| 1. |
- Andersson, Lisbet
(author)
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Med dig vid min sida : -det vårdande mötets betydelse när barn genomgår anestesi i en högteknologisk operationsmiljö
- 2022
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Doctoral thesis (other academic/artistic)abstract
- Aim: The overall aim of this thesis was to contribute with knowledge of and gain a greater understanding of the encounter between children, parents, and anesthesia staff in a high-technological surgical environment.Methods: This thesis is based on four studies with descriptive, interpretive and cross-sectional designs. Study I includes 28 children with a focus on the meaning of being anesthetized. Data were collected with non-participant video observations, field notes, and interviews. Data were analyzed using a lifeworld hermeneutical approach according to Dahlberg et al. Study II includes six parents with a focus on the meaning of being a parent at one’s child’s first anesthesia in day surgery. The data analysis was carried out with a phenomenological perspective according to Giorgi’s human science method. Study III includes 809 questionnaires completed by nurse anesthetists about the importance of Families’ in Nursing Care (FINC-NA). Data were analyzed with descriptive statistics and multiple linear regression analysis. Finally, study IV includes 27 non-participant observations when children are being anesthetised. The data analysis was carried out with an observational design with a hermeneutic approach grounded in the philosophy of Gadamer and further described by Ericsson et al.Results: The children’s experiences of being anesthetized are: like being powerless, striving for control, experiencing ambiguous comprehensibility, and they are seeking security. They struggle with anxiety as a result of their inability to protect themselves. Their parents experience ambivalence between worry and relief, and a feeling of losing control. They need to be prepared, be present, and have emotional support. The nurse anesthetists generally had a positive attitude towards the importance of parental presence. Working in a district hospital, working only with children, having routines, being a woman, and allowing both parents to be present and greather experience of children’s anesthesia were associated with a more positive attitude. However, the operating room is not designed for children or the parent’s comfort during the child’s anesthesia induction, and there is a need to be inviting and to be invited, a need for varying compliance, there is a need for mutual dependence, and a need to give and receive emotional support.Conclusions: The reasons children experience anxiety are multifaceted. It is thus essential to listen to the voice of each child and each parent, support them, strive to create an individually adopted caring with so much protection as possible, and see parents as a resource and a conversational partner. The caring encounter is essential when children undergo anesthesia in a high-technical surgical environment. The anesthesia staff can be a powerful resource depending on their demeanour.
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| 2. |
- Brambila-Macias, Sergio, 1980-, et al.
(author)
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Development of an environmental evaluation tool in the transport sector and its impact on decision-making in the early stages of design
- 2018
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In: Designing Sustainable Technologies, Products and Policies. - Cham : Springer. - 9783319669816 - 9783319669809 ; , s. 381-389
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Conference paper (peer-reviewed)abstract
- Due to government policies and regulations as well as customer and societal demands, organizations around the world are looking for ways to manage their economic, environmental and social sustainability. One of the most frequently used standards for organizations seeking to manage their environmental responsibilities is ISO 14001. This framework, however, is generic because it can be used by any organization irrespective of sector, activity or core values. Therefore, implementation of generic guidelines might result in the use of alternative tools that respond better to specific organizational needs and that provide outcomes that can be useful for decision-making. Through case study methodology, this paper shows how Volvo Group, a world-leading producer of transport solutions, developed an internal environmental evaluation tool called Environmental Screening (EnvS) to improve the environmental performance of its solutions.
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| 3. |
- Engh Kraft, Lisbet, 1954-, et al.
(author)
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School Nurses Avoid Addressing Child Sexual Abuse
- 2017
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In: Journal of School Nursing. - : SAGE Open. - 1059-8405 .- 1546-8364. ; 33:2, s. 133-142
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Journal article (peer-reviewed)abstract
- Child sexual abuse (CSA) is a global public health problem with major consequences for the individual child and society. An earlier Swedish study showed that the school nurses did not initially talk about nor mention CSA as one form of child abuse. For the child to receive adequate support, the disclosure is a precondition and is dependent on an available person prepared to listen. The aim of the study was to explore the ability of the school nurses to detect and support sexually abused children. It is a secondary analysis of focus group interviews with school nurses. Thematic analysis was performed. Results showed that the school nurses avoided addressing CSA due to arousal of strong emotions, ambivalence, and a complicated disclosure process. In order to detect CSA and support abused children, attentiveness of sexual abuse as a possible cause of physical and mental illhealth is crucial.
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| 4. |
- Engh Kraft, Lisbet, et al.
(author)
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The School Nurse's Ability to Detect and Support Abused Children : A Trust-Creating Process
- 2015
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In: Journal of School Nursing. - : Sage Publications. - 1059-8405 .- 1546-8364. ; 31:5, s. 353-362
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Journal article (peer-reviewed)abstract
- Child abuse has negative health consequences. Early detection and preventive measures lead to avoidance of prolonged and more complex problems. School nurses have a child protection role and should pay attention to vulnerable children. Through health dialogues and other interactions with pupils, school nurses have the opportunity to detect child abuse. The aim of the study was to explore how school nurses detect child abuse and initiate support measures. Focus group interviews were conducted with 23 school nurses. The data were analyzed using a grounded theory approach. Results showed that the main concern of the school nurses was support and assistance to children who are abused which was preceded by a trust-creating and trust-strengthening process. Trust contains self-confidence and confidence in the system and trust can be strengthened or undermined. Building trustful relations is time consuming and is facilitated by networking, refined assessment instruments, and collaboration.
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| 5. |
- Engh, Lisbet, PhD, 1954-, et al.
(author)
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Att fråga om våld vid hälsosamtalet hjälper barn att berätta
- 2021
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Reports (other academic/artistic)abstract
- Skolsköterskan har potential att upptäcka våld mot barn vid sina regelbundna kontakter med elever. Syftet med studien var att utveckla ett nytt instrument (muntlig enkät) med frågor om våld att användas vid hälsosamtalet med eleven. Frågeställningarna inkluderade om våldsutsatthet upptäcktes, stödåtgärder samt reflektioner kring samtalet. Mixad metod användes, vilket inkluderar både kvantitativa och kvalitativa data. Totalt deltog 139 elever. Vid hälsosamtalet avslöjades elevers våldsutsatthet. Flickorna rapporterade mer utsatthet på alla områden jämfört med pojkarna. Frågorna om våld stimulerade även till fördjupade samtal. Eleverna upplevde att de vuxna som frågade var genuint intresserade av deras situation, vilket bidrog till en stämning av tillit och trygghet samt beslut att berätta om sin utsatthet. Studien visar också värdet av kunskap om våld mot barn, som ger en trygghet att ställa icke värderande frågor, tolka signaler och agera vid våldsutsatthet. Slutsatsen är att hälsosamtalet kan inkludera frågor om våld. Det visar även värdet av fördjupat samtal, vilket kan förebygga framtida negativa hälsokonsekvenser.
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| 6. |
- Engh, Lisbet, 1954-, et al.
(author)
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Can school attachment modify the relation between foster care placement and school achievement?
- 2018
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In: British Journal of School Nursing. - : Mark Allen group. - 1752-2803 .- 2052-2827. ; 13:4, s. 175-185
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Journal article (peer-reviewed)abstract
- The aim of this research is to examine the relation between school attachment and school achievement and foster care placement.A cross-sectional study was carried out with data from 20 340 pupils in Sweden, aged 10, 13 and 16 years, 252 of the children were placed in foster care.Data on children's health, school attachment and school achievement were obtained from the Pupil Health Database.The results show that school achievement was significantly poorer for children in foster care than for other children, but only when they had low school attachment. When they had high school attachment, there was no difference in school achievement between the groups. Therefore, the results of this study suggests that school attachment could modify the relation between foster care placement and school achievement. The interaction effect was statistically significant after adjusting for age and sex. By promoting school attachment for children in foster care through creating supportive relations and a friendly school environment, the school achievement can be improved.
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| 7. |
- Engh, Lisbet, 1954-
(author)
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Skolsköterskans möjlighet att upptäcka och stödja barn som far illa eller riskerar att fara illa
- 2018
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Doctoral thesis (other academic/artistic)abstract
- Since children are a vulnerable group, the society has a special responsibility to protect them. The school nurse sees all pupils at school at regular health visits and thereby gains knowledge of their health and living conditions. The overall aim of the thesis was to develop empirical knowledge and understanding of the ability of the school nurse to detect and support children who are maltreated or at risk to be maltreated. The thesis is based on four studies. Study I was based on focus group interviews with school nurses. Data was analysed in accordance with Grounded Theory. Study II was a secondary analysis of study I and performed with Thematic Analysis. Studies III and IV were based on population data which was analysed by univariate and multivariate logistic regressions. The results showed that the school nurse has ability to detect children who are maltreated or at risk to be maltreated. However, also obstacles for detection were found such as lack of trust, avoidance, strong feelings and insufficient documentation. The obstacles were partly due to organisational shortcomings and dearth of resources affecting also internal and external collaboration. The school nurse strived for building trustful relations to pupils, to parents and to professionals. If the school nurse failed to report suspected child maltreatment to the child protection services it was because of worries that the reporting did not benefit the child. The school nurse avoided addressing child sexual abuse because of its particular sensitiveness, which affected the possibility to detect the abuse. Pupils in foster care were at higher risk of health problems, a more risky lifestyle, a lower degree of school attachment and lower school performance compared to pupils not in foster care. The results emphasize the potential of the school nurse to detect and support maltreated children through regular contacts with pupils, their confidence in the school nurse and trustful relations with other professionals.
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| 8. |
- Engh, Lisbet, 1954-, et al.
(author)
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Swedish population-based study of pupils showed that foster children faced increased risks for ill health, negative lifestyles and school failure.
- 2017
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In: Acta Paediatrica. - : Wiley-Blackwell. - 0803-5253 .- 1651-2227. ; 106:10, s. 1635-1641
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Journal article (peer-reviewed)abstract
- AIM: This population-based study explored whether foster children faced a higher risk of health problems than children of the same age who were not in foster care.METHODS: Data for 13 739 pupils aged 10, 13 and 16 years were obtained from the Pupil Health Database in the county of Värmland, Sweden, for the school years 2012/2013 and 2013/2014. These included data on school performance, health, lifestyle and social relationships, based on children's interviews with school nurses.RESULTS: Of all the pupils, 171 (1.2%) were in foster care. Children in foster care were generally unhealthier than other children. Both girls and boys were at higher risk of chronic health problems, daily smoking, use of drugs and school failure. When the girls in foster care were compared to other girls, we found that they faced a higher risk of psychological and psychosomatic symptoms. This difference was not found for boys. Foster children were also more likely to express a more negative view on life.CONCLUSION: We confirmed earlier studies that children in foster care tended to have inferior health and well-being than other children. These findings emphasise that health, risky behaviour and school performance should be considered together when assessing foster children.
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| 9. |
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| 10. |
- Södergren, Anna, et al.
(author)
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Atherosclerosis in early rheumatoid arthritis : very early endothelial activation and rapid progression of intima media thickness
- 2010
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In: Arthritis Research & Therapy. - : Springer Science and Business Media LLC. - 1478-6362 .- 1478-6354. ; 12:4, s. R158-
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Journal article (peer-reviewed)abstract
- INTRODUCTION : In this study we aimed to investigate whether there are indications of premature atherosclerosis, as measured by endothelial dependent flow-mediated dilation (ED-FMD) and intima media thickness (IMT), in patients with very early RA, and to analyze its relation to biomarkers of endothelial dysfunction, taking inflammation and traditional cardiovascular disease (CVD) risk factors into account. METHODS : Patients from the three northern counties of Sweden diagnosed with early RA are followed in an ongoing prospective study of CVD co-morbidity. Of these, all patients aged ≤60 years were consecutively included in this survey of CVD risk factors (n = 79). Forty-four age and sex matched controls were included. IMT of common carotid artery and ED-FMD of brachial artery were measured using ultrasonography. Blood was drawn for analysis of lipids, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), plasminogen activator inhibitor-1 (PAI-1), tissue plasminogen activator (tPA)-mass, VonWillebrand factor (VWF), soluble intercellular adhesion molecule-1 (sICAM), soluble vascular cell adhesion molecule-1 (sVCAM), sE-selectin, sL-selectin and monocyte chemotactic protein-1 (MCP-1). In a subgroup of 27 RA patients and their controls the ultrasound measurements were reanalysed after 18 months. RESULTS : There were no significant differences between RA patients and controls in terms of IMT or ED-FMD at the first evaluation. However after 18 months there was a significant increase in the IMT among the patients with RA (P < 0.05). Patients with RA had higher levels of VWF, sICAM-1 (P < 0.05) and of MCP-1 (P = 0.001) compared with controls. In RA, IMT was related to some of the traditional CVD risk factors, tPA-mass, VWF (P < 0.01) and MCP-1 and inversely to sL-selectin (P < 0.05). In RA, ED-FMD related to sL-selectin (P < 0.01). DAS28 at baseline was related to PAI-1, tPA-mass and inversely to sVCAM-1 (P < 0.05) and sL-selectin (P = 0.001). CONCLUSIONS : We found no signs of atherosclerosis in patients with newly diagnosed RA compared with controls. However, in patients with early RA, IMT and ED-FMD were, to a greater extent than in controls, related to biomarkers known to be associated with endothelial dysfunction and atherosclerosis. After 18 months, IMT had increased significantly in RA patients but not in controls.
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