| 1. |
- Carlsson, Noomi
(author)
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A Zero-vision for Children’s Tobacco Smoke Exposure : Tobacco prevention in Child Health Care
- 2012
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Doctoral thesis (other academic/artistic)abstract
- Adverse health effects in children caused by environmental tobacco smoke (ETS) are well known. Children are primarily exposed by their parents’ smoking in their homes. A comprehensive evidence base shows that parental smoking during pregnancy and ETS exposure in early childhood are associated with an increased risk for a range of adverse health problems. Child Health Care nurses, who meet nearly all families in Sweden with children aged 0-6 years, have thus an important role in tobacco preventive work in order to support parents in their ambitions to protect their children from ETS exposure.The overall aim of this thesis was to develop, test and evaluate a new model for tobacco preventive work in Child Health Care (CHC) with special focus on areas with a high prevalence of parental smoking. In a first step CHC nurses’ and parents’ views on tobacco preventive work were analysed in two studies based on questionnaires.The intervention was performed during the second step, based on the results from nurses’ and parents’ experience of the tobacco preventive work in CHC, and with methods from Quality Improvement. An “intervention bundle” was developed which included evidence based methods for prevention of ETS exposure, and four learning sessions for the nurses. The instrument “Smoking in Children’s Environment Test” (SiCET) included in the bundle was evaluated with focus group interviews with the CHC nurses who participated in the intervention. Two urine samples were analysed to measure cotinine levels in children which provide an estimate for ETS exposure. Parents’ answers from the SiCET questionnaire, measurements of cotinine, and data from the nurses’ log-books were used in the evaluation of the effects of the intervention. In areas with a high prevalence of parental smoking 22 nurses recruited 86 families of whom 72 took part for the entire one-year period of the intervention.The results showed that parents wanted to have information on the harmful effects tobacco smoke have on their children and how they can protect their children from ETS exposure. The nurses saw tobacco preventive work as important but they experienced difficulties to reach certain groups such as fathers, foreign-born parents, and those who are socio-economically disadvantaged. The SiCET instrument provided a basis for dialogue with parents. The main results from the intervention showed that ten parents (11%) quit smoking, thirty-two families (44%) decreased their cigarette consumption in the home, and fewer children were exposed to tobacco smoke. Consequently, more children showed levels of urinary cotinine less than 6 ng/ml (base-line n=43, follow up n=54; p=0.05). The total number of outdoor smokers did not change. Seven of the nurses (30%) had successful results in their areas with a decrease of smokers in families with a child of 8 months, from 20% in 2009 to 12% in 2011. The corresponding figures for the whole county as well as the country did not decrease during the same period.The sustainability of the intervention has to be followed and thus measures should be followed prospectively over time. The SiCET instrument was found useful and might be applicable in other arenas where children’s ETS exposure is discussed. The development of an instant cotinine test using dipsticks would make it possible to give parents immediate feedback on the effectiveness of taken protective actions. This could work as a pedagogic resource in the dialogue with parents.
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| 2. |
- Grandin, Martina, 1980-
(author)
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Tribology of Metal-Graphite Composites : A Study of Sliding Electrical Contact Surfaces
- 2017
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Doctoral thesis (other academic/artistic)abstract
- An environmentally sustainable production of electrical power is important for preserving the earth’s natural resources. In order to utilize this power as efficiently as possible, it is of great importance to minimize the losses, for example in sliding electrical contacts. A sliding electrical contact is where current is transferred from one rotating to one stationary component and power is lost due to friction and contact resistance. Also in some signal applications, high performance sliding contacts are crucial to ensure stable signal transfer with low noise. Although sliding electrical contacts are primarily designed for good electrical performance, the system will benefit also from optimization of the tribological properties.The aim of this thesis is to increase the fundamental knowledge of the tribological and electrical performance of metal-graphite composite materials for sliding electrical contacts. The influence of mechanical and electrical load was investigated. Different stationary materials, from pure copper to nanocomposite coatings, were tested against copper- and silver-graphites. Two complementary test setups were used, one with reciprocating and one with unidirectional sliding. Surface analysis was essential to gain deepened understanding of the influence of the interaction on the surfaces. Especially my novel imaging of cross-sections has advanced the level on knowledge in this research field.On the stationary material surface, a tribofilm forms with constituents from the metal-graphite and the surrounding atmosphere. Cross-sectioning reveals a material flow that indicates turbulence. Furthermore, the presence of oxides in the tribofilm is not necessarily detrimental for the contact resistance as long as there is also pure metal available. The presence of graphite is vital for low friction and wear. It is shown that the tribological and electrical behaviour of this system is only marginally influenced by the material selection of the stationary contact. Increasing the metal content in the composite, on the other hand, greatly reduces the contact resistance while there is no significant impact on friction and wear. The mechanical load has to be optimized to compromise between low wear (achieved with low load) and low contact resistance (achieved with high load). Pure mechanical tests show a lower friction and higher wear rate in comparison to tests with a five ampere current.
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| 3. |
- Lindell, Charlotta, 1970-
(author)
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Child physical abuse : Reports and interventions
- 2005
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Doctoral thesis (other academic/artistic)abstract
- This thesis was begun in 1998 at a time when increased numbers of police reports regarding child physical abuse was presented. The increase had been overshadowed by the research on the sexual abuse of children and showed that child physical abuse in Sweden had only been scarcely investigated since the institution of the Swedish anti spanking law in 1979.The aim of this thesis was to investigate child physical abuse from a judicial, social, child- and adolescent psychiatric and a user perspective where a parent or equivalent was the perpetrator. One police district was investigated between 1986 and 1996 and all reports regarding child physical abuse were included. The abused children (n=126) were also followed through social services’ files and child and adolescent psychiatric service charts from birth to a 4-year follow up from the abuse incident studied. Finally, mothers of the physically abused children were interviewed.The greatest increase in police reports during the years investigated, turned out to be concerned with violence between children. The incidence where a carer was the abuser proved to be comparable to the incidence in other Nordic countries, with the adjustment that first generation immigrants were found to abuse their children 8 times as often as native Swedish citizens and second generation immigrants. There were a wide variety of injuries inflicted on the children, where bruises were the most common. Only a few cases where injuries could be verified ended up in court. Social services contact was common among the abused children and their families prior to the abuse incident studied, as were previous reports on child abuse and neglect. Injuries from the abuse as well as familial and context characteristics had an impact on referred social services interventions. The two most important factors for a child still to be receiving social services interventions 4 years after the abuse incident were whether the mother was mentally ill and whether there had been reports on child abuse or neglect prior to the studied abuse incident. About half of the children had been receiving interventions from the mental health services at some point in time, but mainly due to other reasons than physical abuse. Mental health treatment for the physically abused children was rare even though many of the children had contact with the child and adolescent psychiatric services repeatedly before, at and after the abuse incident. The interviewed mothers conveyed a picture of satisfaction with the police’s work but were mainly critical towards the social services. The mental health service was considered to be doing a good job, but needed to do even better.The results indicate that despite an environment that supports public values, attitudes and laws confirming a standpoint against violence towards children, there is still a gap between intentions and reality in Sweden. The thesis provides one way of looking at child physical abuse, but puts forward the urgent need of further studies.
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| 4. |
- Olofsson, Niclas
(author)
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Violence through the life cycle : A public health problem
- 2012
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Doctoral thesis (other academic/artistic)abstract
- Background: Violence has probably always been part of the human experience. Its impact can be seen, in various forms, in all parts of the world. In 1996, WHO:s Forty-Ninth World Health Assembly adopted a resolution , declaring violence a major and growing public health problem around the world. Public health work centers around health promotion and disease prevention activities in the population and public health is an expression of the health status of the population taking into account both the level and the distribution of health. Exposure to violence can have many aspects, differing throughout the life course — deprivation of autonomy, financial exploitation, psychological and physical neglect or abuse — but all types share common characteristics: the use of destructive force to control others by depriving them of safety, freedom, health and, in too many instances, life; the epidemic proportions of the problem, particularly among vulnerable groups; a devastating impact on individuals, families, neighborhoods, communities, and society.Methods: Three different data sources were used in the four articles, three cross-sectional studies (“Life and Health in Norrland” and “Health on Equal Terms 2004 and 2006”) and one longitudinal (“Level-of-Living Survey”).Results: We present an important picture of the strong association between exposure to violence and ill health through the life cycle. A population-based study showed an increased risk of poorer physical and psychological health among boys and girls aged 0-18, as reported by their mothers exposed to violence. Further, a strong association between those exposed to violence and physical and mental ill health was demonstrated in young adults aged 18-25, also after adjusting for possible confounders, specifically for women. Even in an elder group aged 65-84, representative results showed an extensive negative health outcome panorama caused by fear of crime and exposure to abuse both in elderly men and women. Lastly, in trying to provide additional empirical support for the association between exposure to violence and ill health the prospective study demonstrated that violence exposure in adolescence and young adulthood presented a negative association to severe illness burden in adulthood for women but not men.Conclusion: Exposure to violence among both men and women is an important risk factor for ill health and should receive greater attention in public health work. A strong association between violence and various health outcomes was demonstrated in different time periods through the life cycle.
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| 5. |
- Lind, Alexander, et al.
(author)
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Anxiety, depression and quality of life in relation to SARS-CoV-2 antibodies in individuals living with diabetes during the second wave of COVID-19
- 2024
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In: Diabetes epidemiology and management. - : Elsevier. - 2666-9706. ; 13
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Journal article (peer-reviewed)abstract
- Aims: The objective was to compare anxiety, depression, and quality of life (QoL) in individuals living with type 1 (T1D) and type 2 (T2D) diabetes with matched controls during the second wave of the COVID-19 pandemic.Methods: Via randomization, individuals living with diabetes T1D (n = 203) and T2D (n = 413), were identified during February-July 2021 through health-care registers. Population controls (n = 282) were matched for age, gender, and residential area. Questionnaires included self-assessment of anxiety, depression, QoL, and demographics in relation to SARS-CoV-2 exposure. Blood was collected through home-capillary sampling, and SARS-CoV-2 Nucleocapsid (NCP) and Spike antibodies (SC2_S1) were determined by multiplex Antibody Detection by Agglutination-PCR (ADAP) assays.Results: Younger age and health issues were related to anxiety, depression, and QoL, with no differences between the study groups. Female gender was associated with anxiety, while obesity was associated with lower QoL. The SARS-CoV-2 NCP seroprevalence was higher in T1D (8.9 %) compared to T2D (3.9 %) and controls (4.0 %), while the SARS-CoV-2 SC2_S1 seroprevalence was higher for controls (25.5 %) compared to T1D (16.8 %) and T2D (14.0 %).Conclusions: A higher SARS-CoV-2 infection rate in T1D may be explained by younger age and higher employment rate, and the associated increased risk for viral exposure.
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| 6. |
- Mindedal, Annika, 1958-
(author)
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Texter i NO - finns de? : En studie om textanvändning och textrelaterade samtal i ett fysiktema i skolår 5
- 2011
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Licentiate thesis (other academic/artistic)abstract
- This thesis describes a field study in which one teacher and one class in Grade 5, with special focus on four pupils, are observed throughout four lessons of about 80-minutes in Physics. The lessons together deal with a project on Magnetism. The main aim of the thesis is to investigate how the teacher uses texts as a resource when designing and implementing Science lessons (Learning Design Sequences). A further aim is to study what texts are used and produced by both the teacher and the pupils, and how these texts are used. The four lessons were recorded with a video camera and the recordings supplemented by field notes and interviews. All the texts used were copied or photographed. A design theoretical frame and a sociocultural perspective have been applied to analyse both the presence of texts during different stages (activities) of the lessons, and to analyse the text-related interaction and communication that has taken place in the classroom. The results confirm several previous studies and show that the teacher is the main producer and consumer of texts before and during the Science lessons. Textbooks, and texts on the Internet, are only used by the teacher to design the lessons, and are then mediated by the teacher during classroom interaction. The pupils mainly read questions, which they write brief answers to, and also read and copy texts written by the teacher on the white board. One interesting finding is that dialogue concerning texts increases the scientific content, which means more empirical or theoretical descriptions and explanations. To become scientifically literate it is therefore argued that pupils need more practice reading and writing in combination with dialogue and activities in the science classroom.
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| 7. |
- Wolfe, Ingrid, 1966-
(author)
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Child Health, Health Services and Systems in UK and other European countries
- 2015
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Doctoral thesis (other academic/artistic)abstract
- BackgroundThis work in child population medicine describes child health problems, increases knowledge of health services, systems, and wider determinants, and makes recommendations for improvements.AimsTo explore trends in UK child health and health service quality and highlight policy lessons from the UK and other European countriesTo study child health and health services in western Europe and derive lessons from different approaches to common challengesTo enhance knowledge on child to adult transition careTo describe trends in UK and EU15+ child and adolescent mortality and seek explanations for deteriorating UK health system performance, and make recommendations for improving survivalMethodsPopulation level measures of health status and system performance; primary and secondary research on policies and practice for health system assessments. Quantitative: mortality rate trends, excess deaths, DALYs, healthcare processes Qualitative: case reports, system descriptions, analyses ResultsEuropean child survival has improved, but variably between countries. The UK has not matched recent EU mortality gains. There are 6,000 excess deaths annually in children under 15 years in EU14 countries. There are child survival inequities; countries investing in social protection have lower mortality. Children in the UK, compared with other EU countries, are more likely to be poor than adults.Non-communicable diseases are now dominant causes of child death, disease, and disability.Mortality, processes, and outcomes of healthcare amenable conditions varies between countries. Better outcomes seem to be associated with flexible health care models promoting cooperation, team working, and transition.ConclusionsChild health in Europe is improving, but unevenly. Child health systems are not adapting sufficiently to meet needs. Recommendations are made for improving health systems and services.
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