| 1. |
- Berggrund, Malin, et al.
(author)
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Temporal changes in the vaginal microbiota in self-samples and its association with persistent HPV16 infection and CIN2
- 2020
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In: Virology Journal. - : Springer Science and Business Media LLC. - 1743-422X. ; 17
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Journal article (peer-reviewed)abstract
- BackgroundThe vaginal microbiota has been reported to be associated with HPV infection and cervical cancer. This study was performed to compare the vaginal microbiota at two timepoints in women performing self-sampling and had a persistent or transient HPV16 infection. The women were tested for 12 high-risk HPV (hrHPV) types but only women with single type (HPV16) were included to reduce confounding variables.MethodsIn total 96 women were included in this study. Of these, 26 were single positive for HPV16 in the baseline test and HPV negative in the follow-up test and 38 were single positive for HPV16 in both tests and diagnosed with CIN2+ in histology. In addition, 32 women that were negative for all 12 HPV tested were included. The samples of vaginal fluid were analyzed with the Ion 16S™ Metagenomics Kit and Ion 16S™ metagenomics module within the Ion Reporter™ software.ResultsK-means clustering resulted in two Lactobacillus-dominated groups, one with Lactobacillus sp. and the other specifically with Lactobacillus iners. The two remaining clusters were dominated by a mixed non-Lactobacillus microbiota. HPV negative women had lower prevalence (28%) of the non-Lactobacill dominant cluster in the baseline test, as compared to women with HPV16 infection (42%) (p value = 0.0173). Transition between clusters were more frequent in women with persistent HPV16 infection (34%) as compared in women who cleared the HPV16 infection (19%) (p value = 0.036).ConclusionsThe vaginal microbiota showed a higher rate of transitioning between bacterial profiles in women with persistent HPV16 infection as compared to women with transient infection. This indicate an instability in the microenvironment in women with persistent HPV infection and development of CIN2+.
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| 2. |
- Hedlund Lindberg, Julia, et al.
(author)
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Toward ovarian cancer screening with protein biomarkers using dried, self-sampled cervico-vaginal fluid
- 2024
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In: iScience. - : Cell Press. - 2589-0042. ; 27:2
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Journal article (peer-reviewed)abstract
- Early detection is key for increased survival in ovarian cancer, but no general screening program exists today due to lack of biomarkers and overall cost versus benefit over traditional clinical methods. Here, we used dried cervico-vaginal fluid (CVF) as sampling matrix coupled with mass spectrometry for detection of protein biomarkers. We find that self-collected CVF on paper cards yields robust results and is suitable for high-throughput proteomics. Artificial intelligence–based methods were used to identify an 11-protein panel that separates cases from controls. In validation data, the panel achieved a sensitivity of 0.97 (95% CI 0.91–1.00) at a specificity of 0.67 (0.40–0.87). Analyses of samples collected prior to development of symptoms indicate that the panel is informative also of future risk of disease. Dried CVF is used in cervical cancer screening, and our results opens the possibility for a screening program also for ovarian cancer, based on self-collected CVF samples.
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| 3. |
- Hermansson, Ruth S., et al.
(author)
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Incidence of oncogenic HPV and HPV-related dysplasia five years after a negative HPV test by self-sampling in elderly women
- 2022
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In: Infectious Agents and Cancer. - : Springer Nature. - 1750-9378. ; 17:42
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Journal article (peer-reviewed)abstract
- Purpose: Cervical cancer prevention for older women can be challenging since there are no specific guidelines for this group. This study aimed to determine the incidence of oncogenic HPV and HPV-related dysplasia in elderly women 5 years after being HPV negative.Methods: Invited women participated five years earlier in a study where self-sampling for HPV testing was applied, at this time, they were all HPV negative. The women were now, five years later invited to perform self-sampling for HPV testing. Women with a positive result performed a repeat HPV test. Those with a positive repeat HPV test were examined by colposcopy, biopsy and cytology.Results: Of the 804 invited women, 634 (76.9%) agreed to participate in the study and a self-sampling kit was sent to them. Of these, 99.6% (632/634) sent a sample to the HPV laboratory. The participation rate in each age group was 93.3% at age 65, 74.0% at age 70, 80.7% at age 75 and 64.6% at age 80. Overall 18 women (2.8%, 95% CI 3.2 to 6.0) were HPV positive in the first test and 8 (1.3%, 95% CI 0.6 to 2.6) in the second test. Sampling for the second test was done on average 5.4 months after the first test. Fifty per cent (4/8) of the women with a positive repeat test had dysplasia in histology.Conclusions: The incidence of HPV in previously HPV-negative elderly women was low. Among women who were HPV positive in a repeat test, there was a high prevalence of low grade dysplasia.
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| 4. |
- Holmström, Inger, 1960-, et al.
(author)
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Better safe than sorry : Registered nurses' strategies for handling difficult calls to emergency medical dispatch centres - An interview study
- 2022
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In: Journal of Clinical Nursing. - : WILEY. - 0962-1067 .- 1365-2702. ; 31:17-18, s. 2486-2494
-
Journal article (peer-reviewed)abstract
- Aims and objectives To describe strategies employed by registered nurses for handling difficult calls to emergency medical dispatch centres. Background At emergency medical dispatch centres, registered nurses encounter a range of difficult calls in their clinical practice. They often use clinical decision support systems, but these may be of limited help if the caller is for instance abusive or has limited language proficiency. Much can be learnt from strategies developed by registered nurses for handling difficult calls. Design A descriptive qualitative study was conducted. Methods A purposeful sample of 24 registered nurses from three different emergency medical dispatch centres were interviewed. The transcribed interviews were analysed using qualitative content analysis. The COREQ checklist was applied. Results An overarching theme was established: "Using one's nursing competence and available resources for a safe outcome", based on three sub-themes: Use one's own professional and personal resources, Use resources within the organisation and Use external resources. The themes in turn consist of ten categories. Conclusions Registered nurses employed a range of strategies to deal with difficult calls, often in combination. They used their personal resources, resources within their own organisation, and collaboration partners to make safe triage decisions and use resources wisely. The effectiveness of these strategies, however, remains unknown. When registered nurses were unable to rule out a high-acuity condition, they used safety-netting and sent an ambulance. Evaluating current strategies and making strategies explicit could further improve the ability of nurses to handle difficult calls. Relevance to clinical practice The strategies described by registered nurses for handling difficult calls to EMDCs included using a consecutive set of strategies. Some of the strategies seemed to be used deliberately, while others seemed tacit and applied in a routinised way. These strategies could potentially be useful for RNs working with telephone triage in different contexts.
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| 5. |
- Holmström, Inger, 1960-, et al.
(author)
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Registered Nurses' experiences of using a clinical decision support system for triage of emergency calls : A qualitative interview study
- 2020
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In: Journal of Advanced Nursing. - : WILEY. - 0309-2402 .- 1365-2648. ; 76:11, s. 3104-3112
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Journal article (peer-reviewed)abstract
- Objectives To describe how Registered Nurses make use of a Clinical Decision Support System to triage calls to emergency medical dispatch centres, from the perspective of professional autonomy. Design The study had a descriptive design with a qualitative inductive approach. Methods Interviews were done with 24 Registered Nurses during 2018-2019. Thematic analysis was conducted. Results Five themes and 16 subthemes were established: (a) Using the CDSS as a general support to professional competence in emergency calls, including subthemes:Support for professional competence,an aid to reflection,a compulsory support; (b) A specific support useful in difficult situations and calls, with subthemes:RN being tired or stressed out;vague and unclear symptoms,rare situations,aggressive and agitated callers; (c) Using the CDSS but changing triage recommendations/priority, including subthemes:Recommending a higher priority than the CDSSandrecommending a lower priority than the CDSS; (d) Development areas for better use of the CDSS in collaboration with other services, with subthemes:Request for common documentation system with ambulancesandcloser collaboration with the national telephone nursing helpline; and (e) Possible technical development areas in the CDSS for optimal use, including subthemes:image transfer,medical records,development of certain areas in the CDSS,update of maps,a need for more knowledge. Conclusion The CDSS was not perceived as a restriction on professional autonomy. It was particularly useful in rare situations. Technical improvements as well as education and training should be done in close collaboration with registered nurses. Impact The study contributes with knowledge about how registered nurses triaging emergency calls use a decision support system. The system was a support for professional competence and did not seem to restrict them. The findings could be useful for clinicians and researchers in development of telephone triage and decision support systems.
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| 6. |
- Holmström, Inger, 1960-, et al.
(author)
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The perspectives of Swedish registered nurses about managing difficult calls to emergency medical dispatch centres : a qualitative descriptive study
- 2021
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In: BMC Nursing. - : BMC. - 1472-6955. ; 20:1
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Journal article (peer-reviewed)abstract
- Background Telephone triage at emergency medical dispatch centres is often challenging for registered nurses due to lack of visual cues, lack of knowledge about the patient, and time pressure - and making the right decision can be a matter of life and death. Some calls may be more difficult to handle, and more knowledge is needed about these calls to develop education and coping strategies. Therefore, the aim of this study was to describe the perspectives of registered nurses' views about managing difficult calls to emergency medical dispatch centres. Methods A descriptive design with a qualitative inductive approach was used. Three dispatch centers in mid-Sweden were investigated, covering about 950,000 inhabitants and handling around 114,000 calls per year. Individual interviews were carried out with a purposeful sample of 24 registered nurses. Systematic text condensation was conducted. Results Seven themes were generated: calls with communication barriers, calls from agitated or rude callers, calls about psychiatric illness, calls from third parties, calls about rare or unclear situations, calls with unknown addresses and calls regarding immediate life-threatening conditions. There was a strong consensus among the registered nurses about which calls were experienced as difficult, with the exception of calls about immediate life-threatening conditions. Some registered nurses thought calls about immediate life-threatening conditions were easy to handle as they simply adhered to protocol, while others described these calls as difficult and were emotionally affected. Conclusion The registered nurses' descriptions of difficult calls focused on the callers, while their own role, the organisational framework, and leadership were not mentioned. Many types of calls included difficulties, which could be related to the caller, their symptoms, or different circumstances. The registered nurses pointed to language barriers and rude, agitated callers as increasing problems. An investigation of actual emergency calls is warranted to examine the extent and nature of such calls.
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| 7. |
- Höglander, Jessica, et al.
(author)
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Implementing A person-centred CommunicaTION (ACTION) educational intervention for in-home nursing assistants – a study protocol
- 2023
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In: BMC Geriatrics. - : BioMed Central (BMC). - 1471-2318. ; 23:1
-
Journal article (peer-reviewed)abstract
- Background: In this study, the focus is on how to support the competence development needed for nursing assistants in home care. Home care services for older persons can be challenging concerning the nature of the interpersonal interaction and communication needed to care for and respond to the diverse needs of older people who seek to live well in our communities. This implies a need to offer more person-centred care (PCC) to older persons. However, there is a lack of knowledge on how to develop such competence. We, therefore, developed A Person-centred CommunicaTION (ACTION) programme, which is a web-based educational intervention aimed at supporting competence development for nursing assistants. The research objective is to evaluate the ACTION programme with respect to participants’ responses to and the effect of the intervention. Methods: A multicentre case–control study with pre- and post-assessments was designed. The ACTION programme will be implemented at home care units, in two different geographic areas in Sweden. A total of 300 nursing assistants will be recruited: 150 for the intervention group and 150 for the control group. We will evaluate the impact measures and the process. Pre- and post-assessments will be performed with data collected via a) audio recordings of communication, b) a questionnaire on self-efficacy communication skills, PCC, empathy and job satisfaction, c) user data, evaluation forms, field notes and observations, and d) interviews. The data will be analysed with descriptive and analytic statistics and/or qualitative methods for meanings. Discussion: This study has the potential to contribute to the evidence supporting competence development required to offer person-centred and quality home care to older persons and to meet upcoming needs for flexible and easily accessible competence development. Trial registration: ISRCTN64890826. Registered 10 January 2022, https://www.isrctn.com/ISRCTN64890826
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| 8. |
- Johansson, Ulrica, 1974-, et al.
(author)
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A randomized, controlled trial of a Nordic, protein-reduced complementary diet in infants : effects on body composition, growth, biomarkers, and dietary intake at 12 and 18 months
- 2023
-
In: American Journal of Clinical Nutrition. - : Elsevier. - 0002-9165 .- 1938-3207. ; 117:6, s. 1219-1231
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Journal article (peer-reviewed)abstract
- Background: High intake of protein and low intake of plant-based foods during complementary feeding can contribute to negative long-term health effects.Objectives: To investigate the effects of a protein-reduced, Nordic complementary diet on body composition, growth, biomarkers, and dietary intake, compared with current Swedish dietary recommendations for infants at 12 and 18 mo.Methods: Healthy, term infants (n = 250) were randomly allocated to either a Nordic group (NG) or a conventional group (CG). From 4 to 6 mo, NG participants received repeated exposures of Nordic taste portions. From 6 to 18 mo, NG was supplied with Nordic homemade baby food recipes, protein-reduced baby food products, and parental support. CG followed the current Swedish dietary recommendations. Measurements of body composition, anthropometry, biomarkers, and dietary intake were collected from baseline and at 12 and 18 mo.Results: Of the 250 infants, 82% (n = 206) completed the study. There were no group differences in body composition or growth. In NG, protein intake, blood urea nitrogen and plasma IGF-1 were lower compared to CG at 12 and 18 mo. Infants in NG consumed 42% to 45% more fruits and vegetables compared to CG at 12 and 18 mo, which was reflected in a higher plasma folate at 12 and 18 mo. There were no between-group differences in EI or iron status.Conclusions: Introduction of a predominantly plant-based, protein-reduced diet as part of complementary feeding is feasible and can increase fruit and vegetable intake.This trial was registered at clinicaltrials.gov as NCT02634749.
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| 9. |
- Johansson, Ulrica, 1974-, et al.
(author)
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Acceptance of a Nordic, Protein-Reduced Diet for Young Children during Complementary Feeding : A Randomized Controlled Trial
- 2021
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In: Foods. - Basel : MDPI. - 2304-8158. ; 10
-
Journal article (peer-reviewed)abstract
- Early life is critical for developing healthy eating patterns. This study aimed to investigate the effects of a Nordic, protein-reduced complementary diet (ND) compared to a diet following the current Swedish dietary guidelines on eating patterns and food acceptance. At 4–6 months (mo) of age infants were randomized to a Nordic group (NG, n = 41) or a Conventional group (CG, n = 40), and followed until 18 mo of age. Daily intake of fruits and vegetables (mean ± sd) at 12 mo was significantly higher in the NG compared to the CG: 341 ± 108 g/day vs. 220 ± 76 g/day (p < 0.001), respectively. From 12 to 18 mo, fruit and vegetable intake decreased, but the NG still consumed 32% more compared to the CG: 254 ± 99 g/day vs. 193 ± 67 g/day (p = 0.004). To assess food acceptance, both groups were tested with home exposure meals at 12 and 18 mo. No group differences in acceptance were found. We find that a ND with parental education initiates healthy eating patterns during infancy, but that the exposure meal used in the present study was insufficient to detect major differences in food acceptance. This is most likely explained by the preparation of the meal. Nordic produce offers high environmental sustainability and favorable taste composition to establish healthy food preferences during this sensitive period of early life.
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| 10. |
- Johansson, Ulrica, 1974-
(author)
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Complementary feeding based on Nordic foods : effects on nutrient intake, growth, biomarkers and eating behavior
- 2021
-
Doctoral thesis (other academic/artistic)abstract
- Background: Early nutrition is fundamental to growth and development. Infants develop long lasting food preferences very early in life from food exposures when the brain is impressionable and sensory pathways are receptive. Early food experiences from bitter and sour tastes found in fruits and vegetables can establish longlasting food preferences and healthy eating behavior. Fruits and vegetables can protect against future non-communicable diseases such as cardiovascular diseases, type 2 diabetes, overweight, obesity and cancer. Nordic fruits, berries and vegetables offer high environmental sustainability and favorable taste compositionto establish a variety of food preferences. In this thesis, the focus is on early feeding among healthy, full-term infants and how to establish eating based on Nordic foods.Methods: The thesis is based on the randomized, controlled trial Optimized complementary feeding study (OTIS), with three papers on the outcomes of the trial and one validation paper. In the trial, the experimental Nordic group (n=125) consumed a diet based on Nordic foods, reduced in protein whereas the control group (n=125) followed the current nutritional recommendations for infants from the Swedish Food Agency. The Nordic group was exposed to a variety of flavors from Nordic, homemade fruit, berry and vegetable purées according to a taste portion schedule with repeated exposures for 24 days during 4-6 months of age. From 6 to 18 months of age the Nordic group experienced a multicomponent intervention of homemade Nordic baby food recipes, family recipes and protein-reduced baby food products together with parental support through social media. The control group followed the Swedish recommendations on how to introduce taste portions and solid foods and were supplied with commercial baby food products with regular content. At baseline, 9, 12 and 18 months of age anthropometry, blood samples, urine samples, questionnaires and dietary data were collected.Results: Of the 250 infants, 82% (n=206) finished the study until 18 months of age. The attrition rate was higher in the Nordic group (p=0.012). The Nordic group consumed more plant-based foods as fruits, berries, roots and vegetables during the entire study period except at 6 months of age. The protein intake was higher in the control group throughout the study. Plasma urea was higher in the control group as a response to the higher protein intake and plasma folate was higher in the Nordic group as a reflection of the higher fruit and vegetables intake. There were no differences in growth, total energy intake, iron status, breastfeeding durationor any demographic variables between the groups.Conclusions: A Nordic diet, reduced in protein, increasedthe daily intake of fruit, berries, roots and vegetables, establishing a preferable eating pattern lasting over 12 months. Parental support and systematical flavor learning of Nordic foods may have impacted the infants’ dietary intake in the Nordic group. The Nordic diet is both feasible and safe for infants’ growth, nutritional requirements and development during complementary feeding period between 4-18 months of age. Thus, it may serve as a healthy and environmentally sustainable alternative to future infants and their parents.
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| 11. |
- Kaminsky, Elenor, et al.
(author)
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Registered nurses' understandings of emergency medical dispatch center work : A qualitative phenomenographic interview study
- 2021
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In: Nursing and Health Sciences. - : John Wiley & Sons. - 1441-0745 .- 1442-2018. ; 23:2, s. 430-438
-
Journal article (peer-reviewed)abstract
- Non-urgent and urgent telephone nursing services are increasing globally, and phenomenographic research has shown that how work is understood may influence work performance. This descriptive study makes a qualitative inductive investigation of understandings of emergency medical dispatch center work among registered nurses. Twenty-four registered nurses at three mid Swedish emergency medical dispatch centers were interviewed. Analysis based on phenomenographic principles identified five categories in the interviews: (i) Assess, prioritize, direct, or refer; (ii) Facilitate ambulance nursing work; (iii) Perform nursing care; (iv) Always be available for the public; and (v) Have the person behind the patient in mind. The first constitutes the basis of the work. The second emphasizes cooperation with and support for the ambulance staff. The third entails remotely providing nursing care, whilst the fourth stresses serving the entire population. The fifth and most comprehensive way of understanding work involves having a holistic view of the person in need, including person-centered care. Provision of high-quality emergency medical dispatch center work involves all categories. Combined, they constitute a "work map," valuable for reflection, competence development, and introduction of new staff.
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| 12. |
- Lara Gutiérrez, Ariadna, et al.
(author)
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Identification of Candidate Protein Biomarkers for CIN2+ Lesions from Self-Sampled, Dried Cervico-Vaginal Fluid Using LC-MS/MS
- 2021
-
In: Cancers. - : MDPI. - 2072-6694. ; 13:11
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Journal article (peer-reviewed)abstract
- Molecular screening programs for cervical cancer detect the presence of human papilloma virus (HPV) in cell material or vaginal fluids. Persistent infection with high-risk HPV is a necessary pre-requisite, but the majority of infections do not lead to pathological states. Additional biomarkers are needed to increase the specificity of the molecular tests. Here, we have investigated the possibility of detecting protein biomarkers using mass spectrometry from dried self-sampled cervico-vaginal fluid deposited on FTA cards. We found significant intra-individual correlations (p < 2.2 × 10-16), although heterogenous protein profiles were obtained between individuals. Out of 3699 proteins found in total, 169 were detected in at least 95% of the samples. Using a discovery/replication design, 18 proteins were found to be significant in the discovery cohort, with higher values in those cases compared to controls. All of these were found to also have higher levels among the cases in the replication cohort, with one protein (DEAD-Box Helicase) remaining statistically significant. Finally, a predictive 7-protein multivariate model was developed with a sensitivity and specificity of 0.90 and 0.55, respectively. Our results demonstrate that robust measurements of protein biomarkers can be obtained from self-sampled dried CVF and that these could be used to predict cervical cancer pre-stages.
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| 13. |
- Lindberg, Inger, et al.
(author)
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"Taken by surprise" : Women's experiences of the first eight weeks after a second degree perineal tear at childbirth
- 2020
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In: Midwifery. - : Elsevier. - 0266-6138 .- 1532-3099. ; 87
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Journal article (peer-reviewed)abstract
- OBJECTIVE: This study explores women's experience of having a second degree perineal tear and related consequences to daily life during the first eight weeks after childbirth.METHOD: Written responses to open-ended questions in a questionnaire distributed about eight weeks postpartum and completed by 1,007 women with second degree perineal tears were excerpted from the national quality register, Perineal Laceration Register. Inductive qualitative content analysis was applied to the data.RESULT: The theme Taken by surprise illustrates women's experience of the first two months after having a second degree perineal tear at childbirth. Women were not prepared for the inconveniences and expressed concerns about their bodies. Further, they expressed distress about their physical and psychological recovery as well as how to return to a pre-childbirth condition.CONCLUSIONS: Although many women recovered fairly well the first months after a second degree perineal tear at childbirth, it was evident that a substantial number of women were unprepared for the pain and discomfort they experienced. It is apparent that also women with the "minor" perineal tears at childbirth need improved postpartum care with tailored analgesia and improved information, but also check-ups and reassurance of recovery from healthcare professionals. Health care professionals need to identify women with persisting problems so that they can be referred to inpatient care for additional assessments of the injury.
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| 14. |
- Lindberg, Inger, et al.
(author)
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Taken by surprise
- 2020
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In: Midwifery. - : ELSEVIER SCI LTD. - 0266-6138 .- 1532-3099. ; 87
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Journal article (peer-reviewed)abstract
- Objective: This study explores womens experience of having a second degree perineal tear and related consequences to daily life during the first eight weeks after childbirth. Method: Written responses to open-ended questions in a questionnaire distributed about eight weeks postpartum and completed by 1,007 women with second degree perineal tears were excerpted from the national quality register, Perineal Laceration Register. Inductive qualitative content analysis was applied to the data. Result: The theme Taken by surprise illustrates womens experience of the first two months after having a second degree perineal tear at childbirth. Women were not prepared for the inconveniences and expressed concerns about their bodies. Further, they expressed distress about their physical and psychological recovery as well as how to return to a pre-childbirth condition. Conclusions: Although many women recovered fairly well the first months after a second degree perineal tear at childbirth, it was evident that a substantial number of women were unprepared for the pain and discomfort they experienced. It is apparent that also women with the "minor" perineal tears at childbirth need improved postpartum care with tailored analgesia and improved information, but also check-ups and reassurance of recovery from healthcare professionals. Health care professionals need to identify women with persisting problems so that they can be referred to inpatient care for additional assessments of the injury. (C) 2020 Elsevier Ltd. All rights reserved.
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| 15. |
- Lindberg, Viveca, 1954-, et al.
(author)
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Betyg och betygssystem förr och nu
- 2021
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In: Ämneslärarens arbete. - Stockholm : Natur och kultur. - 9789127828902 ; , s. 409-447
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Book chapter (other academic/artistic)abstract
- Bedömning av elevers kunskaper – eller snarare deras prestationer så som de kommer till uttryck vid ett specifikt tillfälle – utgör en central del av lärares arbete. Frågan om svårigheterna med betygssättning är inte specifika för 2000-talet, dagens utmaningar kan spåras tillbaka till 1940-talets betygsutredningar. Genom att sätta ett betyg ges en signal om hur väl en elev har tillgodogjort sig undervisningen i ett visst ämne vid en viss tidpunkt men också givet den form för prövning som läraren väljer. Detta val styrs både av ämnets traditioner och ämnets karaktär. Betyget har på detta sätt en informerande funktion. I de policytexter som skriver fram betygens funktion betonas också att betygen ska ha en motiverande funktion. Samtidigt har betygen även andra funktioner som lärare inte nödvändigtvis har i fokus vid betygssättningen. Exempelvis har det slutliga betyget som ges från grundskolan respektive gymnasieskolan en urvalsfunktion när det gäller till vilka utbildningar eleven kan söka. Hur riktlinjerna för betygssättning utformas, vad som utgör referenspunkt för lärarnas bedömning och hur en sådan referenspunkt är tänkt att användas skapar både möjligheter och begränsningar för lärares betygssättande arbete. Syftet med det här kapitlet är att ge en inblick i dagens betyg med grund i hur olika frågor och problem har hanterats över tid, huvudsakligen i Sverige. I kapitlet ges en bild över betygens utformning och funktion i folkskolan och läroverken fram till dagens skolformer och reformer.
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| 16. |
- Lindberg, Viveca, 1954-, et al.
(author)
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Kunskapsprodukter för lärarprofessionen : skolforskningsinstitutets projekt 2016 och 2017
- 2023
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In: Forskning om undervisning och lärande. - 2000-9674 .- 2001-6131. ; 11:3, s. 58-84
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Journal article (peer-reviewed)abstract
- Syftet med denna artikel är att beskriva och diskutera vilka, för lärare, användbara ochrelevanta kunskapsprodukter som har genererats i 11 forskningsprojekt, finansieradeav Skolforskningsinstitutet och beviljade år 2016 och 2017. Forskningsfrågorna är: Vad iresultaten kan ses som kunskapsprodukter och vilken karaktär har dessa? På vilka sätt harlärare medverkat i processen att ta fram dessa kunskapsprodukter? Sammantaget har 55öppet tillgängliga granskade publikationer analyserats. Sex kvalitativt skilda kategorierav kunskapsprodukter har identifierats: 1) Kunnanden och förmågor, 2) Undervisnings- ochlektionsdesign, 3) Didaktiska exempel, 4) Redskap, 5) Processer och metaperspektiv och 6)Generella eller kontextuella förutsättningar. Graden av medverkan från lärares sida har varieratavsevärt; från en aktiv medverkan, där lärare och forskare samarbetar på likvärdigavillkor, till en låg grad, där lärare primärt fungerar som bollplank eller forskningsobjekt.
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| 17. |
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| 18. |
- Mattisson, Marie, 1968-
(author)
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"I'm calling for hope, comfort and maybe some advice..." : Interaction and caller satisfaction in telenursing
- 2023
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Doctoral thesis (other academic/artistic)abstract
- Background: The provision of nursing over the telephone is an appreciated asset in many parts of the world. Interaction between telenurse and caller is important for caller satisfaction, and satisfaction in turn is positively related to outcomes such as adherence, engagement in self-care and well-being. Despite the long history of telehealth services, research about interaction in telenursing is still in a developmental stage.Aim: The overall aim of the thesis was to develop a questionnaire that enables valid and reliable exploration of telenurse–caller interaction, and caller satisfaction with calls, and to explore interaction and its importance for caller satisfaction.Methods: The thesis applied a deductive approach based on a theoretical nursing model; the Interaction Model of Client Health Behavior (IMCHB). Interaction in the IMCHB, is divided into four components: health information, affective support, decisional control, and professional-technical competencies. In the first study (I), the Telenursing Interaction and Satisfaction Questionnaire (TISQ) was developed. Variables were identified through a literature review, structured according to the IMCHB, and worded as questionnaire items. Content validity was evaluated with input from cognitive interviews with callers, and professionals using the Content Validity Index (CVI). A consecutive sample of 1,400 callers received the TISQ by post, and test-retest reliability of single items was evaluated. In Study two (II), 25 items from the TISQ focusing on interaction between callers and telenurses were selected to form the Telenursing Interaction and Satisfaction Scale (TISS), a scale for the measurement of caller satisfaction with interaction in four subscales according to the IMCHB. Psychometric properties of the TISS were evaluated with a focus on data quality, factor structure, convergent validity, and reliability. In Study three (III), caller satisfaction with interaction (i.e., TISS scores) and their associations to overall satisfaction with calls were explored using descriptive statistics, repeated measures ANOVA and ordinal logistic regression models. In Study four (IV), 30 transcripts of authentic calls were analysed using content analysis with directed approach. A coding scheme based on the four components of interaction in the IMCHB was developed and applied for deductive categorisation of data. Manifest content of conversations (n = 37,447 words) was presented quantitatively and qualitatively. In addition, data was coded and analysed in relation to phases in the conversation process for telenursing: opening, listening, analysing, motivating, and ending.Results: The 60 item TISQ showed good content validity in the telenursing setting (I), with a Scale-CVI of 0.91. Test–retest reliability of single items was moderate to good (I). TISS-data deviated significantly from a normal distribution, but all response options were endorsed (II). The confirmatory factor analysis confirmed the four-factor structure of the TISS, and factor correlations were high (rs = 0.88 to 0.96) (II). A higher order model showed marginally deteriorated model fit values (II). Ordinal alpha, scale reliability, and test–retest reliability were satisfactory for all scales, and convergent validity was satisfactory (II). Callers expressed the highest level of satisfaction with affective support, while their satisfaction with decisional control was comparatively lower (III). Callers’ satisfaction with interaction was positively associated with overall satisfaction with calls, even when considering experienced waiting time, main result of the call, fulfilment of expectations, age, gender, self-rated health status and time of call (III). A total of 97% of manifest words in conversations were identified as nursing interaction based on the IMCHB (IV). Health information was the primary focus, particularly during the listening and analysing phases (IV). Affective support was the least prominent component, and callers’ reactions to advice were seldom discussed (IV). The opening phase was the shortest, and analysing phase the most word consuming (IV).Conclusions: The TISQ, including the TISS, provide a valid and reliable questionnaire for the study of telenurse-caller interaction, and caller satisfaction. Caller satisfaction with the interaction can be measured using the four subscales in the TISS. In cases where there is a problem with multicollinearity, a total scale score from the TISS can be utilized. All four components of interaction in the IMCHB play a crucial role in determining overall caller satisfaction with calls. Therefore, the development of interaction in telenursing need to consider all four components. The exchange of health information presents challenges for both telenurses and callers, and affective support can be provided to callers without verbalizing emotions. Among the four components, decisional control may have the largest potential for improvement in the studied setting. This can be achieved by acknowledging callers’ reactions to advice.
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| 19. |
- Nordmark, Sofi, et al.
(author)
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“It’s all about time and timing”: nursing staffs’ experiences with an agile development process, from its initial requirements to the deployment of its outcome of ICT solutions to support discharge planning
- 2022
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In: BMC Medical Informatics and Decision Making. - : Springer Nature. - 1472-6947. ; 22
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Journal article (peer-reviewed)abstract
- BackgroundAgile projects are statistically more likely to succeed then waterfall projects. The overall aim of this study was to explore the nursing staffs’ experiences with an agile development process, from its initial requirements to the deployment of its outcome of ICT solutions aimed at supporting discharge planning.MethodsAn explorative design with quantitative and qualitative methods was used. Qualitative data was collected through seven focus group interviews. Quantitative data was collected via an ICT-system, and with an evaluation form submitted by fourteen registered nurses and nine district nurses.ResultsQualitative result of the experiences with the agile development process and its outcome resulted in one theme, four categories, and ten subcategories. The theme was found to be about time and timing, namely the amount of time for the different activities and the timing of activities within and between organisations. The agile development process increased the participants’ readiness for change by offering time to learn, practice, engage and reflect, and then adopt the ICT as a support to daily practice. Quantitative results showed a variated adoption of the ICT.ConclusionThere is a need for time to prepare, understand and adopt new tools, services and procedures and a need for additional time to prepare, understand and adopt the new among individuals, collectives, organizations, and sometimes even between different collectives or organizations. The agile development process offered the end-users involvement through the development process, which gave them time to change it both individually and collectively. However, there is a need for close collaboration between the development project team and management to reach an organizational change that is timely for both the individual and the collective change. When time or timing fails in the development or implementation process, there is a huge risk of non-adoption of new tools, services, or procedures or among the end-users.
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| 20. |
- Persson, Margareta, et al.
(author)
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Regional and clinical guidelines for prevention and care of obstetric anal sphincter injuries - A critical frame analysis
- 2023
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In: Midwifery. - : Elsevier. - 0266-6138 .- 1532-3099. ; 119
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Journal article (peer-reviewed)abstract
- Objective: Policy documents govern how the prevention and care of obstetric anal sphincter injuries (OASIS) are implemented. Thus, in the absence of Swedish national guidelines on OASIS, differing views may be visible in the regional and local policy documents. Therefore, we aimed to analyse regional and local policies, guidelines, and care programs on the prevention of OASIS and care for OASIS-affected women in a Swedish context by applying a critical frame analysis inspired by Verloo.Design and setting: A cross-sectional study of existing policy documents from Swedish healthcare regions was performed. The documents were analysed using Verloo's critical frame analysis.Findings: We found that OASIS was framed as a preventable problem addressed by skilled protective manoeuvres of the healthcare staff. Education, communication, and teamwork were three frames of crucial solutions to minimise the prevalence of OASIS. However, complicating power dimensions between professional groups and between professionals and birthing women were identified. Furthermore, several discursive struggles were found, predominantly regarding the scientific evidence for the suggested prevention and care.Conclusion: The policy documents emphasised that OASIS is preventable, and improved education, communication, and teamwork could diminish the OASIS prevalence. Nevertheless, power dimensions and discursive struggles may challenge the preventive efforts. Furthermore, each Swedish region has the sovereignty to develop its policies, which was reflected in our findings and may imply inequities in care provision. Thus, there is an urgent need to develop comprehensive national high-quality guidelines of high quality for OASIS prevention and care so that all women giving birth have access to equal care and treatment in Sweden.
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| 21. |
- Tjernström, Katharina, et al.
(author)
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Negotiating the ambiguity of an (in)authentic working life : a grounded theory study into severe perineal trauma
- 2023
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In: BMC Women's Health. - : BioMed Central (BMC). - 1472-6874. ; 23:1
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Journal article (peer-reviewed)abstract
- Background: In Sweden, persistent physical and psychological health problems occur in about three in ten women who sustain severe perineal trauma (SPT) during childbirth. As most Swedish women work outside the home, the question of if and how SPT-related morbidity influences working life needs exploration. This study aims to qualitatively explore how women with persistent SPT-related morbidities experience and conceptualise their problems concerning working life. Further, we theorise the findings by applying Simone de Beauvoir’s feminist framework of immanence and transcendence as well as authentic and inauthentic life.Methods: Ten interviews with women recruited via a Swedish social media community for perineal trauma were analysed according to Charmaz’s constructivist approach to grounded theory.Results: The theoretical model and related core category ‘Negotiating the ambiguity of an (in)authentic working life’ reflected the women’s negotiations of immanence as ‘the silent covert object’ versus transcendence as the ‘the resourceful overt subject’. The model also mirrored the conflict of (in)authenticity in working life. An inauthentic working life was experienced when women were denied their subjectivity at work or constructed themselves as subjects in denial of their SPT. On the other hand, women who acknowledged their SPT and were constructed as subjects by ‘others’ achieved an authentic working life despite SPT.Conclusions: The conflicting gendered process of ‘the silent covert object’ versus ‘the resourceful overt subject’ problematised women’s vulnerability at work. Aspects that enable subjectification and transcendence are essential for policymakers, employers, healthcare services, and society to eradicate the taboo of SPT and create a working environment characterised by understanding, support, and flexibility. Further, access to adequate care, sick leave, and occupational rehabilitation are essential. Such measures support transcendence towards an authentic working life and, consequently, a more gender-equal working environment that does not deprive women of career opportunities due to a physical ailment.
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| 22. |
- Tjernström, Katharina, et al.
(author)
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Overlooked by the obstetric gaze - how women with persistent health problems due to severe perineal trauma experience encounters with healthcare services : a qualitative study
- 2024
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In: BMC Health Services Research. - : BioMed Central (BMC). - 1472-6963. ; 24:1
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Journal article (peer-reviewed)abstract
- BACKGROUND: During the first year postpartum, about 25 per cent of Swedish women with severe perineal trauma (SPT), i.e., a third- or fourth-degree perineal laceration at childbirth, are unsatisfied with their healthcare contacts. Further, there is a lack of research on the more long-term experiences of healthcare encounters among women with persistent SPT-related health problems. This study explores how women with self-reported persistent SPT-related health problems experience their contact with healthcare services 18 months to five years after childbirth when the SPT occurred.METHODS: In this descriptive qualitative study, a purposive sample of twelve women with self-reported persistent health problems after SPT were individually interviewed from November 2020 - February 2022. The data was analysed using inductive qualitative content analysis.RESULTS: Our results showed a paradoxical situation for women with persistent health problems due to SPT. They struggled with their traumatised body, but healthcare professionals rejected their health problems as postpartum normalities. This paradox highlighted the women's difficulties in accessing postpartum healthcare, rehabilitation, and sick leave, which left them with neglected healthcare needs, diminished emotional well-being, and loss of financial and social status. Our results indicated that these health problems did not diminish over time. Consequently, the women had to search relentlessly for a 'key person' in healthcare who acknowledged their persistent problems as legitimate to access needed care, rehabilitation, and sick leave, thus feeling empowered.CONCLUSIONS: Our study revealed that women with persistent SPT-related health problems experienced complex health challenges. Additionally, their needs for medical care, rehabilitation, and sick leave were largely neglected. Thus, the study highlights an inequitable provision of SPT-related healthcare services in Sweden, including regional disparities in access to care. Hence, the authors suggest that Swedish national guidelines for SPT-related care need to be developed and implemented, applying a woman-centered approach, to ensure equitable, effective, and accessible healthcare.
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| 23. |
- Zou, Zhiyuan V., et al.
(author)
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Genomic profiling of the transcription factor Zfp148 and its impact on the p53 pathway
- 2020
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In: Scientific Reports. - : Springer Science and Business Media LLC. - 2045-2322. ; 10:1
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Journal article (peer-reviewed)abstract
- Recent data suggest that the transcription factor Zfp148 represses activation of the tumor suppressor p53 in mice and that therapeutic targeting of the human orthologue ZNF148 could activate the p53 pathway without causing detrimental side effects. We have previously shown that Zfp148 deficiency promotes p53-dependent proliferation arrest of mouse embryonic fibroblasts (MEFs), but the underlying mechanism is not clear. Here, we showed that Zfp148 deficiency downregulated cell cycle genes in MEFs in a p53-dependent manner. Proliferation arrest of Zfp148-deficient cells required increased expression of ARF, a potent activator of the p53 pathway. Chromatin immunoprecipitation showed that Zfp148 bound to the ARF promoter, suggesting that Zfp148 represses ARF transcription. However, Zfp148 preferentially bound to promoters of other transcription factors, indicating that deletion of Zfp148 may have pleiotropic effects that activate ARF and p53 indirectly. In line with this, we found no evidence of genetic interaction between TP53 and ZNF148 in CRISPR and siRNA screen data from hundreds of human cancer cell lines. We conclude that Zfp148 deficiency, by increasing ARF transcription, downregulates cell cycle genes and cell proliferation in a p53-dependent manner. However, the lack of genetic interaction between ZNF148 and TP53 in human cancer cells suggests that therapeutic targeting of ZNF148 may not increase p53 activity in humans.
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