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1.	Kerstis, Birgitta, et al. (author) Depressive symptoms postpartum among parents are associated with marital separation : A Swedish cohort study 2014 In: Scandinavian Journal of Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 42:7, s. 660-668 Journal article (peer-reviewed)abstract Aims: To study whether there is an association between dyadic consensus, depressive symptoms, and parental stress during early parenthood and marital separation 6–8 years after childbirth, among couples in Sweden.Methods: At baseline, 393 couples were included. The couples answered three questionnaires, including: Dyadic consensus at 1 week post-partum, depressive symptoms at 3 months post-partum and parental stress at 18 months post-partum. The parents’ addresses were followed up after 6–8 years, to study the marital separation rate.Results: We found, 6–8 years after childbirth, that 20% of study couples were separated. Separation was associated with less dyadic consensus (mothers p < 0.001; fathers p < 0.001), depressive symptoms (mothers p = 0.022; fathers p = 0.041) and parental stress (mothers p = 0.002; fathers p = 0.040). The hazard ratio (HR) for marital separation was related to dyadic consensus for fathers (HR 0.51; 95% CI 0.28–0.92), depressive symptoms for mothers (HR 1.69; 95% CI 1.01–2.84) and fathers (HR 1.92; 95% CI 1.12–3.28), and the mother’s parental stress (HR 2.16; 95% CI 1.14–4.07).Conclusions: Understanding how dyadic consensus, depressive symptoms and parental stress are associated with marital separation is important for health professionals. It could be useful in developing interventions to provide parents with adequate support during pregnancy and early parenthood. This knowledge is also important for the public. Parents should get support in pregnancy and while bringing up children, which may help prevent marital separation and optimize conditions for the children.
2.	Engström, Birgitta, et al. (author) Relatives' involvement in nursing care : a qualitative study describing critical care nurses' experiences 2011 In: Intensive & Critical Care Nursing. - : Elsevier BV. - 0964-3397 .- 1532-4036. ; 27:1, s. 1-9 Journal article (peer-reviewed)abstract ObjectivesWhen patients become critically ill it also affects their relatives. The aim of this study was to describe critical care nurses’ experience of relatives’ involvement in the nursing care of patients in an intensive care unitMethodSemi-structured personal interviews with eight critical care nurses in an intensive care unit in the northern part of Sweden were conducted during 2010. The interview texts were subjected to qualitative content analysis which resulted in the formulation of two main categories and five sub-categories.FindingsThe findings showed that relatives’ involvement was appreciated and seen as great resource for both patients and critical care nurses. Protecting the integrity of patients was one reason for limiting their involvement. The environment and lack of time were experienced as other obstacles to the involvement of relatives.ConclusionAligning the needs of the relatives to be involved in the care with the needs of the patient and the work situation of the nurses requires open communication between all three parties.
3.	Engström, Elisabet, et al. (author) Auditory event-related potentials and mismatch negativity in children with hearing loss using hearing aids or cochlear implants : A three-year follow-up study 2021 In: International Journal of Pediatric Otorhinolaryngology. - : Elsevier. - 0165-5876 .- 1872-8464. ; 140 Journal article (peer-reviewed)abstract Objectives: The primary aim was to examine how event-related potentials (ERPs) and mismatch negativity (MMN) change and develop over time among children with hearing loss (HL) using hearing aids (HAs) or cochlear implants (CIs). Children with normal hearing (NH) were tested as a reference group.Methods: This three-year follow-up study included 13 children with sensorineural HL (SNHL); 7 children using bilateral HAs and 6 children using CIs; and 10 children with NH as a reference group. ERPs were recorded at baseline and after three years. At time for the original study the children were approximately 5-8 years old and at the follow-up study 8-11 years old. ERP recordings and data processing were identical in both sessions. A standard stimulus alternated with five different deviants (gap, intensity, pitch, location and duration), presented in a pseudorandom sequence, thus following the multi-feature paradigm, Optimum-1. MMN was calculated from the average ERP of each deviant minus the standard stimuli. Repeated measures ANOVA was used for the statistical analyses and the results were based on samples within a specific time interval; 80-224 ms.Results: There was a statistically significant difference in the obligatory responses between the NH and HA groups at baseline, but this difference disappeared after three years in our follow-up study. The children with HA also showed a significant difference in mean ERP at baseline compared to follow-up, and significant differences between the deviants at follow-up but not at baseline. This suggests an improvement over time among the children with HAs. On the other hand, the children with CIs did not differ from the NH children at baseline, but after three years their mean ERP was significantly lower compared to both the children with HA and NH, indicating a reduced development of the central auditory system in this age span among the children with CIs. Regarding MMN, there was an interaction between the duration deviant and time for the children with HA, also indicating a possible improvement over time among the HA children.Conclusions: This three-year follow-up study shows neurophysiological differences between children with HL and children with NH. The results suggest a delay in the central auditory processing among the HA children compared to children with NH, but a possible catch-up, over time, and this potential may be worth to be utilized. Regarding the CI children, similar improvement in this age span is missing, meaning there are differences between the subgroups of children with HL, i.e. the children with HAs vs. CIs. The results highlight the importance of distinguishing between subgroups of children with HL in further research.
4.	Kerstis, Birgitta, et al. (author) Association between mothers' and fathers' depressive symptoms, sense of coherence and perception of their child's temperament in early parenthood in Sweden 2013 In: Scandinavian Journal of Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 41:3, s. 233-239 Journal article (peer-reviewed)abstract Aims: To examine whether there was any association between mothers' and fathers' post-partum depressive symptoms and sense of coherence and perception of their child's temperament. The hypotheses were that parents with depressive symptoms: 1) have more often a poor sense of coherence, and 2) perceive their child's temperament to be more difficult than parents without depressive symptoms. Methods: A total of 401 Swedish-speaking couples, who were the parents of children born through the years 2004-2006 in the northern part of the county of Vastmanland, Sweden, were invited to participate in the study. The parents answered 3 questionnaires including: at inclusion of the study: demographic data (n = 393 couples); at 3 months: the Edinburgh Postnatal Depression Scale and the Sense of Coherence Scale (n = 308 couples); and at 18 months: the Infant Characteristics Questionnaire (n = 272 couples). Results: Depressive symptoms measured at 3 months, were reported by 17.7% of mothers and 8.7% of fathers, and correlated significantly between mothers and fathers within couples (rho = 0.165, p = 0.003). Mothers and fathers with depressive symptoms had a poorer sense of coherence (p < 0.001, p < 0.001) and perceived their child's temperament as more difficult than mothers and fathers without depressive symptoms at 3 (p = 0.028, p < 0.001) and 18 months (p = 0.145, p = 0.012 respectively). Conclusions: Early parenthood has been studied thoroughly in mothers, but few studies have included fathers. Identifying problems in early parenthood could help predict later problems exhibited by the preschool child, which might be prevented by supportive programmes.
5.	Kerstis, Birgitta, et al. (author) Association between parental depressive symptoms and impaired bonding with the infant 2016 In: Archives of Women's Mental Health. - : Springer. - 1434-1816 .- 1435-1102. ; 19:1, s. 87-94 Journal article (peer-reviewed)abstract Impaired bonding with the infant is associated with maternal postpartum depression but has not been investigated extensively in fathers. The primary study aim was to evaluate associations between maternal and paternal depressive symptoms and impaired bonding with their infant. A secondary aim was to determine the associations between parents’ marital problems and impaired bonding with the infant. The study is part of a population-based cohort project (UPPSAT) in Uppsala, Sweden. The Edinburgh Postnatal Depression Scale (EPDS) at 6 weeks and 6 months postpartum and the Postpartum Bonding Questionnaire at 6 months postpartum were completed by 727 couples. The prevalence of impaired bonding was highest among couples in which both spouses had depressive symptoms. Impaired bonding was associated with higher EPDS scores in both mothers and fathers, as well as with experiencing a deteriorated marital relationship. The association between maternal and paternal impaired bonding and the mothers’ and fathers’ EPDS scores remained significant even after adjustment for relevant confounding factors. Depressive symptoms at 6 weeks postpartum are associated with impaired bonding with the infant at 6 months postpartum for both mothers and fathers. It is critical to screen for and prevent depressive symptoms in both parents during early parenthood.
6.	Kerstis, Birgitta, 1963- (author) Depressive Symptoms among Mothers and Fathers in Early Parenthood 2015 Doctoral thesis (other academic/artistic)abstract Aims: The overall aims were to study depressive symptoms among mothers and fathers in early parenthood and how depressive symptoms are related to dyadic consensus (DCS), sense of coherence (SOC), perceiving of the child temperament, separation within the couple and bonding to the infant.Methods: Study I-III was based on the BiT-study, a longitudinal project where 393 couples answered 3 questionnaires including instruments measuring DCS at one week after childbirth, depressive symptoms at 3 months and parental stress at 18 months after childbirth. Study IV was based on the UPPSAT-study, a population based cohort project, where 727 couples answered questionnaires measuring depressive symptoms at 6 weeks and 6 months after childbirth, and impaired bonding at 6 months after childbirth.Results: In the BiT-study, 17.7% of the mothers and 8.7% of the fathers scored depressive symptoms at 3 months after childbirth, using the Edinburgh Postnatal Depression Scale (EPDS) cut-off of ≥10. There was an association between depressive symptoms and less consensus (DCS), and the parents partly differed regarding which areas of their relationship they perceived that they disagreed about. Parents with depressive symptoms had a poorer SOC and perceived their child as more difficult than parents without depressive symptoms. Among the couples, 20% were separated 6-8 years after childbirth. Separation was associated with less dyadic consensus, more depressive symptoms and parental stress. In the UPPSAT-study, 15.3% of the mothers and 5.1% of the fathers scored depressive symptoms 6 weeks after childbirth, using the EPDS cut-off of ≥10. Further, there was an association between impaired bonding at 6 months and the parents’ depressive symptoms, as well as experience of deteriorated relationship with the spouse.Conclusions and clinical implications: Health professionals need the knowledge that depressive symptoms are common in both mother and fathers in early parenthood. It is also important to understand how depressive symptoms are associated to dyadic consensus, SOC, separation and impaired bonding in order to optimize conditions for the whole family. This knowledge is also important for the public, so those who are pregnant and new parents as well as the society are aware that there might be problems in early parenthood as depressive symptoms.
7.	Kerstis, Birgitta, et al. (author) Depressive symptoms postpartum among parents are associated with marital separation – A Swedish cohort study 2014 In: Depressive symptoms postpartum among parents are associated with marital separation – A Swedish cohort study. Conference paper (pop. science, debate, etc.)abstract Aims: To determine whether there is an association between dyadic consensus, depressive symptoms, and parental stress during early parenthood and marital separation 6–8 years after childbirth among couples in Sweden. Methods: At baseline, 393 couples were included. The couples answered three questionnaires including: dyadic consensus at one week post-partum, depressive symptoms at three months post-partum, and parental stress at 18 months post-partum. The parents’ addresses were followed up after 6-8 years to study the marital separation rate. Results: Six to eight years after childbirth, 20% of the couples were separated. Separation was associated with less dyadic consensus (mothers p < 0.001, fathers p < 0.001), depressive symptoms (mothers p = 0.022, fathers p = 0.041), and parental stress (mothers p = 0.002, fathers p = 0.040). The hazard ratio (HR) for marital separation was related to dyadic consensus for fathers (HR, 0.51; 95% confidence interval (CI), 0.28--0.92), depressive symptoms for mothers (HR, 1.69; 95% CI, 1.01--2.84) and fathers (HR 1.92; 95% CI, 1.12--3.28), and parental stress for mothers (HR, 2.16; 95% CI, 1.14--4.07). Conclusions: Understanding how dyadic consensus, depressive symptoms, and parental stress are associated with marital separation is important for health professionals and could be useful in developing interventions to provide parents with adequate support during pregnancy and early parenthood. This knowledge is also important for the public. Parents should get support in pregnancy and while bringing up children, which may help prevent marital separation and optimize conditions for the children.Key Words: Depressive symptoms, Dyadic consensus, Marital separation, Parental stress, Parenthood
8.	Widarsson, Margareta, et al. (author) Parental stress in early parenthood among mothers and fathers in Sweden 2013 In: Scandinavian Journal of Caring Sciences. - : WILEY. - 0283-9318 .- 1471-6712. ; 27:4, s. 839-847 Journal article (peer-reviewed)abstract Parental stress affects parenting behaviour and the quality of dyadic parent-child interactions. Mothers generally show higher parental stress than fathers. Aims: Our aims were to assess the perceived level of parental stress in early parenthood and examine the differences between mothers and fathers within couples in relation to their levels of education, parental experience, existence of a parental role model and sense of coherence. Methods: In total, 307 mothers and 301 fathers of 18-month-old children answered the Swedish Parenthood Stress Questionnaire (SPSQ); and 318 mothers and 311 fathers answered the Sense of Coherence (SOC-3) scale; 283 couples answered both the SPSQ and SOC-3. Results: Mothers perceived higher levels of stress than fathers in the sub-areas incompetence (p < 0.001), role restriction (p < 0.001), spouse relationship problems (p = 0.004) and health problems (p = 0.027), and in total (p = 0.001). In contrast, fathers perceived higher stress than mothers in the sub-area social isolation (p < 0.001). When the data were stratified with respect to education, parental experience, existence of a parental role model and sense of coherence, significant results were observed in some of these sub-areas. Conclusions: Mothers and fathers experience stress in different areas during their early parenthood. Healthcare professionals should be aware of the differences in stress that exist between mothers and fathers, so that parents can be adequately prepared for parenthood and avoid parental stress.
9.	Abu Hamdeh, Sami, et al. (author) Surgical site infections in standard neurosurgery procedures-a study of incidence, impact and potential risk factors 2014 In: British Journal of Neurosurgery. - : Informa UK Limited. - 0268-8697 .- 1360-046X. ; 28:2, s. 270-275 Journal article (peer-reviewed)abstract Objectives. Surgical site infections (SSIs) may be devastating for the patient and they carry high economic costs. Studies of SSI after neurosurgery report an incidence of 1 - 11%. However, patient material, follow-up time and definition of SSI have varied. In the present study we prospectively recorded the prevalence of SSI 3 months after standard intracranial neurosurgical procedures. The incidence, impact and risk factors of SSI were analysed. Methods. We included patients admitted during 2010 to our unit for postoperative care after standard neurosurgical procedures. SSI was defined as evident with positive cultures from surgical samples or CSF, and/or purulent discharge during reoperation. Follow-up was done after 3 and 12 months and statistics was obtained after 3 months. The predictive values on the outcome of demographic and clinical factors describing the surgical procedure were evaluated using linear regression. Results. A total of 448 patients were included in the study and underwent a total of 466 procedures. Within 3 and 12 months, 33 and 88 patients, respectively, had died. Of the surviving patients, 20 (4.3% of procedures) developed infections within 3 months and another 3 (4.9% of procedures) within 12 months. Risk factors for SSI were meningioma, longer operation time, craniotomy, dural substitute, and staples in wound closure. Patients with SSI had significantly longer hospital stay. Multivariate analysis showed that factors found significant in univariate analysis frequently occur together. Discussion. We studied the prevalence of SSI after 3 and 12 months in a prospective 1-year material with standard neurosurgical procedures and found it to be 4.3% and 4.9%, respectively. The analysis of the results showed that a combination of parameters indicating a longer and more complicated procedure predicted the development of SSI. Our conclusion is that the prevention of SSI has to be done at many levels, especially with patients undergoing long surgical procedures.
10.	Athlin, Elsy, et al. (author) Vårdtyngdmätning - jämförelse och prövning av instrument för patientklassificering : Utvecklingsarbete på kirurgisk och medicinsk klinik 1992 In: Vård i Norden. - : SAGE Publications. - 0107-4083 .- 1890-4238. ; 12:3-4, s. 40-44 Journal article (peer-reviewed)
11.	Bailey, Leslie, et al. (author) Small molecule inhibitors reveal a role for the Chlamydia type III secretion system in iron acquisition Other publication (other academic/artistic)
12.	Bergvall-Kåreborn, Birgitta, et al. (author) CASE 7: Smart Growth MeMo : A business model tool for mobile services 2011 In: Meeting the challenges of Europe 2020. - : Europe Innova. ; , s. 12-12 Book chapter (pop. science, debate, etc.)
13.	Bisholt, Birgitta, 1963-, et al. (author) Nursing students' assessment of the learning environment in different clinical settings 2014 In: Nurse Education in Practice. - : Elsevier. - 1471-5953 .- 1873-5223. ; 14:3, s. 304-310 Journal article (peer-reviewed)abstract INTRODUCTION: Nursing students perform their clinical practice in different types of clinical settings. The clinical learning environment is important for students to be able to achieve desired learning outcomes. Knowledge is lacking about the learning environment in different clinical settings.AIM: The aim was to compare the learning environment in different clinical settings from the perspective of the nursing students.DESIGN: A cross-sectional study with comparative design was conducted.METHOD: Data was collected from 185 nursing students at three universities by means of a questionnaire involving the Clinical Learning Environment, Supervision and Nurse Teacher (CLES + T) evaluation scale. An open-ended question was added in order to ascertain reasons for dissatisfaction with the clinical placement.RESULTS: The nursing students' satisfaction with the placement did not differ between clinical settings. However, those with clinical placement in hospital departments agreed more strongly that sufficient meaningful learning situations occurred and that learning situations were multi-dimensional. Some students reported that the character of the clinical setting made it difficult to achieve the learning objectives.CONCLUSION: In the planning of the clinical placement, attention must be paid to whether the setting offers the student a meaningful learning situation where the appropriate learning outcome may be achieved.
14.	Bisholt, Birgitta, et al. (author) Vårdorganisation och sjuksköterskestudenters värdering av lärandemiljö 2012 In: Verksamhetsförlagd utbildning i högskolans vårdutbildningar – möjligheter och utmaningar. Conference paper (other academic/artistic)
15.	Blomberg, Karin, 1970-, et al. (author) Clinical group supervision in nursing education for integrate ethical reasoning : students and supervisors’ view 2012 Conference paper (peer-reviewed)
16.	Blomberg, Karin, 1970-, et al. (author) Riskfaktorer för stress hos sjuksköterskestudenter i verksamhetsförlagd utbildning 2012 In: Verksamhetsförlagd utbildning i högskolans vårdutbildningar. Conference paper (other academic/artistic)
17.	Blomberg, Karin, 1970-, et al. (author) Swedish nursing students' experience of stress during clinical practice in relation to clinical setting characteristics and the organisation of the clinical education 2014 In: Journal of Clinical Nursing. - : Wiley-Blackwell Publishing Ltd.. - 0962-1067 .- 1365-2702. ; 23:15-16, s. 2264-2271 Journal article (peer-reviewed)abstract AIMS AND OBJECTIVES: To describe nursing students' experience of stress during clinical practice and evaluate the risk of stress in relation to the clinical setting characteristics and the organisation of the clinical education. BACKGROUND: Stress during clinical practice is well documented, but there is a lack of knowledge concerning whether the clinical setting characteristics and the organisation of the education make a difference. DESIGN: A cross-sectional study with evaluative design. METHODS: Data were collected by means of a numerical rating scale for the assessment of stress and questions about the clinical setting characteristics and the organisation of the education. One hundred and eighty-four students who had completed their final year on the nursing programme at three universities in Sweden were included. RESULTS: Nearly half of the students (43%) experienced high level of stress during clinical practice. Measured by decision in the tree analysis, the absolute risk of stress was 57% in students with placements in hospital departments, as compared to 13% in students with placements in other clinical settings. The risk of stress increased to 71% if the students with placement in a hospital took the national clinical final examination. Performance of practice in a hospital department overcrowded with patients was also associated with increased risk of stress. The organisation of supervision and number of students at the clinical placement had an effect on the experience of stress, but did not prove to be risk factors in the analysis. CONCLUSIONS: The risk of stress in nursing students during their clinical practice differs depending on clinical setting characteristics. The taking of the national clinical final examination could be a source of stress, but this requires further investigation. RELEVANCE TO CLINICAL PRACTICE: It is important that supervisors are aware that students in hospital departments overcrowded with patients are at risk of stress and may have increased need of support.
18.	Blomberg, Karin, 1970-, et al. (author) Work stress among newly graduated nurses in relation to workplace and clinical group supervision 2016 In: Journal of Nursing Management. - : Wiley-Blackwell Publishing Ltd.. - 0966-0429 .- 1365-2834. ; 24:1, s. 80-87 Journal article (peer-reviewed)abstract The aim was to investigate occupational stress among newly graduated nurses in relation to the workplace and clinicla group supervision. Being a newly graduated nurse is particulary stressful. Whar remains unclear is wehter teh workplace and clinical group supervision affect the stress. A cross-sectional comperative study was performed. Data were collected by means of a numerical scale measuring occupational stress, questions about workplace and clinicla group supervision. One hundred and thirteen nusres were included in the study. Conclusions: Newly graduated nurses experience great strss and need support. Nusrse participating in clinical group supervision reported significantly less stress.
19.	Borné, Yan, et al. (author) Anthropometric measures in relation to risk of heart failure hospitalization : a Swedish population-based cohort study 2014 In: European Journal of Public Health. - : Oxford University Press (OUP). - 1101-1262 .- 1464-360X. ; 24:2, s. 215-220 Journal article (peer-reviewed)abstract Background: It is unclear which anthropometric measure is most useful for assessment of the cardiovascular risk. We investigated the association between different anthropometric measures and risk of heart failure (HF) hospitalization. Methods: BMI, waist-hip ratio (WHR), waist circumference (WC), body fat percentage (BF%), weight and height were measured among 26 653 subjects (aged 45-73 years) without history of myocardial infarction (MI), stroke or HF from the Malmo Diet and Cancer cohort at baseline in 1991-96. Incidence of HF hospitalizations was monitored during a mean follow-up of 15 years. Results: Seven hundred and twenty-seven subjects were hospitalized with HF as primary diagnosis, of whom 157 had an MI before or concurrent with the HF. After adjustment for potential confounding factors, the hazard ratios of HF hospitalization (fourth vs. first sex-specific quartile) were 1.80 (95% CI: 1.45-2.24) for BMI, 1.87 (1.50-2.34) for WC, 1.77 (1.43-2.19) for WHR, 1.35 (1.09-1.68) for BF%, 1.93 (1.57-2.39) for weight and 1.18 (0.96-1.44) for height. Significant interactions between BMI and WC and WHR, respectively, were observed, and the joint exposure of high BMI and high WC or high WHR further increased the risk. The results were similar in secondary analyses, i.e. excluding incident HF with previous MI during the follow-up. Conclusion: Our results support the view that raised BMI, WC, WHR or BF% increases the risk of HF hospitalization. The joint exposure of high BMI and high WHR or high WC further increased the risk in an additive way.
20.	Borné, Yan, et al. (author) Country of birth and risk of hospitalization due to heart failure : a Swedish population-based cohort study 2011 In: European Journal of Epidemiology. - : Springer Science and Business Media LLC. - 0393-2990 .- 1573-7284. ; 26:4, s. 275-283 Journal article (peer-reviewed)abstract To explore the relation between country of birth and risk of hospitalization due to heart failure (HF). All 40-89 year-old inhabitants in the city of Malmö, Sweden (n = 114,917, of whom 15.2% were born outside Sweden) were followed from November 1st, 1990 until December 31st, 2007. During a mean follow-up of 13.5 ± 5.3 years, a total of 7,640 individuals (47.4% men) were discharged from hospital with first-ever HF as primary diagnosis. Of them, 1,243 individuals had myocardial infarction (MI) before or concurrent with the HF hospitalization. The risk of HF was compared between immigrants from selected countries and Swedish natives. The overall analysis showed substantial differences among immigrant groups (P < 0.001). Compared to Swedish natives, significantly increased HF risk was found among immigrants from Finland (HR (hazard ratio): 1.40; 95% CI, 1.10-1.81), Former Yugoslavia (1.45: 1.23-1.72) and Hungary (1.48: 1.16-1.89), taking age, sex, marital status, annual income and housing condition into account. Analysis results were similar when cases with MI before or concurrent with the HF hospitalization were included in the analysis. In general, the risk of HF was significantly higher among immigrants from high-income and middle-income countries. Marital status, annual income and housing condition were also significant independent risk factors for HF in this population. There are substantial differences in risk of hospitalization due to HF among immigrants from different countries that can not be explained by socioeconomic factors. To what extent these differences could be explained by biological risk factors remains to be explored.
21.	Borné, Yan, et al. (author) Immigrant status and increased risk of heart failure: the role of hypertension and life-style risk factors 2012 In: BMC Cardiovascular Disorders. - : Springer Science and Business Media LLC. - 1471-2261. ; 12:20 Journal article (peer-reviewed)abstract Background: Studies from Sweden have reported association between immigrant status and incidence of cardiovascular diseases. The nature of this relationship is unclear. We investigated the relationship between immigrant status and risk of heart failure (HF) hospitalization in a population-based cohort, and to what extent this is mediated by hypertension and life-style risk factors. We also explored whether immigrant status was related to case-fatality after HF. Methods: 26,559 subjects without history of myocardial infarction (MI), stroke or HF from the community-based Malmo Diet and Cancer (MDC) cohort underwent a baseline examination during 1991-1996. Incidence of HF hospitalizations was monitored during a mean follow-up of 15 years. Results: 3,129 (11.8%) subjects were born outside Sweden. During follow-up, 764 subjects were hospitalized with HF as primary diagnosis, of whom 166 had an MI before or concurrent with the HF. After adjustment for potential confounding factors, the hazard ratios (HR) for foreign-born were 1.37 (95% CI: 1.08-1.73, p = 0.009) compared to native Swedes, for HF without previous MI. The results were similar in a secondary analysis without censoring at incident MI. There was a significant interaction (p < 0.001) between immigrant status and waist circumference (WC), and the increased HF risk was limited to immigrants with high WC. Although not significant foreign-born tended to have lower one-month and one-year mortality after HF. Conclusions: Immigrant status was associated with long-term risk of HF hospitalization, independently of hypertension and several life-style risk factors. A significant interaction between WC and immigrant status on incident HF was observed.
22.	Brorson Norberg, Birgitta, 1946-, et al. (author) Muntlig kommunikation under en lektion om energikällor i årskurs 5 : [Oral Communication during a Lesson on Energy Sources in Grade 5] 2014 In: Nordic Studies in Science Education. - Oslo : University of Oslo Library. - 1504-4556 .- 1894-1257. ; 10:1, s. 35-47 Journal article (peer-reviewed)abstract Studies have shown that students’ awareness of the goals and purposes of the laboratory activityis important for their possibility to participate in and learn from the activity. While practical activitiesoften have been considered to be a central part of science education, relatively few studies haveexamined laboratory work in situ. In this paper we addressed these issues by examining (a) whatpurposes are distinguished when students’ work with a laboratory assignment and (b) how thesepurposes are made continuous with the teacher’s aim with the assignment. The data was based onclassroom observations from two ordinary laboratory settings, one from a chemistry class in lowersecondary school and one from a physics class in the natural science programme in upper secondaryschool. Although both student groups acknowledged their teacher’s intentions with the practical andcould act towards the more student centered purposes of the activity, e.g. describe what happens withthe copper and measure the speed of a small vessel respectively, there were differences regarding thepossibilities the students had to act toward the activity’s final aim. The results showed that these factorscan be referred to the amount of purposes introduced by the teacher as well as those that arosebecause of contingences, and the connection of these purposes to students’ prior experiences.
23.	Chronéer, Diana, et al. (author) Born global in a heartbeat 2009 In: Proceedings of the XX ISPIM Conference, Vienna, Austria, 21-24 June 2009. Conference paper (peer-reviewed)abstract This paper aims to enhance the knowledge of business model development in the mobile service sector by exploring the underlying components of a business model for organizations within that industry. By drawing from business model literature combined with findings from a longitudinal case study of an iPhone application, a conceptual business model for mobile services was developed. Proposed model extends earlier frameworks by adding contingency aspects and the view of core resources into a dynamic business model. Findings from the study highlight the importance for application developers to have an overall resource strategy in order to support the sustainability of their business models. This is particularly important due to the rapid pace of change in the industry and the technology.
24.	Claesson Lingehall, Helena, 1965- (author) Delirium in older people after cardiac surgery : risk factors, dementia, patients’ experiences and assessments 2016 Doctoral thesis (other academic/artistic)abstract Background:Delirium is common in older people undergoing cardiac surgery. Delirium is an acute or subacute neuro-psychiatric syndrome, characterized by a change in cognition, disturbances in consciousness; it fluctuates, develops over a short period of time and always has an underlying cause. It is associated with a disturbance in psychomotor activity, and is classified according to different clinical profiles such as hypoactive, hyperactive and mixed delirium. Delirium after cardiac surgery is not harmless, it increases the risk of complications such as prolonged stay in hospital, falls, reduced quality of life, reduced cognitive function and increased mortality.Aim:The overall aim of this thesis was to investigate postoperative delirium in older people undergoing cardiac surgery with Cardiopulmonary Bypass (CPB), focusing on risk factors, dementia and patients’ experiences; and to evaluate an assessment for screening delirium.Methods:This thesis compromises four studies. All participants (n=142) were scheduled for cardiac surgery with use of CPB at the Cardiothoracic Surgery Department, Heart Centre, Umeå University Hospital, Sweden, between February and October 2009. Six structured interviews were conducted preoperatively, day one and day four postoperatively, and in home visits, one, three and five years after surgery (2010, 2012 and 2014). The assessment scales used in Studies I, II and IV were: the Mini-Mental State Examination (MMSE) for cognition, the Organic Brain Syndrome Scale (OBS) for delirium, Geriatric Depression Scale 15 (GDS-15) for depression, Katz staircase with Activities of Daily Living (ADL) for participants’ functional status and the Numerical Rating Scale (NRS) for pain. During the hospital stay, nursing staff used the Swedish version of the Nursing Delirium Screening Scale (Nu-DESC) to assess delirium. Semi-structured interviews were also carried out (III) in the one-year follow up. Delirium, dementia and depression were diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders (DSM IV TR).Results: Out of 142 participants 54.9% (78/142) developed delirium after cardiac surgery (I). Independent risk factors, predisposing and precipitating, associated with delirium were: age, diabetes, gastritis/peptic ulcer, volume load during operation, longer time on ventilator in intensive care, increased temperature and plasma sodium concentration in the intensive care unit. Out of 114 participants thirty (26.3%) developed dementia within the five years of follow-up. It was shown that a lower preoperative MMSE score and postoperative delirium were factors independently associated with development of dementia (II). One year after cardiac surgery, participants diagnosed with postoperative delirium described in detail feelings of extreme vulnerability and frailty. Despite this, the participants were grateful for the care they had received (III). Hypoactive was the most common symptom profile for delirium. The Swedish version of Nu-DESC showed high sensitivity in detecting hyperactive delirium, but low sensitivity in detecting hypoactive delirium (IV).Conclusion:Delirium was common among older patients undergoing cardiac surgery. Both predisposing and precipitating factors contributed to postoperative delirium. Preventive strategies should be considered in future randomized studies. It might also be suggested that cognitive function should be screened for preoperatively and patients who develop delirium should be followed up to enable early detection of symptoms of dementia. Whether prevention of postoperative delirium can reduce the risk of future dementia remains to be studied. To minimise unnecessary suffering, patients and next of kin should be informed about and prepared for the risk of delirium developing during hospitalization. The Swedish version of Nu-DESC should be combined with cognitive testing to improve detection of hypoactive delirium, but further research is needed. Healthcare professionals need knowledge concerning postoperative delirium in order to prevent, detect and treat delirium so as to avoid and relieve the suffering it might cause.
25.	Claesson Lingehall, Helena, et al. (author) Dementia after postoperative delirium in older people who have undergone cardiac surgery: a longitudinal cohort study Other publication (other academic/artistic)
26.	Claesson Lingehall, Helena, et al. (author) Preoperative Cognitive Performance and Postoperative Delirium Are independently Associated With Future Dementia in Older People Who Have Undergone Cardiac Surgery : A Longitudinal Cohort Study 2017 In: Critical Care Medicine. - 0090-3493 .- 1530-0293. ; 45:8, s. 1295-1303 Journal article (peer-reviewed)abstract Objective: To investigate if postoperative delirium was associated with the development of dementia within 5 years after cardiac surgery.Design: Longitudinal cohort study.Setting: Cardiothoracic Division, Umeå University Hospital, Sweden.Patients: Patients aged 70 years old or older (n = 114) scheduled for routine cardiac procedures with cardiopulmonary bypass without documented dementia were enrolled in 2009.Intervention: Structured assessments were performed preoperatively, 1 and 4 days after extubation, and 1, 3, and 5 years postoperatively.Measurements and Main Results: Patients were assessed comprehensively, including cognitive and physical function, coexisting medical conditions, demographic characteristics, and medications. Diagnoses of delirium, depression, and dementia were made according to Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision criteria. During the 5-year period, 30 of 114 participants (26.3%) developed dementia. Postoperative delirium had occurred in 87% of those who later developed dementia. A multivariable logistic regression model showed a lower preoperative Mini-Mental State Examination score (p < 0.001; odds ratio, 0.68; 95% CI, 0.54–0.84) and the occurrence of postoperative delirium (p = 0.002; odds ratio, 7.57; 95% CI, 2.15–26.65) were associated with dementia occurrence.Conclusions: Our findings suggest that older patients with reduced preoperative cognitive functions or who develop postoperative delirium are at risk of developing dementia within 5 years after cardiac surgery. Cognitive functions should be screened for preoperatively, those who develop postoperative delirium should be followed up to enable early detection of dementia symptoms, and management should be implemented.
27.	Claesson Lingehall, Helena, et al. (author) Validation of the Swedish version of the Nursing Delirium Screening Scale used in patients 70 years and older undergoing cardiac surgery 2013 In: Journal of Clinical Nursing. - : Blackwell Publishing. - 0962-1067 .- 1365-2702. ; 22:19-20, s. 2858-2866 Journal article (peer-reviewed)abstract AIMS AND OBJECTIVES: Validation of the Swedish version of the Nursing Delirium Screening Scale as a screening tool for nurses to use to detect postoperative delirium in patients 70 years and older undergoing cardiac surgery.BACKGROUND: Delirium is common among old patients after cardiac surgery. Underdiagnosis and poor documentation of postoperative delirium is problematic, and nurses often misread the signs.DESIGN: A prospective observational study.METHODS: Patients (n = 142) scheduled for cardiac surgery were assessed three times daily by the nursing staff using the Nursing Delirium Screening Scale. Nursing Delirium Screening Scale was compared with the Mini Mental State Examination and the Organic Brains Syndrome Scale, evaluated day one and day four postoperatively. Delirium was diagnosed according to Diagnostic and Statistical Manual of Mental Disorders - DSM-IV-TR criteria.RESULTS: A larger proportion of patients were diagnosed with delirium according to the Mini Mental State Examination and Organic Brains Syndrome Scale compared with the Nursing Delirium Screening Scale, both on day one and day four. The Nursing Delirium Screening Scale protocol identified the majority of hyperactive and mixed delirium patients, whereas several with hypoactive delirium were unrecognised.CONCLUSIONS: The Swedish version of the Nursing Delirium Screening Scale was easily incorporated into clinical care and showed high sensitivity in detecting hyperactive symptoms of delirium. However, in the routine use by nurses, the Nursing Delirium Screening Scale had low sensitivity in detecting hypoactive delirium, the most prevalent form of delirium after cardiac surgery. Nursing Delirium Screening Scale probably has to be combined with cognitive testing to detect hypoactive delirium.RELEVANCE TO CLINICAL PRACTICE: Nurses play a key role in detecting delirium. The Nursing Delirium Screening Scale was easy incorporated instrument for clinical practice and identified the majority of hyperactive and mixed delirium, but several of the patients with hypoactive delirium were unrecognised. Training of assessment and cognitive testing seems to be necessary to detect hypoactive delirium.
28.	Enghag, Margareta, et al. (author) A Teacher Professional Development Programme on Dialogic Inquiry 2018 In: Professional Development for Inquiry-Based Science Teaching and Learning.. - Heidelberg Germany : Springer. - 9783319914060 ; , s. 223-243 Book chapter (peer-reviewed)
29.	Enghag, M., et al. (author) A Teacher Professional Development Programme on Dialogic Inquiry 2018 In: Professional Development for Inquiry-Based Science Teaching and Learning. - Cham : Springer Science and Business Media B.V.. - 9783319914060 ; , s. 223-243 Book chapter (other academic/artistic)abstract In this chapter we report and discuss inquiry-based science teaching/learning and more specifically dialogic inquiry, as a basis for a professional development programme for teachers. The pilot programme aimed at (1) considering teachers’ experience, (2) letting teachers develop their current lessons and (3) prompting teachers’ reflections on generic competencies coming from the theory about communicative approaches and writing in dialog. The intention was to make a long-term difference for science in schools due to teachers’ enhanced awareness of dialogic inquiry. We focus on the teachers’ experience of the research-informed professional development programme. The programme was designed with six meetings, when teachers met and reflected on different aspects of dialogic inquiry, based on video clips of good practice episodes from science lessons. Between the meetings, the teachers developed and analysed their own teaching by using instruments, developed by the researchers, to find out how they used their lesson time on different lesson activities, different communicative approaches and writing. We argue that the balance between dialogic inquiry as a deep meaning-making process and dialogic inquiry as a way to organise the lesson depends on the teacher’s experience, subject knowledge and their students’ interests and creativity. Findings show that teachers observed that too much time was spent on giving instructions, that the writing of hypotheses could be improved and that the teachers’ choice of lesson activities had an impact on learning opportunities. The difference between dialogic inquiry and inquiry is discussed.
30.	Engström, Birgitta, 1941- (author) Information to the patient : an attempt to satisfy the patient's need for information 1986 Doctoral thesis (other academic/artistic)abstract Dissatisfaction with medical information is a common problem among patients. There is also evidence that patients lack information that physicians believe they have given to the patient. The aims of this study were to 1) survey patients' subjective need for, and satisfaction with, the information that they received during their hospital stay 2) develop and evaluate systematic routines for giving information to the patients and also communication and collaboration between the medical and nursing staff concerning the satisfaction of the patients' need for information.The study was an intervention project and the research perspective was organizational psychology.Survey study. The patients experienced a considerable need for medical information, especially about the examination results and prognosis. The patients' need for information regarding prognosis was the least satisfied.Intervention 1. A general improvement of the information to the patients occurred when the systematic routines were established. The patients' subjective need for information was unchanged throughout two years. Their satisfaction with information, after an initial improvement, did not increase throughout these two years. There was low correlation between the patients' and their physicians' estimations concerning the patients' need for information on diagnosis, prognosis and examination results. Likewise, concerning the adequacy of that information.Intervention 2. Communication and collaboration between the medical and nursing staff included a system for assessment and solution of the patients' information problems. Problem-solving took place at a multidisciplinary team conference (MTC). Medical problems were better elucidated than the patients' psychological problems. After training of registered nurses (RN) as conference chairpersons, the patients need for information was better understood. The staff reported 42 information problems after training compared to two before. For half of the information problems decisions were discussed on steps to be taken in order to satisfy the patients' need for information. A year after the system for assessment and solution of information problems was established, the patients were more satisfied with information about examinations and their results and on information about medication (p< 0.05). Further, new norms for the patients' need for information were established and a change was initiated.The results are discussed with regard to how and why patients' shall have information, by whom and to whom information shall be given, when and where information shall be given and which content it shall have.
31.	Engström, Birgitta, 1941-, et al. (author) Sjuksköterska med uppdrag att leda 2009. - 2 [omarb.] i boken angivet som 2:1 Book (other academic/artistic)
32.	Engström, Birgitta, 1941- (author) Tvärprofessionell prioritering inom strokevård med stöd av nationell modell för öppna vertikalaprioriteringar : ett samarbetsprojekt mellan FSA, LSR, SSF och Vårdförbundet 2009 Reports (other academic/artistic)abstract Under de senaste åren har många arbetsterapeuter, sjukgymnaster och sjuksköterskor påtalat behov av att få stöd för att kunna diskutera och genomföra öppna prioriteringar i sina verksamheter. Användbara metoder har också efterfrågats. Detta är bakgrunden till att Förbundet Sveriges Arbetsterapeuter (FSA), Legitimerade Sjukgymnasters Riksförbund (LSR), Svensk Sjuksköterskeförening (SSF) och Vårdförbundet med stöd från PrioriteringsCentrum i Östergötland genomfört ett flertal projekt för att pröva en modell för prioriteringar. I de tre projekt som genomförts påtalades behovet av utveckling av prioriteringsmodellen som är den som används av Socialstyrelseni riktlinjearbetet, så att användbarheten inom omvårdnad och rehabilitering skulle förbättras. Efter ett utvecklingsarbete av PrioriteringsCentrum och Socialstyrelsen, med representanter bland annat från SSF och Vårdförbundet i nära samarbete med FSA och LSR finns sedan 2007 en nationell modell för öppna vertikala prioriteringar. Eftersom det finns liten erfarenhet av prioriteringsarbete i praxis liksom av prioriteringsarbete i teambaserad verksamhet väcktes vårt intresse kring att ta reda på om modellen fungerar som ett stöd vid prioriteringar i den kliniska vardagen. Vårdförbundet, FSA, LSR och SSF valde därför att genomföra ett tvärprofessionellt projekt för att pröva den utvecklade gemensamma arbetsmodellen för vertikala öppna prioriteringar i klinisk praxis.Syftet med projektet var att använda den nationella arbetsmodellen som stöd för tvärprofessionella prioriteringar genom att gemensamt utarbeta ett förslag till rangordning av insatser och en prioriteringsordning inom strokevård vad gäller omvårdnad, arbetsterapi och sjukgymnastik.Verksamhetsområdet strokevård valdes dels eftersom stroke är en vanligt förekommande sjukdom men framförallt för att teamarbetet har en avgörande betydelse för både vårdens resultat och patientens hälsa. Arbetsterapeuter, sjukgymnaster, sjuksköterskor och undersköterskor är alla så gott som alltid involverade i patientens omvårdnad och rehabilitering. De nationella riktlinjerna för strokevård och kunskapssammanställningar inom området utgör en viktig kunskapskälla i prioriteringsarbete.
33.	Engström, Elisabet, et al. (author) Computer-assisted reading intervention for children with hearing impairment using cochlear implants : Effects on auditory event-related potentials and mismatch negativity 2020 In: International Journal of Pediatric Otorhinolaryngology. - : Elsevier. - 0165-5876 .- 1872-8464. ; 137 Journal article (peer-reviewed)abstract OBJECTIVES: The primary aim was to find out whether a computer-assisted reading intervention program with a phonic approach can affect event-related (ERPs) and mismatch negativity (MMN) in hearing impaired (HI) children using cochlear implants (CIs).METHODS: This study involved a test group of 15 HI children with CIs and a control group of 14 normal hearing (NH) children. The children were 4 years and 10 months to 8 years and 1 month old. ERPs were recorded immediately before and after 4 weeks of training with a computer-assisted reading intervention, GraphoGame. A multi-feature paradigm, Optimum-1, was used, i.e. a standard stimulus alternated with five different deviants: gap intensity, pitch, location and duration. MMN was calculated from the mean amplitude ERP of each deviant minus the standard stimulus response in a specific time interval, 80 - 224 ms. Repeated measures ANOVA was used for the statistical analysis.RESULTS: The results did not show any significant changes with the computerassisted training in the ERPs and MMNs among the HI children with CIs. The presence of both MMN and a positive mismatch response (pMMR), which might reflect an immaturity, complicates interpreting the results in this age group. Individually, there was a mix of MMNs and pMMRs among all participants, pre and post training, and the change of each deviant after intervention was not predictable.CONCLUSIONS: There are no significant changes in ERP or MMN after intervention, however lack of significances must be interpreted with caution. Besides the presence of both MMNs and pMMRs, only modest changes are to be expected on an individual basis and small samples hinder making statistical conclusions regarding the training's effects. The study contributes to some more descriptive pieces of ERPs and MMNs among the HI children with CIs. The issues of MMN and pMMR are highlighted.
34.	Engström, Elisabet, et al. (author) Computer-assisted reading intervention for children with sensorineural hearing loss using hearing aids : Effects on auditory event-related potentials and mismatch negativity 2019 In: International Journal of Pediatric Otorhinolaryngology. - : Elsevier. - 0165-5876 .- 1872-8464. ; 117, s. 17-25 Journal article (peer-reviewed)abstract OBJECTIVES: The primary aim was to investigate whether computer-assisted reading intervention somehow can affect event-related potentials (ERP) and mismatch negativity (MMN) in hearing impaired (HI) children with hearing aids (HAs) and normal hearing (NH) children.METHODS: The study included 15 HI children with sensorineural hearing loss (SNHL) using bilateral HAs and 14 NH children as a reference group; all children between the ages of 5 and 8. A multi-feature MMN-paradigm, Optimum-1, with a standard stimulus alternating with 5 different deviants was used. ERPs were recorded pre and post intervention, i.e. one month of repeatedly computer-assisted training (GraphoGame). MMN was calculated from the average ERP of each deviant minus standard. Data were based on samples within a specific time interval, 80-224 ms, and repeated measures ANOVA was used to analyze possible interactions.RESULTS: There was a significant difference between groups before training, though, the mean obligatory responses or MMN was not statistically significantly different before versus after training, neither among the NH nor the HI children. Further, the HI children did generally achieve lower levels in GraphoGame compared to the NH children. Altogether, our findings indicate differences between the groups and that training may affect the neurophysiological processing in the brain, gaining the HI children. Both MMN and positive mismatch response (pMMR) were seen among both the HA and NH children, irrespective to deviant type. Individually, changes of the MMN and pMMR after training seem unpredictable.CONCLUSION: There are statistically significant differences in both the obligatory responses in ERP and the MMNs between the NH and HI groups before the computer-assisted training. Though, these differences disappear after the intervention. This suggests possible training effects regarding the central auditory processing among the HI children.
35.	Engström, Elin, 1983- (author) Eketorps veckningar : Hur arkeologi formar tid, rum och kön 2015 Doctoral thesis (other academic/artistic)abstract This thesis examines the history of the cultural heritage site of Eketorp, a prehistoric ring-fort, on the island of Öland, Sweden. The archaeological excavations at Eketorp, which began in 1964, lasted for a decade and soon turned into one of the largest archaeological research projects in Sweden. The scale and the implementation of the excavations, as an interdisciplinary and international research project, fostered a whole generation of archaeologists and resulted in numerous research publications. After the excavations the archaeological site was transformed into a full-scale archaeological reconstruction by the Swedish National Heritage Board. Since the mid-1980s the site has been a popular tourist attraction and open-air museum.The history of the site itself connects to several academic fields, including archaeology, history of archaeology, cultural heritage and museum studies. Through Ludwig Fleck’s concept thought collective and Donna Haraway’s situated knowledge, which are used as analytical tools, the aim of this thesis is to explore how these different fields interacted throughout the history of Eketorp. Further, the analytical tools are used to highlight how these interactions have generated notions of time, space, and gender.The study takes an interdisciplinary approach with the history of Eketorp analysed in three analytical chapters, each of them with different chronological and empirical focus. First, Eketorp is explored as a contemporary museum space through ethnographic fieldwork. Second, archive material is used to analyse how the archaeological excavation and the following archaeological reconstruction were conducted during the 1960s and onwards. Third, scientific texts are used to analyse how interpretations of Eketorp as a prehistoric site has changed. The concluding chapter integrates the results of the three chapters in order to critically examine how notions of time, space and gender interconnect between these fields. Illustrated by a wide chronological and interdisciplinary approach, the central argument of the thesis is thus that the Eketorp thought collective and thought style, intimately connected to hierarchies in academic practice, were created, performed, and maintained through several scientific and heritage institutions.
36.	Engström, Karin, et al. (author) Attityder till deltagande i planering av undervisning hos elever på gymnasieskolans vårdlinje : Gren för hälso- och sjukvård vid Stensöskolan i Kalmar 1984 Reports (other academic/artistic)
37.	Engström, Kerstin, 1959- (author) Genus & genrer : forskningsanknutna genusdiskurser i dagspress 2008 Doctoral thesis (other academic/artistic)abstract At the centre of this study lies the question of how research-related media texts contribute to the social construction of sex and gender conceptions when they use research, either as a main source, or to support or comment on specific issues and statements, from the political arena, for example. The principal aim of the study has been to analyze and problematize the ways in which different types of newspapers, genres and editorial sections reproduce, or contribute to change, in existing gender discourses.The material was collected from two Swedish newspapers during the year 2001: the national morning paper Dagens Nyheter (DN), and the national evening paper Aftonbladet.The theories of discourse, agenda-setting and -framing in this study are related to the questions: what kinds of knowledge on women and men, and biological, physiological, psychological, social and cultural perspectives on sex/gender are represented; how are they described; and how do content and form contribute to the (re)production of, or change in, gender discourses? The main analytical perspectives are those about gender discourse (re)production, genres as ideological forms, and the epistemologies of journalism.A combination of analytical strategies and methods was used: content and thematic analysis, and qualitative analysis of text and language with methodological tools from different traditions of discourse analysis.In my study, I can see an interplay between research traditions and genre conventions in the (re)production of gender discourses. Since the news sections repeatedly choose to publish research as empiric and in the form of results, and then within that, primarily findings from medicine and the social sciences, these areas are reproduced as important and relevant, and as producers of objective, true knowledge that can be presented as simple facts. Research-related texts in culture journalism, on the other hand, follow the tradition of primarily treating research within the humanities, and nowadays also gender and queer theoretical perspectives within different disciplines. Through the genre conventions of culture journalism, this research is reproduced as something that you can reflect upon, problematize, criticize, form an opinion of, and judge.The study also gives reason to argue that media logic and institutionalized genre conventions contribute to the reproduction of science and research as different worlds and cultures, in which the natural sciences and the humanities are found in different media spaces, and different forms of knowledge about sex/gender are given space on different conditions and in different forms.
38.	Engström, Maria, 1966- (author) A Caregiver Perspective on Incorporating IT Support into Dementia Care 2006 Doctoral thesis (other academic/artistic)abstract Aim: The overall aim of the present thesis was to describe and evaluate IT support in dementia care from the perspectives of staff and relatives. More specifically, it was to examine staff members’ satisfaction with work, life satisfaction and sense of coherence before and after increased IT support, to describe staff members’ opinions and perceptions of IT support during the process of implementation, to describe relatives’ opinions of IT support and to compare relatives’ perceptions of their irritations with care and life satisfaction before and after increased IT support. In addition, three questionnaires were further developed and tested among staff working in elderly care, and then used in the staff evaluation. Methods: A quasi-experimental design with baseline assessments and follow-ups and experimental and control groups was used in two studies to investigate the outcomes of IT support. A descriptive design was used to study staff views on IT support, and a correlative design was used in the methodological study. Participants were 33 staff members and 22 relatives in the evaluation, 14 staff members in the descriptive study and 299 staff members in the methodological study. Data collection methods were questionnaires and group interviews. The IT support consisted of passive passage alarms, fall detectors, sensor-activated night-time illumination of the lavatory, movement detectors, email communication, an Internet website and additional computers. Findings and conclusions: Staff job satisfaction and perceived quality of care increased in the experimental group. The relatives were generally positive about the IT support, and the experimental group showed a decrease in practical/logistical irritations. Staff described ‘moving from fear of losing control to perceived increase in control and security’ and ‘constant struggling with insufficient/deficient systems’. Conclusions are that IT support can be a resource in dementia care as perceived by caregivers if IT support is incorporated into the care system.
39.	Engström, Maria, 1958-, et al. (author) Brain Activation During Compassion Meditation : A Case Study 2010 In: Journal of Alternative and Complementary Medicine. - United States : Mary Ann Liebert, Inc. Publishers. - 1075-5535 .- 1557-7708. ; 16:5, s. 597-599 Journal article (peer-reviewed)abstract Objectives: B.L. is a Tibetan Buddhist with many years of compassion meditation practice. During meditation B.L. uses a technique to generate a feeling of love and compassion while reciting a mantra. The aim of the present study was to investigate the neural correlates of compassion meditation in 1 experienced meditator. Methods: B.L. was examined by functional magnetic resonance imaging during compassion meditation, applying a paradigm with meditation and word repetition blocks. Results: The most significant finding was the activation in the left medial prefrontal cortex extending to the anterior cingulate gyrus. Other significant loci of activation were observed in the right caudate body extending to the right insula and in the left midbrain close to the hypothalamus. Conclusions: The results in this study are in concordance with the hypothesis that compassion meditation is accompanied by activation in brain areas involved with empathy as well as with happy and pleasant feelings (i.e., the left medial prefrontal cortex and the anterior cingulate gyrus).
40.	Engström, Maria, et al. (author) District nurses' self-reported clinical activities, beliefs about and attitudes towards obesity management 2013 In: Applied Nursing Research. - : Elsevier BV. - 0897-1897 .- 1532-8201. ; 26:4, s. 198-203 Journal article (peer-reviewed)abstract Aim: To describe district nurses' self-reported clinical activities, beliefs about and attitudes towards obesity management; and to examine associations between the variables. Background: Obesity is increasing worldwide and primary care could play a central role in the management. Methods: Questionnaire data were collected from 247 nurses in 33 centres. Results: The most common activities performed weekly were; advice about physical activity (40.1%) and general lifestyle advice (34.8%). However, nearly one third seldom/never performed these activities. Approximately half seldom/never performed BMI assessment and even fewer waist circumference (78.1%). Values for the factors Importance of obesity and Personal effectiveness were skewed towards a positive view and Negative view close to neutral. Multivariate analysis revealed that nurses with specialized tasks, longer working experience and higher perceived personal effectiveness performed more clinical activities. Conclusion: Managers need to make efforts to engage all personnel in obesity management; and strategies to increase self-efficacy are called for.
41.	Engström, Maria, 1966-, et al. (author) Evaluation of OLD@HOME virtual health record : staff opinions of the system and satisfaction with work 2009 In: Telemedicine journal and e-health. - : Mary Ann Liebert Inc. - 1530-5627 .- 1556-3669. ; 15:1, s. 53-61 Journal article (peer-reviewed)abstract The aim of the present research was to study outcomes of use of the OLD@HOME Virtual Health Record with regard to staff opinions about information, communication technology, and satisfaction with work. A quasi-experimental design was used. Staff opinions about the information and communication technology were assessed using a study-specific questionnaire at the test site (n =22) and at other settings in the municipality (n =172). Staff (n =22) job satisfaction, perceived quality of care, and psychosomatic health were assessed using the Satisfaction with Work Questionnaires before and after a 5-month period of testing the technology in an intervention and a comparison group. Staff opinions about the information and communication technology were significantly more positive at the test site compared to other settings in the municipality. For the total scale of quality of care and the factor documentation, there were significant differences in change scores between intervention and comparison groups, with improvements for the comparison group. For job satisfaction and psychosomatic health, there were no differences in change scores between the groups. Participatory design enhances staff opinions about information and communication technology. However, a 5-month test period showed no benefits regarding staff satisfaction with work when compared to a comparison group. On the contrary, the comparison group improved in documentation, and for the intervention group, there was a trend toward deterioration, which may be due to their knowing how to document, but not having time when using both paper-based and electronic systems.
42.	Engström, Maria, et al. (author) Functional Magnetic Resonance Imaging of Hippocampal Activation During Silent Mantra Meditation 2010 In: Journal of Alternative and Complementary Medicine. - : Mary Ann Liebert, Inc.. - 1075-5535 .- 1557-7708. ; 16:12, s. 1253-1258 Journal article (peer-reviewed)abstract Objectives: The objective of the present study was to investigate whether moderately experienced meditators activate hippocampus and the prefrontal cortex during silent mantra meditation, as has been observed in earlier studies on subjects with several years of practice. Methods: Subjects with less than 2 years of meditation practice according to the Kundalini yoga or Acem tradition were examined by functional magnetic resonance imaging during silent mantra meditation, using an on-off block design. Whole-brain as well as region-of-interest analyses were performed. Results: The most significant activation was found in the bilateral hippocampus/parahippocampal formations. Other areas with significant activation were the bilateral middle cingulate cortex and the bilateral precentral cortex. No activation in the anterior cingulate cortex was found, and only small activation clusters were observed in the prefrontal cortex. Conclusions: In conclusion, the main finding in this study was the significant activation in the hippocampi, which also has been correlated with meditation in several previous studies on very experienced meditators. We propose that the hippocampus is activated already after moderate meditation practice and also during different modes of meditation, including relaxation. The role of hippocampal activity during meditation should be further clarified in future studies, especially by investigating whether the meditation-correlated hippocampal activity is related to memory consolidation.
43.	Engström, Maria, 1958-, et al. (author) Paradigm design of sensory–motor and language tests in clinical fMRI 2004 In: Neurophysiologie clinique. - : Elsevier BV. - 0987-7053 .- 1769-7131. ; 34:6, s. 267-277 Journal article (peer-reviewed)abstract Functional magnetic resonance imaging (fMRI) paradigms on sensory–motor and language functions are reviewed from a clinical user’s perspective. The objective was to identify special requirements regarding the design of fMRI paradigms for clinical applications. A wide range of methods for setting up fMRI examinations were found in the literature. It was concluded that there is a need for standardised procedures adapted for clinical settings. Sensory–motor activation patterns do not vary much at different hand motion tasks. Nevertheless it is one of the most important clinical tests. In contrast, the language system is much more complex. In several studies it has been observed that word production tasks are preferable in determination of language lateralisation. Broca’s area is activated by most tasks, whereas sentence processing and semantic decision also involve activation in temporoparietal and frontal areas. However, combined task analysis (CTA) of several different tasks has been found to be more robust and reliable for clinical fMRI compared to separate task analysis.
44.	Engström, Maria, et al. (author) Relatives’ opinions of IT support, perceptions of irritations and life satisfaction in dementia care 2006 In: Journal of Telemedicine and Telecare. - : SAGE Publications. - 1357-633X .- 1758-1109. ; 12:5, s. 246-250 Journal article (peer-reviewed)abstract We studied relatives' opinions of IT support at a residential home for persons with dementia. We also investigated the relatives' perceptions of irritations and life satisfaction before and after increased IT support. This was accomplished using an experimental group (n = 14) and a control group (n = 8) of subjects in dementia care. The design was quasi-experimental with baseline assessments and three follow-ups. Data were collected using two questionnaires measuring opinions of the IT support: irritations in care (the Nursing Home Hassles Scale) and life satisfaction (the Life Satisfaction Questionnaire). Results showed that relatives' opinions of IT support were generally positive. In the experimental group, relatives' perceptions of practical/logistical irritations decreased between baseline and 12-month follow-up. In the control group, there was an increase in the total Nursing Home Hassles score between baseline and three-month follow-up. This difference did not persist at seven- and 12-month follow-ups. No significant differences were found for life satisfaction. We conclude that relatives had positive opinions of IT support, and their perceptions of practical/logistical irritations decreased after implementation of the IT support package.
45.	Engström, Martin, et al. (author) Should central venous catheters, with the tip accidentally placed retrograde in the internal jugular vein, be corrected 2001 In: Acta Anaesthesiologica Scandinavica. - : Wiley. - 0001-5172. ; 45:5, s. 653-654 Journal article (peer-reviewed)
46.	Engström, Maria, et al. (author) Staff members' opinions and perceptions of new IT support in dementia care during the process of implementation Other publication (other academic/artistic)
47.	Engström, Maria, et al. (author) Staff members' perceptions of a ICT support package in dementia care during the process of implementation 2009 In: Journal of Nursing Management. - : Hindawi Limited. - 0966-0429 .- 1365-2834. ; 17:7, s. 781-789 Journal article (peer-reviewed)abstract AIM The aim of the present study was to describe staff members' perceptions of an information and communication technology (ICT) support package during the process of implementation. BACKGROUND ICT in dementia care will likely increase in the future. The diffusion of new innovations can be better understood through diffusion research. METHODS Fourteen staff members in dementia care were interviewed, in groups, once before the new ICT, twice during its implementation and once after. Data were analysed using qualitative content analyses. The ICT included monitors/alarms: passage alarms, fall detectors, sensor-activated night-time illumination of the lavatory, and communication technology: Internet communication and additional computers. RESULTS The results showed two themes 'Moving from fear of losing control to perceived increase in control and security' and 'Struggling with insufficient/deficient systems'. CONCLUSIONS Staff perceptions of ICT were diverse and changed during the implementation. Benefits were more pronounced than disadvantages, and improvements were described both in care and in staff job situation. IMPLICATIONS FOR NURSING MANAGEMENT Functioning and use of ICT may relate to design as well as by application and the surrounding structure, and the whole system: the organizational structure, the employers and the new product needs to be taken into consideration when implementing new technology.
48.	Engström, Maria, et al. (author) Staff perceptions of job satisfaction and life situation before and 6 and 12 months after increased information technology support in dementia care 2005 In: Journal of Telemedicine and Telecare. - : SAGE Publications. - 1357-633X .- 1758-1109. ; 11:6, s. 304-309 Journal article (peer-reviewed)abstract We measured staff members' satisfaction with their work beforeand after increased information technology (IT) support in dementiacare. Comparisons were also performed of perceived life satisfactionand sense of coherence. Data were collected before, and 6 and12 months after implementation of the first part of an IT supportproject. Instruments used were the Satisfaction with Work Questionnaires,the Life Satisfaction Questionnaire (LSQ) and the Sense of Coherence(SOC) scale. The study was performed in a residential home forpersons with dementia. The participants were 33 staff members.The IT technology included general and individualized passagealarms, sensor-activated night-time illumination, fall detectorsand Internet communication. Results showed that staff members'job satisfaction and perceived quality of care improved in comparisonwith the control group. Personal development, workload, expectationsand demands, internal motivation and documentation, as wellas the total scores for 'psychosocial aspects of job satisfaction'and 'quality of care aspects', increased in the experimentalgroup. There were significant interaction effects for the factorsfamily relation, close friend relation (LSQ), the total SOCscale and the meaningfulness subscale. The study showed thatIT support in dementia care increased staff members' satisfactionwith their work in several ways.
49.	Engström, Maria, et al. (author) Staff satisfaction with work, perceived quality of care and stress in elderly care : psychometric assessments and associations 2006 In: Journal of Nursing Management. - : Hindawi Limited. - 0966-0429 .- 1365-2834. ; 14:4, s. 318-328 Journal article (peer-reviewed)abstract AIMS: To evaluate validity and reliability of three questionnaires measuring 'work satisfaction', 'patient care' and 'staff health' for staff in elderly care and to study the relationship between staff members' satisfaction with work and perceived stress.BACKGROUND: Increased workload, difficulties in recruiting and retaining nurses are reported in elderly care. Valid and reliable instruments measuring staffs' perceptions of work are needed.METHODS: A convenience sample of 299 staff answered the questionnaires.RESULTS: Factor analysis of 'work satisfaction' gave eight factors, 'patient care' four factors and 'staff health' two factors, explaining 52.2%, 56.4% and 56.8% of the variance. Internal consistency was mostly satisfactory. Multiple regression analysis revealed a model that explained 41% of the variance in perceived stress symptoms.CONCLUSIONS: There was support for the instruments' validity and reliability. Older age, higher scores/satisfaction with workload, cooperation, expectations and demands, personal development and lower scores on internal motivation contributed to less stress.
50.	Engvall, Caroline, 1976- (author) Drug Partitioning into Natural and Artificial Membranes : Data Applicable in Predictions of Drug Absorption 2005 Doctoral thesis (other academic/artistic)abstract When drug molecules are passively absorbed through the cell membrane in the small intestine, the first key step is partitioning of the drug into the membrane. Partition data can therefore be used to predict drug absorption. The partitioning of a solute can be analyzed by drug partition chromatography on immobilized model membranes, where the chromatographic retention of the solute reflects the partitioning. The aims of this thesis were to develop the model membranes used in drug partition chromatography and to study the effects of different membrane components and membrane structures on drug partitioning, in order to characterize drug–membrane interactions. Electrostatic effects were observed on the partitioning of charged drugs into liposomes containing charged detergent, lipid or phospholipid; bilayer disks; proteoliposomes and porcine intestinal brush border membrane vesicles (BBMVs), and on the retention of an oligonucleotide on positive liposomes. Biological membranes are naturally charged, which will affect drug partitioning in the human body. Proteoliposomes containing transmembrane proteins and cholesterol, BBMVs and bilayer disks were used as novel model membranes in drug partition chromatography. Partition data obtained on proteoliposomes and BBMVs demonstrated how cholesterol and transmembrane proteins interact with drug molecules. Such interactions will occur between drugs and natural cell membranes. In the use of immobilized BBMVs for drug partition chromatography, yet unsolved problems with the stability of the membrane were encountered. A comparison of partition data obtained on bilayer disks with data on multi- and unilamellar liposomes indicated that the structure of the membrane affect the partitioning. The most accurate partition values might be obtained on bilayer disks. Drug partition data obtained on immobilized model membranes include both hydrophobic and electrostatic interactions. Such partition data should preferably be used when deriving algorithms or computer programs for prediction of drug absorption.

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