| 1. |
- Lundin, Anette
(författare)
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Rättfärdigade prioriteringar : en kvalitativ analys av hur personal i äldreomsorgen hanterar motstridiga verksamhetslogiker
- 2017
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This dissertation aims at contributing to social scientific knowledge about prevailing prioritizations in eldercarepractice by looking at an economic and a caring logic, and how these logics are overlapping, contradictory or comein conflict with each other. A more concrete aim is to understand how the personnel describe their work with orfor balance between the logics and their justifications prioritizations made in the care of older persons. The researchquestion is: How do personnel and care unit manager at a public nursing home understand and handle the twologics that govern care work for facilitating wellbeing of the residents. The aim and research question led to threesub-aims: 1) to analyze the personnel’s experiences of and meaning making about the care work they carry out, 2)to illuminate and problematize the two logics above, and 3)to analyze how the personnel justify their prioritizationsin prevailing context, and how their accountability have an effect on their professional identities.Empirical material was gathered through 13 individual interviews with care personnel and their care unitmanager at a public nursing home in Sweden. These interviews were complemented by a group interview. Thematerial was analyzed by the use of three methods: phenomenology (Paper I and II), reflexive analysis (Paper III),and a positioning analysis (Paper IV). Paper I found that the personnel understands the residents’ well-being asbeing characterized by feeling of being existentially touched. This essence is constituted by feeling freedom ofchoice, pleasure, and closeness to someone or something. In Paper II, the work for facilitating this kind of wellbeingwas characterized by three ambiguities: (i) freedom of choice for the older persons vs. institutionalconstraints, (ii) the residents' need for activation vs. wanting not to be activated, and (iii) the residents' need forroutine vs. the eldercarers' not being able to know what the residents need. Paper III showed that the care unitmanager created a hybrid of the two logics (economy is care and vice versa) and that the personnel oppose thishybrid. The opposition is shaped as the personnel divides their work in care and “those other things”. Thesefindings showed how interaction between the logics expresses itself in practice and that it is the personnel who hasto handle contradictions between the logics in their everyday care work. The positioning analysis in Paper IV hadthree levels. The first level showed how the carers align with their peers and that they find the organizationalframe, within which they have agency, changed due to increased workload. This change led to an order of priorities.The second level showed that the carers relate to three aspects when making accounts: the care itself, the olderpersons, and the media. The third level showed that the carers share a view of administration, cleaning, servingmeals, and filling up supplies, as not being parts of caring.The dissertation’s theoretical framework focused on theories on logics, accountability, and professionalidentity. The conclusion is that both logics are needed in order to facilitate the well-being of the older persons. Therelationships between the two logics are not always clear and if their contradictions are not illuminated, there is arisk for a care practice that does not facilitate the well-being of their residents. An important theoreticalcontribution is that logics of activities should be understood vertically (form political, through management, anddown to the level of practice) instead of horizontally. The practical implications emphasize the importance ofsupporting the personnel’s professional identity on the one hand, and discussing the logics on the other. Byunderstanding differences between definitions on management-level and practice level, a homogeneity can bereached.
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| 2. |
- Balk, Lennart, et al.
(författare)
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Widespread episodic thiamine deficiency in Northern Hemisphere wildlife
- 2016
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Ingår i: Scientific Reports. - : Nature Publishing Group. - 2045-2322. ; 6
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Tidskriftsartikel (refereegranskat)abstract
- Many wildlife populations are declining at rates higher than can be explained by known threats to biodiversity. Recently, thiamine (vitamin B-1) deficiency has emerged as a possible contributing cause. Here, thiamine status was systematically investigated in three animal classes: bivalves, ray-finned fishes, and birds. Thiamine diphosphate is required as a cofactor in at least five life-sustaining enzymes that are required for basic cellular metabolism. Analysis of different phosphorylated forms of thiamine, as well as of activities and amount of holoenzyme and apoenzyme forms of thiaminedependent enzymes, revealed episodically occurring thiamine deficiency in all three animal classes. These biochemical effects were also linked to secondary effects on growth, condition, liver size, blood chemistry and composition, histopathology, swimming behaviour and endurance, parasite infestation, and reproduction. It is unlikely that the thiamine deficiency is caused by impaired phosphorylation within the cells. Rather, the results point towards insufficient amounts of thiamine in the food. By investigating a large geographic area, by extending the focus from lethal to sublethal thiamine deficiency, and by linking biochemical alterations to secondary effects, we demonstrate that the problem of thiamine deficiency is considerably more widespread and severe than previously reported.
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| 3. |
- Berg, Marie, 1955, et al.
(författare)
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Diabetes och graviditet : Den komplicerade graviditeten
- 2016
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Ingår i: Reproduktiv hälsa - barnmorskans kompetensområde. Helena Lindgren et al. Del 2, 18.6, s. 357-368. - Lund : Studentlitteratur AB. - 9789144090054 ; , s. 357-368
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Bokkapitel (refereegranskat)abstract
- Reproduktiv, perinatal och sexuell hälsa är ett självständigt huvudområde knutet till livets början och området för mänsklig reproduktion i ett livscykel- och genusperspektiv. Inom huvudområdet studeras och utvecklas kunskap om den normala processen och dess avvikelser i samband med graviditet, förlossning och nyföddhetsperiod samt föräldraskapets utveckling. Vidare studeras och utvecklas kunskap och teorier om kvinnors reproduktiva hälsa, sexualitet och fertilitetskontroll samt barnmorskans främjande, förebyggande, vårdande och behandlande arbete - med och för - kvinnan, barnet och familjen. Reproduktiv hälsa omfattar barnmorskans verksamhet inom reproduktiv, perinatal och sexuell hälsa. Boken är uppbyggd utifrån ICM:s (International Confederation of Midwives) beskrivning av barnmorskans kompetensområden, och den omfattar även ett webbmaterial med bland annat sammanfattningar i form av bildspel, tester och undervisningsfilmer. Boken riktar sig till barnmorskestudenter och yrkes verk samma barnmorskor samt till övriga hälsoprofessioner verksamma inom reproduktiv hälsa. Reproduktiv hälsa är framtagen i dialog med, och granskad av, vårt vetenskapliga råd. Vi rekommenderar att den används som lärobok i barnmorskeutbildningen fortsättningsvis.
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| 4. |
- Berg, Ulla B., et al.
(författare)
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New standardized cystatin C and creatinine GFR equations in children validated with inulin clearance
- 2015
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Ingår i: Pediatric Nephrology. - : Springer Science and Business Media LLC. - 1432-198X .- 0931-041X. ; 30:8, s. 1317-1326
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Tidskriftsartikel (refereegranskat)abstract
- This study compares glomerular filtration rate (GFR) equations in children based on standardized cystatin C (CYSC) and creatinine (CREA) and their combinations with renal clearance of inulin (C-inulin). A total of 220 children with different renal disorders were referred for C-inulin (median 84 ml/min/1.73 m(2)). Bias, precision (interquartile range, IQR), and accuracy (percentage of estimates +/- 30 % of C-inulin; P30) were evaluated for two cystatin C equations, CAPA(CYSC) and Berg(CYSC), for creatinine equations, Schwartz(CREA) and Gao(CREA), the arithmetic mean of CAPA(CYSC) and Schwartz(CREA) (MEAN(CAPA+Schwartz)), Berg(CYSC) and Schwartz(CREA) (MEAN(BERG+SCHWARTZ)) and the composite equation Chehade(CYSC+CREA). Overall results of CAPA(CYSC), Berg(CYSC), Schwartz(CREA), Gao(CREA), MEAN(CAPA+Schwartz,) MEAN(BERG+SCHWARTZ) and Chehade(CYSC+CREA) were: median bias -7.6/-4.9/-3.7/-2.3/-4.6/-4.0/-10.1 %, IQR 20.0/19.9/21.7/22.4/21.0/20.9/23.3 ml/min/1.73 m(2) and P30 86/86/80/83/89/91/83 %. The cystatin C equations, MEAN(CAPA+Schwartz) and MEAN(BERG+SCHWARTZ) had a more stable performance across subgroups compared with Schwartz(CREA), Gao(CREA) and Chehade(CYSC+CREA). Cystatin C was the preferred filtration marker for GFR estimation in children, while the benefit of combining cystatin C and creatinine deserves further investigations.
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| 5. |
- Björk, Jonas, et al.
(författare)
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Validation of standardized creatinine and cystatin C GFR estimating equations in a large multicentre European cohort of children
- 2019
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Ingår i: Pediatric Nephrology. - : Springer Science and Business Media LLC. - 0931-041X .- 1432-198X.
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Tidskriftsartikel (refereegranskat)abstract
- Background: Most validations of paediatric glomerular filtration rate (GFR) estimating equations using standardized creatinine (CR) and cystatin C (CYS) assays have comprised relatively small cohorts, which makes accuracy across subgroups of GFR, age, body mass index (BMI) and gender uncertain. To overcome this, a large cohort of children referred for GFR determination has been established from several European medical centres. Methods: Three thousand four hundred eight measurements of GFR (mGFR) using plasma clearance of exogenous substances were performed in 2218 children aged 2–17 years. Validated equations included Schwartz-2009CR/2012CR/CYS/CR+CYS, FASCR/CYS/CR+CYS, LMRCR, Schwartz-LyonCR, BergCYS, CAPACYS, CKD-EPICYS, AndersenCR+CYS and arithmetic means of the best single-marker equations in explorative analysis. Five metrics were used to compare the performance of the GFR equations: bias, precision and three accuracy measures including the percentage of GFR estimates (eGFR) within ± 10% (P10) and ± 30% (P30) of mGFR. Results: Three of the cystatin C equations, BergCYS, CAPACYS and CKD-EPICYS, exhibited low bias and generally satisfactory accuracy across all levels of mGFR; CKD-EPICYS had more stable performance across gender than the two other equations. Among creatinine equations, Schwartz-LyonCR had the best performance but was inaccurate at mGFR < 30 mL/min/1.73 m2 and in underweight patients. Arithmetic means of the best creatinine and cystatin C equations above improved bias compared to the existing composite creatinine+cystatin C equations. Conclusions: The present study strongly suggests that cystatin C should be the primary biomarker of choice when estimating GFR in children with decreased GFR. Arithmetic means of well-performing single-marker equations improve accuracy further at most mGFR levels and have practical advantages compared to composite equations.
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| 6. |
- Carlsson, Ninni, 1962, et al.
(författare)
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Forskare i könsrelaterat våld svarar David Eberhard : Okunskap i GP om #MeeToo och sexuella kränkningar
- 2017
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Ingår i: Göteborgs-Posten, Ledarbloggen, 2017-11-20. - 1103-9345.
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Tidskriftsartikel (populärvet., debatt m.m.)abstract
- Syftet med denna artikel är att granska och problematisera en gästkrönika i Göteborgs-Posten den 6 november 2017, där psykologen David Eberhard kritiserar #metoo-rörelsen. Med exempel från lagstiftning och aktuell forskning diskuterar artikelförfattarna, sex forskare i könsrelaterat våld vid Institutionen för Socialt arbete, Göteborgs universitet, hur krönikan präglas av okunskap om sexuella kränkningar och tidigare kvinnorörelsers arbete; och hur den uttrycker en könsdiskriminerande och stigmatiserande attityd till dem som nu bryter tystnaden om egna erfarenheter. Artikeln är en replik till Eberhard som publicerades på Göteborgs-Postens ledarblogg den 20 november 2017.
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| 7. |
- Coppo, Rosanna, et al.
(författare)
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Risk factors for progression in children and young adults with IgA nephropathy : an analysis of 261 cases from the VALIGA European cohort
- 2017
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Ingår i: Pediatric nephrology (Berlin, West). - : Springer Science and Business Media LLC. - 0931-041X .- 1432-198X. ; 32:1, s. 139-150
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Tidskriftsartikel (refereegranskat)abstract
- There is a need for early identification of children with immunoglobulin A nephropathy (IgAN) at risk of progression of kidney disease. Data on 261 young patients [age < 23 years; mean follow-up of 4.9 (range 2.5-8.1) years] enrolled in VALIGA, a study designed to validate the Oxford Classification of IgAN, were assessed. Renal biopsies were scored for the presence of mesangial hypercellularity (M1), endocapillary hypercellularity (E1), segmental glomerulosclerosis (S1), tubular atrophy/interstitial fibrosis (T1-2) (MEST score) and crescents (C1). Progression was assessed as end stage renal disease and/or a 50 % loss of estimated glomerular filtration rate (eGFR) (combined endpoint) as well as the rate of renal function decline (slope of eGFR). Cox regression and tree classification binary models were used and compared. In this cohort of 261 subjects aged < 23 years, Cox analysis validated the MEST M, S and T scores for predicting survival to the combined endpoint but failed to prove that these scores had predictive value in the sub-group of 174 children aged < 18 years. The regression tree classification indicated that patients with M1 were at risk of developing higher time-averaged proteinuria (p < 0.0001) and the combined endpoint (p < 0.001). An initial proteinuria of ae0.4 g/day/1.73 m(2) and an eGFR of < 90 ml/min/1.73 m(2) were determined to be risk factors in subjects with M0. Children aged < 16 years with M0 and well-preserved eGFR (> 90 ml/min/1.73 m(2)) at presentation had a significantly high probability of proteinuria remission during follow-up and a higher remission rate following treatment with corticosteroid and/or immunosuppressive therapy. This new statistical approach has identified clinical and histological risk factors associated with outcome in children and young adults with IgAN.
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| 8. |
- Hagström, Åke, et al.
(författare)
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Isolates as models to study bacterial ecophysiology and biogeochemistry
- 2018
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Ingår i: Aquatic Microbial Ecology. - : Inter-Research. - 0948-3055 .- 1616-1564. ; 80:1, s. 15-27
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Tidskriftsartikel (refereegranskat)abstract
- Here, we examine the use of bacterial isolates growing in artificial media or seawater as a means to investigate bacterial activity in the upper ocean. The discovery of a major role of bacteria in the ocean's carbon cycle owes greatly to the development of culture-independent assemblage-level approaches; however, this should not detract from the recognition of model isolates as representing the environmental microbiome. A long-established tool for culturing bacteria, in medicine and general microbiology, has been agar plates. In addition, a great variety of liquid substrates including seawater have been used to successfully identify and cultivate important bacteria such as Pelagibacter ubique. Yet, the discrepancy between microscopic counts and plate counts, the great plate count anomaly, has led to a biased perception of the limited relevance of isolated bacteria. Linking isolates to whole-genome sequencing, phylogenetic analysis and computational modeling will result in culturable model bacteria from different habitats. Our main message is that bacterial ecophysiology, particularly growth rates in seawater, and functionalities inferred through the identity, abundance and expression of specific genes could be mechanistically linked if more work is done to isolate, culture and study bacteria in pure cultures. When we rally behind a strategy aimed at culturing targeted phenotypes, we are not saying that culture independent studies of bacteria in the sea are not informative. We are suggesting that culturebased studies can help integrate the ecological and genomic views.
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| 9. |
- Johansson, Annica E M, et al.
(författare)
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Participation in the workforce after a traumatic brain injury : a matter of control
- 2016
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Ingår i: Disability and Rehabilitation. - : Informa UK Limited. - 0963-8288 .- 1464-5165. ; 38:5, s. 423-432
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: This study sought to explore individual experience in developing a mastery of daily activities and roles after a traumatic brain injury (TBI) with the objective of returning to work.METHOD: Eight 30-60-year-old men, employed at the time of injury, were each interviewed three times over a 6-month period. Ten to 21 months after the injuries, four participants had returned to work at least part time. Grounded theory was adapted for analyses.RESULTS: A single core category emerged: a desire for control: focusing on high-priority issues. Still, 2 years after injury, the participants were uncertain about their abilities with respect to what was expected of them at work. They felt they would do better as time progressed.CONCLUSIONS: The participants' uncertainty about their efficacy cast doubt on their beliefs in improving their skills, balancing daily activities and work. They wondered about the sustainability of their health and efficacy at work. Wanting to control their own improvement, the participants asked for counselling in strategies and techniques to help with their progress. This issue could be taken into account in follow-up rehabilitation programmes. Additionally, the workplace might be the ideal context in which to develop the structures and routines necessary to master life in general. Implications for Rehabilitation Two years after injury, the participants remained uncertain about their abilities with respect to what was expected of them at work. The participants felt they would do better as time progressed. The participants, wanting to control their own improvement, sought counselling to help sort out their priorities and found it could contribute to help with their progress in finding a suitable balance between daily activities and work. A consequence of our main finding, in a multidisciplinary context, is that counselling in structures and routines with respect to work-related tasks should be considered to be an integral part of any rehabilitation programme after TBI.
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| 10. |
- Lundin, Anette, et al.
(författare)
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Witnessing presence : Swedish care professionals' experiences of supporting resident's well-being processes within the frame of residential care homes (RCH)
- 2016
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Ingår i: Journal of Aging Studies. - : Elsevier. - 0890-4065 .- 1879-193X. ; 37, s. 1-9
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Tidskriftsartikel (refereegranskat)abstract
- The purpose of this article is to analyse the phenomenon of supportive care for older persons' well-being. The phenomenon is seen from the eldercarers' meaning-making through their lifeworld perspective at a residential care home. Based on primary empirical interview material with twelve professionals in the context of Swedish eldercare, a phenomenological analysis was undertaken. The result shows that the phenomenon of supportive care for older persons' well-being creates certain ambiguities in the professionals' meaning-making. In practice, it balances between the older persons' (from hereon called residents) needs and the conditions of the eldercare organization. The ambiguities (the what) is made up by three constituents: (i) freedom of choice for the older persons vs. institutional constraints, (ii) the residents' need for activation vs. wanting not to be activated, and (iii) the residents' need for routine vs. the eldercarers' not being able to know what the residents need. The conclusions drawn are that this ambiguity has consequences for the eldercarers' choice of handling supportive care for older persons' well-being (the how). They have to navigate between the support for authenticity, dwelling and mobility, and their own presence and time. In performing supportive care for older persons' well-being, the eldercarers have to consider aspects concerning the resident's lifeworld, the social setting of the eldercare ward, and the institutional demands of the organization. The practical implications for supporting well-being in the care of older residents are manifested in the importance of 'the little things', and the eldercarer's ability to give receptive attention, which requires presence.
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