the Internet-based programme responded to the pre-treatment questionnaire. Of these, 53 (48.6%) in the booklet group and 27 (16.3%) in the Internet group responded to the follow-up. The mean age of booklet users was higher, 59.4 years vs. 54.5 years (p = .005). The proportion of women with post-secondary education was high, 59% in the booklet group and 67% in the Internet group. The mean reduction in the symptom score was 2.6 points (SD 3.4) in the booklet group, and 3.4 (SD 2.9) in the Internet group. These reductions were significant within both groups, with no difference between the groups, and in the same order of magnitude as in the previous randomised controlled study.Conclusion: Two self-management programmes for SUI, one provided as a booklet and one as an Internet-based programme, also rendered clinically relevant improvements when made freely available.Key points:Female stress urinary incontinence can be treated using self-management programmes focused on pelvic floor muscle training. This study evaluates the effect of two different programmes, one provided as a booklet and one Internet-based, when made freely available to the public.Both programmes rendered clinically relevant improvements, in the same order of magnitude as in the previous randomised controlled study.Self-management of stress urinary incontinence should be recommended to women that request treatment.
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36.
  • Borg, Erik, et al. (författare)
  • Audiometric Characterization of a Family with Digenic Autosomal, Dominant, Progressive Sensorineural Hearing Loss
  • 2000
  • Ingår i: Acta Oto-Laryngologica. - : Informa UK Limited. - 0001-6489 .- 1651-2251. ; 120:1, s. 51-57
  • Tidskriftsartikel (refereegranskat)abstract
    • In this study, a non-syndromic progressive bilateral high frequency hearing loss is described in a family with 141 identified members. Recent genetic analyses indicated a digenic inheritance with linkage to the gene loci DFNA2 and DFNA12. The affected family members who shared haplotypes at both loci (type I) showed an early postlingual onset and a more rapid rate of progress compared with those with one either of the two disease associated haplotypes (type II). The audiometric pattern was cochlear without a vestibular involvement. Auditory brainstem response audiometry and magnetic resonance imaging indicated normal retrocochlear features. The otoacoustic emissions were affected for both type I and type II, whereas the acoustic stapedius reflex thresholds were normal in most cases. It is concluded that both types had an outer hair cell/micro-mechanical abnormality, but that the DFNA 2 type might have an additional dysfunction at the level of the inner hair cells. It is furthermore pointed out that the application of refined audiometric techniques as well as a further development of new techniques is needed in order to characterize the phenotypes of the rapidly expanding number of genetically defined inner ear abnormalities.
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37.
  • Bülow, B, et al. (författare)
  • The gender differences in growth hormone-binding protein and leptin persist in 80-year-old men and women and is not caused by sex hormones.
  • 2003
  • Ingår i: Clinical Endocrinology. - : Wiley. - 1365-2265 .- 0300-0664. ; 59:4, s. 6-482
  • Tidskriftsartikel (refereegranskat)abstract
    • objective Leptin and growth hormone-binding protein (GHBP) both show gender differences that might be explained by sex hormones. To study the potential relevance of oestradiol and testosterone, we have examined 80-year-old subjects in whom oestradiol is higher in men than in women. The interrelationships between leptin, insulin, GHBP and fat mass in this age group were also investigated. design and subjects Ninety-four subjects (55 females and 39 males), all 80 years old, were investigated in a community-based study. None of the investigated subjects was being treated for diabetes mellitus and none of the women had oestrogen replacement. methods Levels of testosterone, oestradiol, SHBG, IGF-I, GHBP, glucose, insulin and leptin were analysed. Body composition was measured with bioimpedance analysis (BIA). results As in younger age groups, serum leptin, the ratio leptin/kilogram fat mass and serum GHBP were higher in the women (all, P <= 0·007), although serum oestradiol was higher in the men (P < 0·001). There were no significant associations between sex hormones and leptin or GHBP either in women or in men (all, r < 0·13, P > 0·1). Leptin correlated to kilogram fat mass in both women (r = 0·55, P < 0·001) and men (r = 0·47, P = 0·003), but in contrast, there were no significant correlations between GHBP and fat mass and GHBP and IGF-I, either in women or in men (all, r < 0·24, P > 0·2). Insulin and leptin were significantly associated with GHBP, both in women (r = 0·48, P < 0·001 and r = 0·43, P = 0·001, respectively) and in men (r = 0·40, P = 0·01 and r = 0·34, P = 0·03, respectively). conclusions Although the 80-year-old men had higher oestradiol levels than the women, the women had higher levels of leptin and GHBP. There were no correlations between sex hormones and leptin and GHBP, which indicates that the gender differences are not caused by sex hormones in old age. In contrast to studies in younger subjects, GHBP did not correlate to fat mass in the investigated 80-year-old men and women. In the older subjects investigated, as in younger subjects, GHBP was significantly correlated with leptin and insulin.
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38.
  • Carlsson, Annelie, et al. (författare)
  • Absence of Islet Autoantibodies and Modestly Raised Glucose Values at Diabetes Diagnosis Should Lead to Testing for MODY : Lessons From a 5-Year Pediatric Swedish National Cohort Study
  • 2020
  • Ingår i: Diabetes Care. - Arlington, VA, United States : American Diabetes Association. - 0149-5992 .- 1935-5548. ; 43:1, s. 82-89
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVE Identifying maturity-onset diabetes of the young (MODY) in pediatric populations close to diabetes diagnosis is difficult. Misdiagnosis and unnecessary insulin treatment are common. We aimed to identify the discriminatory clinical features at diabetes diagnosis of patients with glucokinase (GCK), hepatocyte nuclear factor-1A (HNF1A), and HNF4A MODY in the pediatric population.RESEARCH DESIGN AND METHODS Swedish patients (n = 3,933) aged 1–18 years, diagnosed with diabetes May 2005 to December 2010, were recruited from the national consecutive prospective cohort Better Diabetes Diagnosis. Clinical data, islet autoantibodies (GAD insulinoma antigen-2, zinc transporter 8, and insulin autoantibodies), HLA type, and C-peptide were collected at diagnosis. MODY was identified by sequencing GCK, HNF1A, and HNF4A, through either routine clinical or research testing.RESULTS The minimal prevalence of MODY was 1.2%. Discriminatory factors for MODY at diagnosis included four islet autoantibody negativity (100% vs. 11% not-known MODY; P = 2 × 10−44), HbA1c (7.0% vs. 10.7% [53 vs. 93 mmol/mol]; P = 1 × 10−20), plasma glucose (11.7 vs. 26.7 mmol/L; P = 3 × 10−19), parental diabetes (63% vs. 12%; P = 1 × 10−15), and diabetic ketoacidosis (0% vs. 15%; P = 0.001). Testing 303 autoantibody-negative patients identified 46 patients with MODY (detection rate 15%). Limiting testing to the 73 islet autoantibody-negative patients with HbA1c <7.5% (58 mmol/mol) at diagnosis identified 36 out of 46 (78%) patients with MODY (detection rate 49%). On follow-up, the 46 patients with MODY had excellent glycemic control, with an HbA1c of 6.4% (47 mmol/mol), with 42 out of 46 (91%) patients not on insulin treatment.CONCLUSIONS At diagnosis of pediatric diabetes, absence of all islet autoantibodies and modest hyperglycemia (HbA1c <7.5% [58 mmol/mol]) should result in testing for GCK, HNF1A, and HNF4A MODY. Testing all 12% patients negative for four islet autoantibodies is an effective strategy for not missing MODY but will result in a lower detection rate. Identifying MODY results in excellent long-term glycemic control without insulin.
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39.
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40.
  • Delli, Ahmed, et al. (författare)
  • Zinc Transporter 8 Autoantibodies and Their Association With SLC30A8 and HLA-DQ Genes Differ Between Immigrant and Swedish Patients With Newly Diagnosed Type 1 Diabetes in the Better Diabetes Diagnosis Study
  • 2012
  • Ingår i: Diabetes. - : American Diabetes Association. - 0012-1797 .- 1939-327X. ; 61:10, s. 2556-2564
  • Tidskriftsartikel (refereegranskat)abstract
    • We examined whether zinc transporter 8 autoantibodies (ZnT8A; arginine ZnT8-RA, tryptophan ZnT8-WA, and glutamine ZnT8-QA variants) differed between immigrant and Swedish patients due to different polymorphisms of SLC30A8, HLA-DQ, or both. Newly diagnosed autoimmune (andgt;= 1 islet autoantibody) type 1 diabetic patients (n = 2,964, andlt;18 years, 55% male) were ascertained in the Better Diabetes Diagnosis study. Two subgroups were identified: Swedes (n = 2,160, 73%) and immigrants (non-Swedes; n = 212, 7%). Non-Swedes had less frequent ZnT8-WA (38%) than Swedes (50%), consistent with a lower frequency in the non-Swedes (37%) of SLC30A8 CT+TT (RW+WW) genotypes than in the Swedes (54%). ZnT8-RA (57 and 58%, respectively) did not differ despite a higher frequency of CC (RR) genotypes in non-Swedes (63%) than Swedes (46%). We tested whether this inconsistency was due to HLA-DQ as 2/X (2/2; 2/y; y is anything but 2 or 8), which was a major genotype in non-Swedes (40%) compared with Swedes (14%). In the non-Swedes only, 2/X (2/2; 2/y) was negatively associated with ZnT8-WA and ZnT8-QA but not ZnT8-RA. Molecular simulation showed nonbinding of the relevant ZnT8-R peptide to DQ2, explaining in part a possible lack of tolerance to ZnT8-R. At diagnosis in non-Swedes, the presence of ZnT8-RA rather than ZnT8-WA was likely due to effects of HLA-DQ2 and the SLC30A8 CC (RR) genotypes.
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41.
  • Det enkla är det sköna : en vänbok till Kjell Granström
  • 2007
  • Samlingsverk (redaktörskap) (övrigt vetenskapligt/konstnärligt)abstract
    • Om språkutveckling / Jan Anward -- Forskningsmiljöer och seminariekulturer : ideal och verklighet / Gunnar Berg -- Gruppens obönhörliga brist på demokrati / Gunnel Colnerud -- Undervisningsspråket : en del av lärares yrkesspråk / Anna-Lena Eriksson Gustavsson, Rose-Marie Fahlén, Ulla-Britt Persson & Joakim Samuelsson -- Dialogism and social constructivism / Per Linell -- Samhällsaktiva skolor och skolaktiva samhällen i glesbygd : utopi eller möjlighet? / Annika Andræ Thelin -- Användningen av tiden i skolan / Mats Ekholm -- Offensiva spelare och coacher i matchen om skolan / Lennart Fahlén, Elisabeth Ahlstrand, Ingrid Westlund & Leif Mideklint -- Analyser av skolors anda / Rolf Lander -- Samhällsförändring, skolprofilering och identitet / Lars Naeslund & Jens Pedersen -- Succession and managing the transition from predecessor to successor / Siv Boalt Boëthius -- Freud som gruppsykolog : en orättvis betraktelse till 150-årsdagen / Stefan Jern -- Gruppens känslomässiga klimat / Eric Olsson -- Från Göteborg till Dortmund : studier i masshändelser / Michael Rosander & Ingrid Hylander -- Gruppetenking og operativ effektivitet i team / Endre Sjøvold -- Existens och relationer / Dan Stiwne -- Är det bra att vara ambitiös? / Viveka Adelswärd och Johan Hofvendahl -- Ja, för jag är så jävla snygg!" : retsekvenser och informellt lärande i högstadiets grupparbeten / Karin Aronsson & Michael Tholander -- Skolpsykolog : beprövad erfarenhet och specialitet på vetenskaplig grund? / Gunilla Guvå & Ingrid Hylander -- Slump, sammanträffanden och spår : om en lärares inflytande / Stefan Jern & Anders Hempel -- Villkor för psykologisk forskning : hur de statliga forskningsråden fördelade sina pengar inom psykologiområdet 1996-98 / Rolf Sandell och Kjell Granström -- Urval publikationer Kjell Granström. Svensk engelsk och norsk text.
  •  
42.
  • Ehrström, Sophia, et al. (författare)
  • Lactic acid bacteria colonization and clinical outcome after probiotic supplementation in conventionally treated bacterial vaginosis and vulvovaginal candidiasis
  • 2010
  • Ingår i: Microbes and infection. - : Elsevier BV. - 1286-4579 .- 1769-714X. ; 12:10, s. 691-699
  • Tidskriftsartikel (refereegranskat)abstract
    • This randomized double-blind placebo controlled study assessed the vaginal colonization of lactic acid bacteria and clinical outcome. Vaginal capsules containing L gasseri LN40, Lactobacillus fermentum LN99, L. casei subsp. rhamnosus LN113 and P. acidilactici LN23, or placebos were administered for five days to 95 women after conventional treatment of bacterial vaginosis and/or vulvovaginal candidiasis. Vulvovaginal examinations and vaginal samplings were performed before and after administration, after the first and second menstruation, and after six months. Presence of LN strains was assessed using RAPD analysis. LN strains were present 2-3 days after administration in 89% of the women receiving LN strains (placebo: 0%, p < 0.0001). After one menstruation 53% were colonized by at least one LN strain. Nine percent were still colonized six months after administration. Ninety-three percent of the women receiving LN strains were cured 2-3 days after administration (placebo: 83%), and 78% after one menstruation (placebo: 71%) (ns). The intervention group experienced less malodorous discharge 2-3 days after administration (p = 0.03) and after the second menstruation (p = 0.04), compared with placebo. In summary, five days of vaginal administration of LN strains after conventional treatment of bacterial vaginosis and/or vulvovaginal candidiasis lead to vaginal colonization, somewhat fewer recurrences and less malodorous discharge. 
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43.
  • Einarsson, Charlotta, 1969-, et al. (författare)
  • Kjell Granströms vängrupp (KGV)
  • 2007
  • Ingår i: Det enkla är det sköna - en vänbok till Kjell Granström. - Linköping : Skapande vetande, Linköpings universitet. - 9789185831289 ; , s. -387
  • Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
    • Om språkutveckling / Jan Anward -- Forskningsmiljöer och seminariekulturer : ideal och verklighet / Gunnar Berg -- Gruppens obönhörliga brist på demokrati / Gunnel Colnerud -- Undervisningsspråket : en del av lärares yrkesspråk / Anna-Lena Eriksson Gustavsson, Rose-Marie Fahlén, Ulla-Britt Persson & Joakim Samuelsson -- Dialogism and social constructivism / Per Linell -- Samhällsaktiva skolor och skolaktiva samhällen i glesbygd : utopi eller möjlighet? / Annika Andræ Thelin -- Användningen av tiden i skolan / Mats Ekholm -- Offensiva spelare och coacher i matchen om skolan / Lennart Fahlén, Elisabeth Ahlstrand, Ingrid Westlund & Leif Mideklint -- Analyser av skolors anda / Rolf Lander -- Samhällsförändring, skolprofilering och identitet / Lars Naeslund & Jens Pedersen -- Succession and managing the transition from predecessor to successor / Siv Boalt Boëthius -- Freud som gruppsykolog : en orättvis betraktelse till 150-årsdagen / Stefan Jern -- Gruppens känslomässiga klimat / Eric Olsson -- Från Göteborg till Dortmund : studier i masshändelser / Michael Rosander & Ingrid Hylander -- Gruppetenking og operativ effektivitet i team / Endre Sjøvold -- Existens och relationer / Dan Stiwne -- Är det bra att vara ambitiös? / Viveka Adelswärd och Johan Hofvendahl -- Ja, för jag är så jävla snygg!" : retsekvenser och informellt lärande i högstadiets grupparbeten / Karin Aronsson & Michael Tholander -- Skolpsykolog : beprövad erfarenhet och specialitet på vetenskaplig grund? / Gunilla Guvå & Ingrid Hylander -- Slump, sammanträffanden och spår : om en lärares inflytande / Stefan Jern & Anders Hempel -- Villkor för psykologisk forskning : hur de statliga forskningsråden fördelade sina pengar inom psykologiområdet 1996-98 / Rolf Sandell och Kjell Granström -- Urval publikationer Kjell Granström. Svensk engelsk och norsk text.
  •  
44.
  • Ejerblad, Elisabeth, et al. (författare)
  • Diagnosis according to World Health Organization determines the long-term prognosis in patients with myeloproliferative neoplasms treated with anagrelide : Results of a prospective long-term follow-up
  • 2013
  • Ingår i: Hematology. - 1024-5332 .- 1607-8454. ; 18:1, s. 8-13
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVES:During long term follow-up of a cohort of patients with essential thrombocythemia (ET) and polycythemia vera (PV) a higher than expected incidence of myelofibrosis (MF) was noted. In order to test if the explanation could be found in the diagnostic criteria a re-evaluation of diagnosis using the 2008 WHO diagnostic criteria for ET and MF was performed.METHODS: This prospective study of 60 patients with ET and PV was set up in 1998 to evaluate the long-term efficacy and tolerability of anagrelide treatment. Bone marrow trephine biopsies were requested from study start, after 2 and 7 years of follow-up. A blinded re-evaluation of the bone marrow trephines was performed. The 2008 WHO bone marrow criteria were used for diagnosis and fibrosis grading.RESULTS: Of 40 patients with an initial diagnosis of ET, 21 were confirmed as 'true ET' whereas 17 were reclassified as primary myelofibrosis (PMF) (12 PMF-0, 3 PMF-1, 2 PMF-2) and 2 as myeloproliferative neoplasms of uncertain origin. After 7 years of follow-up, 19 of 21 patients with 'true ET' were alive, none had transformed to MF, leukemia, or myelodysplastic syndrome. In contrast, 4/17 patients reclassified as PMF had died, two patients transformed to myelodysplastic syndrome and 7 patients progressed to overt MF.DISCUSSION:We conclude that a blinded re-evaluation of bone marrow trephines from study start and after 7 years of follow-up using 2008 World Health Organization criteria was able to differentiate between true ET and PMF with a marked difference in follow-up outcome.
  •  
45.
  • Ekersund, J., et al. (författare)
  • A mobile app for the treatment of female mixed and urgency incontinence : a cost-effectiveness analysis in Sweden
  • 2022
  • Ingår i: International Urogynecology Journal. - : Springer Science+Business Media B.V.. - 0937-3462 .- 1433-3023. ; 33, s. 1273-1282
  • Tidskriftsartikel (refereegranskat)abstract
    • Introduction and hypothesis: A previous randomized controlled trial (RCT) demonstrated that the app Tät II, for self-management of mixed urinary incontinence (MUI) and urgency urinary incontinence (UUI), yielded significant, clinically relevant improvements in symptom severity and quality of life (QoL) compared with a control group. We aimed to assess the cost-effectiveness of Tät II.Methods: A cost–utility analysis with a 1-year societal perspective was carried out, comparing Tät II with an information app. Data were collected alongside an RCT: 122 community-dwelling women aged ≥18 years with MUI or UUI ≥2 times/week were randomized to 3 months of Tät II treatment focused on pelvic floor muscle training (PFMT) and bladder training (BT; n = 60), or to an information app (n = 62). Self-assessed data from validated questionnaires were collected at baseline and at 3-month and 1-year follow-ups. Costs for assessment, treatment delivery, incontinence aids, laundry, and time for PFMT and BT were included. We calculated quality-adjusted life-years (QALYs) using the International Consultation on Incontinence Modular Questionnaire Lower Urinary Tract Symptoms Quality of Life. The incremental cost-effectiveness ratio (ICER) between the groups was our primary outcome. Sensitivity analyses were performed.Results: The mean age was 58.3 (SD = 9.6) years. Annual overall costs were €738.42 in the treatment group and €605.82 in the control group; annual QALY gains were 0.0152 and 0.0037 respectively. The base case ICER was €11,770.52; ICERs in the sensitivity analyses ranged from €−9,303.78 to €22,307.67.Conclusions: The app Tät II is a cost-effective treatment method for women with MUI and UUI.
  •  
46.
  • Ellman Kareld, Louise, et al. (författare)
  • Länsprogram Kronobergs län : Regional miljöövervakning 2015-2020
  • 2014
  • Rapport (övrigt vetenskapligt/konstnärligt)abstract
    • SammanfattningLänsprogrammet för Regional miljöövervakning, 2015-2020 för Kronobergs län, omfattar åtta programområden: Luft, Skog, Jordbruk, Våtmarker, Landskap, Sötvatten, Miljögiftssamordning och Hälsorelaterad miljöövervakning. Övervakning planeras inom 24 delprogram, fördelade på åtta programområden. Inom två delprogram sker övervakning först nästa programperiod.Fem ingående delprogram är nationella, de genomförs över hela landet. I länet har övervakning genom Gemensamma delprogram prioriterats.19 delprogram är sådana och genomförs i samarbete med andra län. De är markerade med en asterisk (*) i anslutning till rubriken. Inga gemensamma delprogram leds dock från länet under den kommande programperioden. De gemensamma delprogrammen möjliggörs övervakning inom samtliga åtta programområden.I länsprogrammet redovisas, oberoende av finansiär, den övervakning i Kronobergs län som ska bedrivas kontinuerligt under programperioden. Den totala kostnaden för hela programmet är svår att beräkna. Naturvårdsverket lämnar bidrag med 852 000 kronor årligen, men det finns även andra medel till andra särskilt riktade medel för exempelvis kalkeffektuppföljningen inom programområde Sötvatten som Hav- och vattenmyndigheten fördelar. Inom programområde Sötvatten finansieras recipientkontrollen helt av Vattenvårdsförbunden m.fl., och råvattenkontrollen delvis av länets kommuner. Övervakning inom programområde Luft sker genom Kronobergs läns luftvårdsförbund. Övervakningen av luftföroreningar i tätorter finansieras till största delen av kommunerna inom ett så kallat samverkansområde för kontroll av luftkvalitet. Inom programområde Hälsa och miljögifter finns en god samverkan med Landstinget Kronoberg och länets kommuner.Länsprogrammet innebär att data samlas in för att ge underlag för uppföljning av preciseringar och regionala miljömål till Miljökvalitetsmålen Frisk luft, Bara naturlig försurning, Giftfri miljö, Ingen övergödning, Levande sjöar och vattendrag, Grundvatten av god kvalitet, Levande skogar, Ett rikt odlingslandskap, God bebyggd miljö och Ett rikt växt- och djurliv.
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47.
  • Emilson, Anette, 1964- (författare)
  • Det önskvärda barnet : Fostran uttryckt i vardagliga kommunikationshandlingar mellan lärare och barn i förskolan
  • 2008
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • The aim of this research is to acquire knowledge about fostering young children, as expressed in everyday interactions between teachers and children in Swedish preschools. The three empirical studies in this doctoral thesis investigated partly specific democratic values such as participation and influence and partly the values that teachers explicitly or implicitly encourage and how these values are communicated to children. The thesis takes a critical approach in order to also acquire knowledge about important fostering aspects that can move hierarchal power structures towards a fostering of values characterized by intersubjectivity. In order to understand the interactions, the concepts of communicative and strategic action (Habermas, 1984) are used, as well as strong and weak classification and framing (Bernstein, 2000). Preschool fostering is also analyzed from a double perspective, with a starting-point in Habermas’ (1984, 1995a) concepts of the system and the life-world. The fieldwork took place with three different groups of toddlers in Swedish preschools. Forty-six children (aged 1 to 3 years) participated, as well as their ten teachers. The data consisted of videotaped observations of teacher and child interactions. The first study investigated how a toddler’s participation can be understood in two kinds of educational activities where the degree of teacher control differs. The results showed how strong classification and framing risk restricting children’s participation and how a weak classification and framing can promote children’s opportunities to participate on their own terms. Important issues for children’s participation were found to be a participant teacher who creates meaningful contexts, where teacher control is about being emotionally present, supportive and responsive. The purpose of the second study was to investigate how very young children can exert an influence in circle-time situations in relation to teacher control. The results showed that the children do, in fact, make choices, mostly based on several fixed alternatives, and that they do take the initiative, sometimes to express an opinion or a right, sometimes to express what they want to do in circle time. It was also found that the influence young children are able to exert varies with the control the teacher exercises. It is evident that strong teacher control is maintained in different ways and that strong control does not necessarily limit children’s influence; it depends on the nature of the control. Children’s influence increases when the teacher’s control over the what and how aspects of communications is weak, and is characterized by closeness to the child’s life-world and a communicative approach. The third study examined the values that teachers explicitly or implicitly encourage and how these values are communicated to children. The analyses resulted in ten specific values embedded in value dimensions of discipline, caring and democracy. These, in turn, can be divided into different social orientations – both collective and individualistic. The values are communicated differently and the what aspect of the communication (the value) is interrelated with the how aspect of the communication; how teachers communicate influences and sometimes changes the communicated value. In order to change power structures in teacher and child interactions, three aspects of importance have been identified: teachers’ closeness to the child’s perspective, their emotional presence and playfulness. Theoretically, the aspects are within the framework of communicative action and contribute to the understanding of what the theory might mean in communication with the youngest children in the educational system. 
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48.
  •  
49.
  •  
50.
  • Engdahl, Ingrid, et al. (författare)
  • Swedish Teachers in the Process of Implementing Education for Sustainability in Early Childhood Education
  • 2021
  • Ingår i: New Ideas in Child and Educational Psychology. ; 1:1, s. 3-23
  • Tidskriftsartikel (refereegranskat)abstract
    • Background. We are living in challenging times, with an urgent need for transformation that requires new and sustainable ways of living. Young children are exposed to these global challenges. This study responds to the need for further understanding of how education for sustainability (EfS) is being handled in early childhood education (ECE). Objective. This study investigated ECE teachers in the process of implementing early childhood education for sustainability (ECEfS). This was initiated by the 2019 revised Swedish National Curriculum for the preschool, where education for sustainable development is included as an overall value and objective. We based our work on a critical and transformative theoretical perspective that highlights the need for critical transformative pedagogies, with a focus on Education for Sustainability. The participating teachers were enrolled in a research and development program initiated by the Swedish institute Ifous. Design. The data presented in this article was obtained in May 2021. An initial questionnaire was emailed to all Ifous participants. One hundred fifty-three teachers (76.5%) responded. The intention of the questionnaire was twofold: first, to investigate what the teachers considered to be education for sustainability in ECE; and second, to scrutinize the teachers’ knowledge base, for the further planning of the research and development program. Content analysis was used to analyze the data. Results. The findings of the study showed a tendency to describe education for sustainability as “business-as-usual” rather than treating EfS as a new field, and to contend that the teachers addressed EfS before it became a compulsory task in 2019. There were few connections made to the UN Sustainable Development Goals (2015) and to the ongoing pandemic. A common trend when describing the content and activities was to divide the content into three areas, following the three dimensions of sustainability. The teachers described the physical changes and pedagogical changes made after the revision of the national curriculum. Most of the changes in the school environment seemed to be a result of priorities set at higher levels in the organizations, e.g., deleting toxic plastic and recycling food waste. Only a few of the teachers described an educational program that included transformative change. Conclusion. The teachers in the study were interested in EfS, and some articulated a longing for more knowledge about ECEfS and for transformative change. The teachers also showed the need for courage and professionalism to lead the way in finding the relevant content and activities for EfS. The teachers were struggling to find new ways to meet the demands from the governing documents especially during a planetary crisis.
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