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- Klope, Eva, 1972-
(author)
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Respektabla frisörer : Femininitet och (yrkes)identitet bland tjejer i gymnasieskolans frisörutbildning
- 2020
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Doctoral thesis (other academic/artistic)abstract
- The aim of this thesis is to contribute with knowledge on how adolescent girls in VET for hairdressers in Swedish Upper Secondary School negotiate and perform (vocational) identities from a class- and gender perspective with special focus on femininity. This is done through ethnographical fieldwork where 18 female students and their vocational teachers were observed for four months. Theoretically the study is inspired by feminist poststructuralist theory together with theory of how working-class women act to become respectable, since class and gender must be fused together to produce an accurate representation of power relations. The results show how the girls position themselves as beauty experts and this expertise involves transforming people to appear in accordance with gendered- and classed beauty norms. To be recognized as a hairdresser-girl the students are supposed to look nice and feminine. The hairdresser’s body and image are described as a trade-mark to be used to look profesional. Moreover, through cleaning-tasks the girls are expected to act as hardworking respectable subjects and to make the practice respectable. The hairdresser student is also positioned as a female entrepreneur, that is constructed through two different discourses. One depicts the vocation as a glamorous profession to love. The other as hard work, low wages, and a craft that requires many hours of education. The meanings of men's absence in VET for hairdressers are also explored. The girls maintain the men’s privileged positions through stories which describe male hairdressers as more skillful. A school class consisiting of girls only is described as problematic where conflicts and ‘drama’ were explained by gender, and caused by the absence of boys. One conclusion of the thesis is that traditionally feminine coded performances, such as careing, being nice, and doing good is reshaped in a neoliberal time where notions of a competitive, strong, and self-governing girl is the one that has become the ideal hairdresser. The position of a self-governing girl neglects issues of class and gender, since discourses of Girl Power position girls in a way that the individual subject owns their success, and that we are living in an equal society.
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| 2. |
- Ackesjö, Helena, 1973-
(author)
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Barns övergångar till och från förskoleklass : Gränser, identiteter och (dis-)kontinuiteter
- 2014
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Doctoral thesis (other academic/artistic)abstract
- The overall aim of this study is to gain knowledge of how the transitions to and from preschool class are described and understood by children. Previous research has indicated that transitions between different school forms can be seen as both problematic and threatening. Transitions should be facilitated and "smooth", something that indicates that continuity is important. Of interest for this study is to gain knowledge of children's perspective of continuities: which continuities and discontinuities children express intransitions.Transitions are theoretically considered as social processes that are constructed, shared and reconstructed together with others. In these processes, children mark and construct borders through speech and action. Their border markings (for example, expression of differences and/or similarities between different communities and between different school forms) also become part of a child's identity constructions.The thesis is based upon the research described in three articles. The empirical data underlying these studies was constructed in a longitudinal ethnographic inspired field work where children have been observed in two transitions between three different school forms: preschool, preschool class and compulsory school.Results suggest that from children’s perspectives the transitions between different school forms contain challenges, opportunities, limitations, changes and preservation. However, the transitions also involve expressions concerning security, risk-taking and include visual markings between the different school forms.One of the conclusions that can be drawn from this work is that it isn’t enough to turn to policy level, such as curricula or even teachers’ aims or aspirations to facilitate these transitions. The child’s perspectives need to be taken into account. Through children's narratives, we have gained knowledge about the opportunities transitions can offer, but also how transitions can be considered as threats or be difficult to interpret for children. This study has also increased our understanding of the importance of continuity as well as discontinuity to mark borders between different school forms.
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| 3. |
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| 4. |
- Arvidsson, Sandra, 1986-
(author)
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Cardiac function in hereditary transthyretin amyloidosis : an echocardiographic study
- 2016
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Doctoral thesis (other academic/artistic)abstract
- Background: Hereditary transthyretin amyloidosis (ATTR) is a lethal disease in which misfolded transthyretin (TTR) proteins accumulate as insoluble aggregates in tissues throughout the body. A common mutation is the exchange of valine to methionine at place 30 (TTR V30M), a form endemically found in the northern parts of Sweden. The main treatment option for ATTR amyloidosis is liver transplantation as the procedure halts production of mutated transthyretin. The disease is associated with marked phenotypic diversity ranging from predominant cardiac complications to pure neuropathy. Two different types of fibril composition – one in which both fragmented and full-length TTR are present (type A) and one consisting of only full-length TTR (type B) have been suggested to account for some phenotypic differences. Cardiac amyloidosis is associated with increased myocardial thickness and the disease could easily be mistaken for other entities characterised by myocardial thickening, such as sarcomeric hypertrophic cardiomyopathy (HCM). The aims in this thesis were to investigate echocardiographic characteristics in Swedish ATTR amyloidosis patients, and to identify markers aiding in differentiating ATTR heart disease from HCM. Another objective was to examine the impact of fibril composition and sex on the phenotypic variation in amyloid heart disease.Methods: A total of 122 ATTR amyloidosis patients that had undergone thorough echocardiographic examinations were included in the studies. Analyses of ventricular geometry as well as assessment of systolic and diastolic function were performed, using both conventional echocardiographic methods and speckle tracking technique. ECG analysis was conducted in study I, allowing measurement of QRS voltage. In study I and study II ATTR patients were compared to patients with HCM. In addition, 30 healthy controls were added to study II.Results: When parameters from ECG and echocardiography were investigated, the results revealed that the combination of QRS voltage <30 mm (<3 mV) and an interventricular/posterior wall thickness quotient <1.6 could differentiate cardiac ATTR amyloidosis from HCM. Differences in degree of right ventricular involvement were also demonstrated between HCM and ATTR amyloidosis, where ATTR patients displayed a right ventricular apical sparing pattern whereas the inverse pattern was found in HCM. Analysis of fibril composition revealed increased LV wall thickness in type A patients compared to type B, but in addition type A women displayed both lower myocardial thickness and more preserved systolic function as compared to type A males. When cardiac geometry and function were evaluated pre and post liver transplantation in type A and B patients, significant deterioration was detected in type A but not in type B patients after liver transplantation.Conclusions: Increasing awareness of typical cardiac amyloidotic signs by echocardiography is important to reduce the risk of delayed diagnosis. Our classification model based on ECG and echocardiography could aid in differentiating ATTR amyloidosis from HCM. Furthermore, the apical sparing pattern found in the right ventricle may pose another clue for amyloid heart disease, although it requires to be studied further. Furthermore, we disclosed that type A fibrils, male sex and increasing age were important determinants of increased myocardial thickness. As type A fibril patients displayed rapid cardiac deterioration after liver transplantation other treatment options should probably be sought for this group of patients.
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| 6. |
- Boo, Sofia
(author)
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Lärares arbete med individanpassning : Strategier och dilemman i klassrummet
- 2014
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Licentiate thesis (other academic/artistic)abstract
- A major challenge for teachers in crowded classrooms is to adapt the teaching to different pupil’s needs and abilities. Previous research shows that learning for pupils in the Swedish primary school has somewhat become an individual project. An increase in the individual work has been at the expense of whole class teaching. This has had a negative impact on pupils' academic performance. However, previous research also indicates that individual adaptation may affect results positively when the teacher is active, has knowledge of pupil’s needs and abilities and also a willingness to meet them.In the last few versions of the Swedish curriculum it is mentioned that teaching should be adjusted based on each pupil's abilities and needs. The purpose of this study is to investigate, describe and analyze how today's teachers in primary school (grades 1-6) handle individual adaptation in teaching, what strategies they use and what dilemmas that occurs. The study focuses on how work is carried out in practice. Qualitative interviews and participant observations are used in the data collection.This study has been conducted in two parts. The first part addresses five teachers and their classes in four different schools. In the second part the study has been extended with one of the above teachers whose classroom work was followed during a period of seven weeks. The results show that teachers are working hard to find methods that promote communication and interaction. They use different strategies to adapt teaching to each student. Individual work is still present but does not dominate the classroom work. Teachers individualize teaching by variation and interaction, by working together with tasks, with active relationship-oriented work and through continuous adjustments in the moment. The study also shows that teachers face several dilemmas when they individualize teaching in the classroom. One dilemma is among the ideal adaptation that teachers have a vision of, versus the time- and efficiencydriven adaptation that is possible to accomplish in the classroom. There is a tension between overall ideal images and teachers' practical everyday reality.
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| 7. |
- Lindqvist, Anna, 1966-
(author)
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Dans i skolan : om genus, kropp och uttryck
- 2010
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Doctoral thesis (other academic/artistic)abstract
- This thesis is a continuation of my licentiate thesis from 2007 “Dansens plats i skolan. Tradition, utveckling och lärande i Skellefteå kommun” [‘The place of dance in schools. Tradition, development and learning and teaching in the Municipality of Skellefteå’]. The overarching aim of the thesis is to interpret and understand dance as a form of expression and phenomenon in schools, which comprises dance teaching, learning in dance, and dance teachers’ attitudes, experiences and ideas. Dance teachers’ experiences and conceptions of dance teaching are at the centre of this thesis. The aim is to interpret and understand dance teachers’ attitude to gender as well as dance as an area of knowledge from dance teachers’ perspective. In the thesis the following will be answered: How do dance teachers describe their experiences and conceptions of gender in the dance teaching of preschools and schools? What is dance teaching in schools from dance teachers’ perspective? The empirical material is principally based on a questionnaire study implemented in the spring of 2008 and answered by 154 dance teachers but also on observations of dance teaching in schools from 2006. The thesis takes a hermeneutic approach. Gender theories and phenomenological theories have been of major importance for the understanding of the result. The thesis deals with central concepts such as ‘gender structures’, ‘masculinities’, ‘relations’, ‘the lived body’, ‘the lifeworld’ and ‘transcendence’. Dance teachers perceive marked differences between girls and boys in three respects. There are fewer boys than girls that are favourably disposed to dance, that clearly try to imitate the dance teacher’s movements and that give full expression to lyrical, peaceful exercises. There is a connection here to dance as a femininely coded subject, homophobic conceptions and the distinction between masculine and feminine movements. As regards wealth of ideas in improvisation exercises, a majority of dance teachers think that there is no difference between boys and girls. Nearly all dance teachers think that they work with the same types of movements for boys and girls, while at the same time they conceive of sex and gender in different ways. This study shows many experiences of dance where gender does not play any role but also that dance in schools may imply a gender-stereotyped attitude. There is also a common view among dance teachers of what dance teaching is. Dance has an existential dimension where the lived body is emphasized. In the thesis the so-called “boy problem” is questioned, since boys’ verbal deprecation is not visible in the dance teaching itself.
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| 8. |
- Magnusson, Maria, 1960-
(author)
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Skylta med kunskap : en studie av hur barn urskiljer grafiska symboler i hem och förskola.
- 2013
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Doctoral thesis (other academic/artistic)abstract
- The topic of this study is to generate knowledge about children’s understandingof graphical symbols. These forms of knowledge are prevalent in contemporarysocieties, for example, in the form of letters, numbers, road signs, maps, andcomputer icons. More specifically, in this thesis is scrutinized in detail howchildren develop symbolic skills and how this can be supported througheducational activities. The theoretical basis of the study is variation theory(Marton & Tsui, 2004). This theory conceptualizes learning in terms ofdifferentiation and integration. Two empirical studies are reported. The first isabout two children, Olle and Lasse, who both are in the age span four to fiveyears. How these children handle graphical symbols in the form of producingsigns that they put up in their homes are followed over time. Hence, thechildren’s own make and use of symbols in their everyday life are studied. In thesecond empirical study, the findings from the first study and theoretical insightfrom variation theory are orchestrated in a preschool center with two teachersand twelve children, to see if these principles can be functional in supportingchildren’s development of symbolic understanding. Both studies are based onvideo data. The findings are that a particular pattern of variation entitled,‘contrast’ is functional in developing such insight, while another pattern ofvariation entitled, ‘induction’ is not. In addition, meta-communication is arguedto be important not only for the researcher to gain access to the child’sunderstanding but also to the child’s development as such. The theoreticaldistinction made by Vygotsky between ‘pseudo concepts’ and ‘concepts (proper)’is used to discuss the findings.
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| 9. |
- Tossavainen, Erik, 1977-
(author)
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In the hands of ohm : hemodynamic aspects in pulmonary hypertension
- 2019
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Doctoral thesis (other academic/artistic)abstract
- Congestive heart failure (CHF) is one of the most challenging diseases in terms of health care demand and mortality, in the western world. Despite major breakthroughs in the fields of diagnosis and treatment over the three last decades, the management of CHF still remains challenging.CHF is defined as inability of the heart to supply sufficient blood flow to meet the needs of the body. This definition however, may be an oversimplification of a complex pathophysiological process since patients with overt CHF may have normal, or even supernormal cardiac output at the expense of increased filling pressures, which subsequently leads to the development of post capillary pulmonary hypertension (PH). In the presence of advanced CHF, clinical signs and symptoms are obvious at rest. However, the majority of affected individuals do not experience any discomfort at rest and may demonstrate normal findings when assessed. Small increases in systemic blood pressure and or venous return, caused by activity may result in severe elevation of filling pressures if left ventricular compliance is significantly decreased. This example highlights the need to perform cardiac investigations during stress to provoke symptoms. Increased pulmonary vascular resistance (PVR), commonly found in pre-capillary PH, is a condition that shares many symptoms with CHF, and is also associated with poor prognosis. Even though the disease is located within the lung vessels, it is highly important and challenging task differentiating pre- and post-capillary PH. Since treatment differs considerably and may be detrimental in case of misdiagnosis, additional sensitive and reliable screening methods are crucial to aid in differentiation.Methods: Out of the four studies included in this thesis, three were conducted solely at Norrland’s University Hospital, while patients in the third study were recruited and examined at Uppsala Akademiska Hospital. All included patients had idiopathic dyspnea and were admitted for right heart catheterization (RHC), which is gold standard with regards to hemodynamics. Echocardiographic examinations were performed simultaneously with RHC, except in the Uppsala study, wherein echocardiography were performed within 3 days to the RHC.Echo-Doppler derived pulmonary artery acceleration time (PAcT) is an easily assessed parameter, indicating elevated pulmonary artery systolic pressure (PASP) and pulmonary artery resistance (PVR). PAcT was tested as a screening method for identification and differentiation of pre and post- capillary PH in a cohort of 56 patients (study 1).The ability to calculate PVR non-invasively, using novel echocardiographic measurements, was made by replacing the invasive pressure and flow components that constitutes the foundation of the PVR = (mean pulmonary artery pressure – Pulmonary capillary wedge pressure (PCWP)) /cardiac output), with novel echocardiographic measurements. PVR = mPAP-Chemla – Left atrial strain rate during atrial systole (LASRa) / Cardiac Output-Echo (study 2).Invasively measured left ventricular filling pressure in response to passive leg lifting, and its ability to predict pathological increase in left ventricular filling pressures during supine bicycling, was tested in a population of 85 patients with normal left ventricular ejection fraction (LVEF) and suspicion of CHF based on NT-proBNP levels alone were investigated (Study 3).Finally, an evaluation of standard and novel Doppler echocardiographic parameters, potentially useful in identifying patients who may develop increased filling pressures during passive leg lifting (PLL), was carried out (study 4).Results:Study 1: PAcT correlated negatively with pulmonary artery systolic pressure (PASP) (r = -0.60, p < 0.001) and PVR (r = -0.57, p < 0.001). PAcT of <90 ms had a sensitivity of 84% and a specificity of 85% in identifying patients with PVR ≥ 3.0 WU. Regardless of normal or elevated left sided filling pressures, PAcT differed significantly in patients with normal, compared to those with elevated levels of, PVR (p < 0.01). A significant difference was also found on comparison of the PAcT/PASP ratio (p < 0.01), with a lower ratio among patients with PVR ≥ 3.0. WU.Study 2: We prospectively used Doppler and 2D echocardiography in 46 patients with sinus rhythm which revealed that left atrial strain rate during atrial systole (LASRa) had the highest significant positive correlation with PCWP (r2 = 0.65, P < 0.001). By adopting a linear line of best-fit, LASRa may therefore be substituted for PCWP. Subsequently, LASRa was substituted into the PVR equation. This novel echocardiographically derived PVR calculation, significantly correlated with RHC generated PVR values (r2 = 0.69, P < 0.001) and minor drift (+0.1WU) when assessed by Bland Altman analysis.Study 3: Only 22% (11/51) of patients with elevated NT-proBNP had PCWP above normal levels at rest. However, in response to PLL, 47% of patients developed elevated PCWP, and the majority of this 47% subsequently developed pathological pressure levels while performing supine cycling exercise. Thus, the likelihood of developing high LVFPs during exercise could be determined by PLL, with a sensitivity and specificity of 90%.Study 4: At rest, left atrial volume indexed to body mass index (BMI) (LAVI) and mitral deceleration time (DT) were independently related to PCWP during PLL. However, during PLL univariate regression analysis revealed LASRa (β = -0.77, P <0,001) and E/LVSRe (β = 0.47, P < 0,021) most related to PCWPPLL. Multiple regression analysis fortified LASRa and E/LVSRe as relevant independent parameters useful in the assessment of filling pressure during PLL.Conclusion: A PAcT < 90ms is strongly suggestive of increased PVR (>3.0 WU). Based on study 1, there is clear evidence suggesting that these findings apply irrespective of LVFPs. PAcT can potentially serve as a rapid screening tool for estimation of PVR, however, is not useful if the exact level of PVR is required. In this case, an established PVR calculation method is preferred, and could be performed with higher precision by inclusion of echocardiography derived LASRa as a surrogate measure of PCWP. Insufficient LV compliance results in the inability to cope with increased cardiac preload. Nt-proBNP is secreted when the myocardium is stretched, however only a small portion of patients within the CHF group (study 3) had a high PCWP at rest. Nearly half of the study population with elevated NT-proBNP showed increased PCWP during PLL, which is indicative of underlying ventricular stiffness. By performing this preload increasing maneuver, patients predisposed to developing high filling pressure during supine cycling could be identified with high sensitivity and specificity. Echocardiography, in comparison with RHC, is more accessible, safer and requires less resources and time, thus is an appealing option in the quest to identify additional, non-invasive methods reflective of invasive pressures, which could be useful in the assessment of filling pressure during different loading conditions. LAVI at rest, LASRa and E/LVSRe during PLL, proved independently related to PCWP during PLL.
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| 10. |
- Vanoli, Davide, 1972-
(author)
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Vascular ultrasound for the assessment of carotid atherosclerosis
- 2017
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Doctoral thesis (other academic/artistic)abstract
- Background: Atherosclerotic cardiovascular disease (CVD) is a common cause for mortality globally, and is expected to remain the single leading cause of death as the global population ages and as life expectancy increases.Cardiovascular screening models have been developed, and continue to be developed, to identify individuals at high-risk of CVD. This is necessary to establish prevention strategies to decrease the occurrence of an acute event or debilitating syndrome. These strategies largely take the form of lifestyle modification and pharmacological intervention. The Framingham risk score, NCEP/ATP II guidelines and SCORE risk assessment protocol are widely used screening models. Ultrasound based methods are non-invasive, affordable and have been suggested to improve assessment and definition of individual patients potential risk of CVD. Increased carotid artery intima-media thickness (cIMT) is a known and established sign of early atherosclerosis. The presence of plaque and the overall burden of atherosclerosis seems to have even greater value in predicting cerebrovascular and cardiovascular events. Ultrasound based texture characteristics of plaques such as entropy, grey scale median, discrete white area, coarseness and juxtaluminal hypoechoic black area have been proposed as useful possible predictors of plaque vulnerability. Moreover, ultrasound contrast agents have been developed to improve visualization and subsequent quantification of an atherosclerotic plaque. Considering the current available data and research, the importance of developing tools and techniques for detection and characterization of atherosclerotic changes, to indicate risk for CVD and the subsequent early intervention and prevention, appears clearly as an effort to improve public health. In this present collection of studies (4 papers) we aim to contribute to the development of clinically useful ultrasound methods and tools for the accurate assessment, understanding and management of atherosclerosis.Methods: To validate ultrasound-based methods for assessment of early signs of atherosclerosis, measured as cIMT, a total of 144 subjects underwent bilateral carotid ultrasound. In study I, the performance of an ultrasonography software capable of fully automated on-screen cIMT measurements was tested and compared with the traditional manual measurement approach. The coefficient of variation and the intraclass correlation coefficient for both methods were compared to verify the reliability and reproducibility of results generated by the new ultrasound software. To test the accessibility and possible clinical applications of this new technology tested in study I, the new software was used by novice’s scanners in study II, and the intraobserver variability of the cIMT measurements were assessed and compared with that of an expert operator. In study III, ultrasound texture characteristics of 327 plaques including entropy, grey scale median, discrete white area, coarseness and juxtaluminal hypoechoic black area were assessed as possible predictors of future cerebrovascular events in a cohort of 133 patients with symptomatic carotid stenosis waiting for carotid surgery. The reproducibility of measuring plaque area (expressed as intraclass correlation coefficient) using conventional ultrasound and contrast enhanced ultrasound was tested in study IV in an attempt to find a simple and reproducible parameter for monitoring changes in atherosclerotic burden.Results: The technology tested in study I was found to have good inter- and intra-system reproducibility compared with conventional methods. Moreover, it was found to produce reproducible results when used by expert and novice operators after a short period of training (study II), confirming the possibility for the employment of this technology in a large screening public health programs. Although such technology may have immediate practical application, other and more sophisticated ultrasound based plaque characteristics (such as grey scale median, entropy, coarseness, juxtaluminal hypoechoic black area) were not shown to be beneficial in predicting plaque vulnerability (study III). Contrast enhanced ultrasound technic tested in study IV did not improve quantification of atherosclerotic plaque burden. Conclusion: Medical ultrasound technology by using a automatically measure of carotid intima media thickness can be used with high reproducibility and also possible to be transferred to primary care by a well designed training program. Plaque characteristic using carotid ultrasound was not found to be useful in risk stratifying symptomatic patients with severe carotid stenosis. Furthermore, contrast enhanced ultrasound technique was found to have high reproducibility in plaque area assessment but not better than conventional b-mode based method in quantifying the atherosclerotic burden. Therefore, more sophisticated ultrasound based methods for assessment plaque characteristics was not found to be beneficial in predicting plaque vulnerability.
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