| 1. |
- Berlin, Marie, 1965-
(författare)
-
Out-of-Home Care and Educational Outcomes : Prevalence, Patterns and Consequences
- 2020
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The aim of this thesis is to examine educational stratification in the context of out-of-home care (OHC; foster family care, residential care) and to place one of society’s most vulnerable groups in the fields of social stratification and family complexity research. About 5% of the Swedish population experience OHC during childhood or adolescence. OHC is not only a matter of protecting children and youth; it is also intended to improve future opportunities and compensate for adverse childhood factors. However, a vast body of international research, including Swedish studies, shows that a substantial proportion of young people from OHC have poor school performance and low educational attainment as adults. Furthermore, this is strongly associated with their high risk of other adverse outcomes in life. To date there are no signs of improvement in this regard, and the disadvantage of having a low education is increasing in today’s knowledge-based society.Many previous OHC studies have relied on small, local samples, and longitudinal data are often lacking. In this respect, Swedish researchers are well positioned to contribute to the field through research based on our high-quality population registers. The main data source in this thesis – the Child Welfare Intervention Register – covers half a century of OHC data. Based on these data, an overview of OHC prevalence in Sweden and patterns of educational outcomes are presented in the introductory chapter. The thesis further consists of five individual studies investigating different aspects of the transition through the educational system to adult life among children and youth from OHC. Two of the five studies focus on children who spent most of their childhood in OHC and for whom society has assumed a long-term commitment of parental responsibilities.The descriptive data show that patterns of poor educational outcomes in the OHC population have remained stable as long as they can be followed in the registers. Study I shows that youth who exited long-term care were disadvantaged as compared to youth without OHC experience, both in terms of educational attainment and regarding the strong association between poor school performance and other adverse outcomes in young adulthood. Up to 55% of their excess risks of later psychosocial problems were statistically attributable to dismal school performance. Study II shows that 54% of clients in substance-misuse treatment in the 1980s had been in OHC, half before their teen years and half as teenagers. In this group, OHC was associated with excess mortality during the 30-year follow-up from exit from treatment, with statistical significance mainly for females who had entered OHC before their teens. School failure was more common in the OHC population than for misuse clients without OHC experience, and was strongly associated with the excess mortality of females. Two Nordic comparative studies (Studies III and IV) show that the OHC population had a substantially higher risk of not completing upper-secondary education across countries, and that poor performance in primary school inflicted a greater risk in OHC youth of being NEET in young adulthood than for their peers without OHC experience. Study V shows that the intergenerational transmission of education was weak and inconsistent in the foster care setting, and that living in a highly educated foster family did not have a robust positive effect on foster children’s educational outcomes.
|
|
| 2. |
- Berlin, Marie, et al.
(författare)
-
The relation between out-of-home care, early school failure, and premature mortality : a 30-year follow-up of people treated for substance misuse in Sweden
- 2021
-
Ingår i: Nordic Social Work Research. - 2156-857X .- 2156-8588. ; 11:4, s. 374-386
-
Tidskriftsartikel (refereegranskat)abstract
- Evidence from Swedish and international studies show that a high proportion of children from out-of-home care (OHC) have poor school performance and that this is strongly associated with their substantial risk of adverse development in future life. However, risk factors for poor school performance and adverse development are difficult to disentangle since they are often interrelated and enforce each other over the life course. This study examines premature mortality in relation to early school failure (drop-out from compulsory school) and OHC experience in childhood (0–17 years of age) among clients who were in treatment for substance misuse in the early 1980s (N = 1,036). The analyses were based on record linkages between interview data collected during treatment and national register data covering approximately 30 years of follow-up, from exit from treatment until 2013. Our results showed that 54 per cent had been placed in OHC as children, half before their teens and half as teenagers. The OHC population had a higher prevalence of school failure compared with clients who had not been exposed to childhood OHC. OHC was associated with an excess mortality, although this was only significant for females who had entered OHC before their teens. Adjusting results for school failure reduced their excess mortality by half, and additional life course factors associated with mortality among people with substance misuse adjusted for most of the remaining excess mortality. School failure was strongly associated with the excess mortality of females, but not with the excess mortality of males.
|
|
| 3. |
- DiSantostefano, Rachael L., et al.
(författare)
-
Research Priorities to Increase Confidence in and Acceptance of Health Preference Research: What Questions Should be Prioritized Now?
- 2023
-
Ingår i: Patient. - 1178-1653 .- 1178-1661. ; 17:2, s. 179-190
-
Tidskriftsartikel (refereegranskat)abstract
- AbstractBackground and ObjectiveThere has been an increase in the study and use of stated-preference methods to inform medicine development decisions. The objective of this study was to identify prioritized topics and questions relating to health preferences based on the perspective of members of the preference research community.MethodsPreference research stakeholders from industry, academia, consultancy, health technology assessment/regulatory, and patient organizations were recruited using professional networks and preference-targeted e-mail listservs and surveyed about their perspectives on 19 topics and questions for future studies that would increase acceptance of preference methods and their results by decision makers. The online survey consisted of an initial importance prioritization task, a best-worst scaling case 1 instrument, and open-ended questions. Rating counts were used for analysis. The best-worst scaling used a balanced incomplete block design.ResultsOne hundred and one participants responded to the survey invitation with 66 completing the best-worst scaling. The most important research topics related to the synthesis of preferences across studies, transferability across populations or related diseases, and method topics including comparison of methods and non-discrete choice experiment methods. Prioritization differences were found between respondents whose primary affiliation was academia versus other stakeholders. Academic researchers prioritized methodological/less studied topics; other stakeholders prioritized applied research topics relating to consistency of practice.ConclusionsAs the field of health preference research grows, there is a need to revisit and communicate previous work on preference selection and study design to ensure that new stakeholders are aware of this work and to update these works where necessary. These findings might encourage discussion and alignment among different stakeholders who might hold different research priorities. Research on the application of previous preference research to new contexts will also help increase the acceptance of health preference information by decision makers.
|
|
| 4. |
- Kadefors, Måns, et al.
(författare)
-
Dipeptidyl peptidase 4 expression is not associated with an activated fibroblast phenotype in idiopathic pulmonary fibrosis
- 2022
-
Ingår i: Frontiers in Pharmacology. - : Frontiers Media SA. - 1663-9812. ; 13, s. 1-12
-
Tidskriftsartikel (refereegranskat)abstract
- Dipeptidyl peptidase 4 (DPP4) has been proposed as a marker for activated fibroblasts in fibrotic disease. We aimed to investigate whether a profibrotic DPP4 phenotype is present in lung tissue from patients with idiopathic pulmonary fibrosis (IPF). The presence of DPP4 + fibroblasts in normal and IPF lung tissue was investigated using flow cytometry and immunohistology. In addition, the involvement of DPP4 in fibroblast activation was examined in vitro, using CRISPR/Cas9 mediated genetic inactivation to generate primary DPP4 knockout lung fibroblasts. We observed a reduced frequency of primary DPP4 + fibroblasts in IPF tissue using flow cytometry, and an absence of DPP4 + fibroblasts in pathohistological features of IPF. The in vivo observations were supported by results in vitro showing a decreased expression of DPP4 on normal and IPF fibroblasts after profibrotic stimuli (transforming growth factor β) and no effect on the expression of activation markers (α-smooth muscle actin, collagen I and connective tissue growth factor) upon knockout of DPP4 in lung fibroblasts with or without activation with profibrotic stimuli.
|
|
| 5. |
- Khalili, Molly, 1996-, et al.
(författare)
-
Pregnancy, delivery, and neonatal outcomes among women with spinal cord injury in Sweden 1997-2015 : A population-based cohort study
- 2022
-
Ingår i: Acta Obstetricia et Gynecologica Scandinavica. - : John Wiley & Sons. - 0001-6349 .- 1600-0412. ; 101:11, s. 1282-1290
-
Tidskriftsartikel (refereegranskat)abstract
- INTRODUCTION: The aim of this study was to describe the rate of pregnancy in spinal cord injured women in Sweden as well as pregnancy, delivery, and neonatal outcomes.MATERIAL AND METHODS: This study was based on data from the Swedish Medical Birth Register and the National Patient Register. The study population included women with spinal cord injury who gave birth in Sweden during the period 1997 to 2015. The general population was used as reference and included all non-spinal cord injured patients who gave birth during the same period of time.RESULTS: In the spinal cord injury group, 109 births were identified. Eighty-nine (82%) of them were among paraplegic women and 20 (18%) were among tetraplegic women. Women with spinal cord injury in our study population had urinary tract infections during pregnancy in five cases (5%) and anemia during pregnancy in nine cases (8%), compared with 0.2% and 4%, respectively, in the general population. Compared with the general population more deliveries were induced in the study population, 18 (17%) in the spinal cord injury group and 12% in the general population. Vaginal delivery was achieved in 52 (48%) of the births with 42 of them (39%) being non-instrumental and 10 (9%) being instrumental vaginal deliveries. Elective cesarean section rate was 34% (n = 37). Sixteen infants (15%) were born preterm (gestational week <37). We found an overall low rate of pregnancy and delivery complications.CONCLUSIONS: Our results show predominantly favorable outcomes of pregnancy and delivery in women with spinal cord injury as well as their infants. These results are in concordance with previous research.
|
|
