| 1. |
- Kågedal, Bertil, 1943-, et al.
(author)
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Determination of glomerular filtration rate, a spin off aftercontrast-enhanced computed tomography among criticallyill patients − proof of concept
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Other publication (other academic/artistic)abstract
- Background Recently, Gong et al. (Gong et al. 2022) showed, in nine heathy subjects, that plasma clearance of high doses of iohexol given as contrast enhanced computed tomography (CT) could be used for determination of glomerular filtration rate (GFR). We utilized high doses of iohexol from angiographic or other contrast enhanced CT given to critical ill patients for calculation of GFRiohexol and compared these data with standard low dose iohexol GFR determinations.Method Patients at intensive care units (ICUs) in Southeast Sweden intended for radiographic investigations that included injection of 45-120 ml of iohexol (Omnipaque) were included, and the concentration of iohexol in plasma was measured by HPLC. Iohexol clearance was calculated by the method of Bröchner-Mortensen. The following days was iohexol clearance determined using the standard low dose of 5 mL of iohexol. Sixteen patients admitted to ICUs were included in this pilot study.Results GFR after high dosing of iohexol at contrast enhanced CT could be measured for all sixteen critically ill patients. Patients with normal or increased renal function had neglectable iohexol concentrations the day following the CT scan. There was excellent correlation between GFR determination with high and standard low iohexol dosing among these 6 patients. Ten patients had decreased renal function and delayed elimination of iohexol, thus was not GFR measurement with low dose iohexol possible to analyse the day after CT scan with high dose iohexol.Conclusion This pilot study showed that GFR can be measured after high doses of iohexol at enhanced CT and compare well with the standard low dose of iohexol clearance determinations.
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| 2. |
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| 3. |
- Abma, Tineke, et al.
(author)
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Enriching evaluation practice through care ethics
- 2020
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In: Evaluation. - : Sage Publications. - 1356-3890 .- 1461-7153. ; 26:2, s. 131-146
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Journal article (peer-reviewed)abstract
- Recently, several authors have called for a critical assessment of the normative dimensions of evaluation practice. This article responds to this call by demonstrating how evaluation practice can be enriched through deliberate engagement with care ethics. Care ethics has a relational and practice view of morality and places caring relationships and responsibilities at the forefront of our being in the world. We will demonstrate how care ethics, in particular Joan Tronto’s moral-political theory of democratic caring, can help evaluators to reshape our way of working by placing caring and relationality at the centre of our evaluative work. Care ethics as a normative orientation for evaluation stretches beyond professional codes of conduct, and rule- or principled-based behaviour. It is part of everything we do or not do, how we interact with others, and what kinds of relationships we forge in our practice. This is illustrated with two examples: a democratic evaluation of a programme for refugee children in Sweden; and a responsive evaluation of a programme for neighbours of people with an intellectual disability in The Netherlands. Both examples show that a caring ethos offers a promising pathway to address the larger political, public issues of our times through the interrogation of un-caring practices. We conclude a caring ethos can help evaluators to strengthen a caring society that builds on people’s deeply felt need to care, to relate, and to connect within and across communities.
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| 8. |
- Andersson, Katarina, et al.
(author)
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Governance, Accountability, and Organizational Development : Eldercare Unit Managers' and Local Politicians' Experiences of and Responses to State Supervision of Swedish Eldercare
- 2018
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In: Journal of Aging & Social Policy. - : Routledge. - 0895-9420 .- 1545-0821. ; 30:5, s. 419-439
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Journal article (peer-reviewed)abstract
- This article explores how local politicians and care unit managers in Swedish eldercare experience and respond to state supervision. Twelve politicians and 12 managers in 15 previously inspected municipalities were interviewed about their experiences of and reactions to state supervision (SSV) in relation to their views of care quality and routines in eldercare practice. The findings indicate that local managers and political chairs perceived SSV in eldercare positively at a superficial level, but were critical of and disappointed with specific aspects of it: in terms of a) governance—chairs and managers said SSV strengthened implementation of national policies via local actors, but were critical of SSV’s narrow focus on control and flaws in eldercare practice; b) accountability—SSV was seen as limited to accountability for finances and systemic performance; and c) organizational development—SSV was seen as limited to improving routines and compliance with legislation, while local definitions of quality are broader than that. In general, local actors regarded SSV as improving administrative aspects and routines in practice but ignoring the relational content of eldercare quality.
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| 9. |
- Andersson, Katarina, 1963-, et al.
(author)
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Statlig tillsyn
- 2019
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In: Perspektiv på granskning inom offentlig sektor. - Malmö : Gleerups Utbildning AB. - 9789151100654 ; , s. 55-70
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Book chapter (other academic/artistic)
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| 10. |
- Benerdal, Malin, 1984-
(author)
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Nationell utvärderingspolicy : utformning och förändring på grundskoleområdet 1988-2014
- 2019
-
Doctoral thesis (other academic/artistic)abstract
- Evaluation has grown in both volume and scope across levels and sectors in recent decades, particularly in the school sector. Despite this growth, there is insufficient knowledge about how and in what ways evaluations are formed, institutionalized and used in education governance and education reforms. This thesis addresses some of these issues by studying evaluation policy. The aim of the thesis is to explore and analyse the design and possible changes in national evaluation policy in compulsory education during two periods of extensive education reforms (1988-1994 and 2008-2014).The theoretical framework builds on evaluation research and policy studies, particularly the literature on policy design. These two strands of literature are supplemented with additional analytical tools from historical institutionalism regarding policy change. Drawing on previous research, a definition of evaluation policy that incorporates the policy context and also enables studying an implicit policy is proposed. On the empirical level, the findings are based on official policy documents, material produced by national government agencies as well as evaluations and evaluation systems.The thesis shows that during the first period (1988-1994), the evaluation policy was characterized as a means of helping to implement the extensive reforms. Evaluations were to be conducted on all levels of the school system to promote development on each executive level. The policy design reflected evaluation as a learning and capacity-building tool. Schools and municipalities were positioned as owners and co-creators of evaluation knowledge. During the second period (2008-2014), the evaluation policy was partially revised in order to come to terms with inadequate evaluations and declining school results. The policy included more sanctions and hortatory tools, and more emphasis was placed on comparisons and rankings. The evaluation policy was based on the assumption that local actors should and will act on evaluative knowledge created by the agencies and international actors, and that they could be motivated to do so by the threat of, for example sanctions or issues of ranking and comparisons.The evaluation policy design was largely stable over time. However, three more incremental but significant changes were identified: i) the policy design element “agents and implementation structures” was altered, ii) the evaluation policy expanded and iii) became more directed towards national and external control. These changes also indicated more negative implications for democracy during the second period. In relation to evaluations’ democratic function the analysis showed that the evaluation policy mainly strengthened the legitimizing and controlling function, whereas the enlightenment function was not prominent.This implies a risk that issues that may be relevant from a broader democratic and societal perspective may be overlooked and not subjected to evaluation. The thesis also acknowledges and illustrates the importance of uncovering and reconstructing evaluation policies, policies that are partly veiled, since also implicit policies will have democratic implications.
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| 17. |
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| 18. |
- Carlbaum, Sara, 1981-, et al.
(author)
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Utvärdering av Läslyftet Slutrapport från den nationella utvärderingen av Läslyftets genomförande och effekter i olika skolformer
- 2020
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Reports (other academic/artistic)abstract
- Utvärderingen av Läslyftet har gjorts på uppdrag av Skolverket i syfte att ta fram kunskap som möjliggör förbättringar som kan vara till nytta i genomförandet av liknande satsningar. Elektroniska enkäter och intervjuer har använts för att undersöka målgruppernas (huvudmäns, rektorers/förskolechefers, handledares och lärares/förskollärares och annan pedagogisk personals) erfarenheter av Läslyftets processer och effekter. Observationer har också genomförts av läslyftsträffar och undervisning. Datainsamlingen har skett vid olika tidpunkter från 2016 till 2019 då det funnits olika antal moduler att välja på. Slutsatser om effekter på undervisning och elever/barnbaseras på lärares/förskollärares och annan pedagogisk personals, och handledares iakttagelser och bedömningar. Resultaten visar att Läslyftet har varit en uppskattad kompetensutveckling där en majoritet av huvudmännen, rektorerna/förskolecheferna, handledarna och lärarna/förskolepersonalen bedömt Läslyftet som ”mycket bra” eller ”ganska bra”. Den mest positiva målgruppen är handledarna medan den minst positiva målgruppen är gymnasielärarna. En mycket liten andel av lärarna i grund- och gymnasieskolan bedömde Läslyftet som dåligt eller mycket dåligt. Utvärderingens övergripande slutsats är att Läslyftet har varit en relativt lyckad kompetensutvecklingssatsning, dock har flera högt ställda mål inte uppfyllts. Läslyftet har främst bidragit till att lärare och förskolepersonal fått nya insikter och kunskaper om språk-, läs- och skrivutveckling som de till en del använt till att utveckla undervisningen. Värdet, avtryck och effekter av Läslyftet skiljer sig mellan skolformer och lärarkategorier. Läslyftet har inte uppfyllt eller bara delvis uppfyllt en del av de högt ställda målen: att förbättra alla elevers språk-, läs- och skrivförmågor och skolresultat, att det ska finnas strukturer som stödjer handledare och lärare i fortsatt samarbete och kollegialt lärande, samt att undervisnings- och fortbildningskulturen kännetecknas av att lärare tillsammans kontinuerligt utvecklar och sprider fungerande undervisningsmetoder till varandra. Läslyftet har främst stärkt undervisningen i läsförståelse och ord/begreppsförståelse, vilket bidragit till att utveckla interaktionen med eleverna/barnen om olika texter och till att eleverna/barnen har fått ett ökat intresse för texter, läsning och deltar i samtal mer än tidigare. Effekterna på elevernas/barnens språk-, läs-och skrivutveckling är enligt lärare/förskolepersonal begränsade (slutsats 1). Resultaten visar att det i stort sett är samma förutsättningar och faktorer som bidragit till olika positiva effekter av Läslyftet. Det är framförallt möjligheten att tillsammans kunna arbeta på ett strukturerat sätt med språk-, läs-och skrivutveckling omkring ett material som de flesta uppfattar som stimulerande, som bidrar till att förklara effekter av Läslyftet. Det som främst bidragit till nya kunskaper och insikter, utveckling av undervisningen, elevernas/barnens intresse och språk- och läsförmågor är: modulerna, lärares och förskolepersonals motivation, tid för genomförandet, väl fungerande kollegiala samtal, aktiva handledare och förskolechefer/rektorer, samt om undervisningskulturen före Läslyftet var kollektivt inriktad (slutsats 2). Resultaten visar också att flera önskade effekter avtar med tiden: Läslyftet uppvisar kvarstående effekter på lärares undervisning och på undervisnings-och fortbildningskulturen men effekterna har minskat ett och ett halvt år efter deltagandet. Lärares insikter och kunskaper från Läslyftet beaktas till en del i undervisningen, när de samtalar och samverkar med kollegor om språk-, läs- och skrivutveckling och i deras interaktion med elever (slutsats 3).
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| 19. |
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| 20. |
- Charalampopoulos, Dimitrios, et al.
(author)
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Exploring Variation in Glycemic Control Across and Within Eight High-Income Countries: A Cross-sectional Analysis of 64,666 Children and Adolescents With Type 1 Diabetes
- 2018
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In: Diabetes Care. - : AMER DIABETES ASSOC. - 0149-5992 .- 1935-5548. ; 41:6, s. 1180-1187
-
Journal article (peer-reviewed)abstract
- OBJECTIVE International studies on childhood type 1 diabetes (T1D) have focused on whole-country mean HbA(1c) levels, thereby concealing potential variations within countries. We aimed to explore the variations in HbA(1c) across and within eight high-income countries to best inform international benchmarking and policy recommendations. RESEARCH DESIGN AND METHODS Data were collected between 2013 and 2014 from 64,666 children with T1D who were amp;lt; 18 years of age across 528 centers in Germany, Austria, England, Wales, U.S., Sweden, Denmark, and Norway. We used fixed-and random-effects models adjusted for age, sex, diabetes duration, and minority status to describe differences between center means and to calculate the proportion of total variation in HbA(1c) levels that is attributable to between-center differences (intraclass correlation [ICC]). We also explored the association between within-center variation and childrens glycemic control. RESULTS Sweden had the lowest mean HbA(1c) (59mmol/mol [7.6%]) and together with Norway and Denmark showed the lowest between-center variations (ICC amp;lt;= 4%). Germany and Austria had the next lowest mean HbA(1c) (61-62 mmol/mol [7.7-7.8%]) but showed the largest center variations (ICC similar to 15%). Centers in England, Wales, and the U.S. showed low-to-moderate variation around high mean values. In pooled analysis, differences between counties remained significant after adjustment for children characteristics and center effects (P value amp;lt; 0.001). Across all countries, children attending centers with more variable glycemic results had higher HbA(1c) levels (5.6mmol/mol [0.5%] per 5mmol/mol [0.5%] increase in center SD of HbA(1c) values of all children attending a specific center). CONCLUSIONS A tsimilar average levels of HbA(1c), countries display different levels of center variation. The distribution of glycemic achievement within countries should be considered in developing informed policies that drive quality improvement.
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| 21. |
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| 22. |
- Edlund, Charlotta, et al.
(author)
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The clinical and microbiological efficacy of temocillin versus cefotaxime in adults with febrile urinary tract infection, and its effects on the intestinal microbiota : a randomised multicentre clinical trial in Sweden
- 2022
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In: The Lancet - Infectious diseases. - : Elsevier. - 1473-3099 .- 1474-4457. ; 22:3, s. 390-400
-
Journal article (peer-reviewed)abstract
- BACKGROUND: Use of third-generation cephalosporins, such as cefotaxime, is associated with an increased risk of selection for antimicrobial resistance, so alternative antibiotics need to be considered. The aim of the present study was to evaluate intestinal colonisation with third-generation cephalosporin-resistant pathogens following use of temocillin-an alternative antibiotic to cefotaxime that is potentially less prone to disturbing the intestinal microbiota-in empirical treatment of febrile urinary tract infection (UTI).METHODS: We did a randomised, multicentre, superiority, open-label phase 4 trial in patients who had been admitted to inpatient care in 12 Swedish hospitals with suspected or diagnosed febrile UTI (complicated or uncomplicated). To meet inclusion criteria, a patient was required to have at least one sign or symptom of pyelonephritis (ie, flank pain; costovertebral angle tenderness; and changes to urinary frequency or urgency or dysuria), a fever of 38·0°C or higher, and a positive urine dipstick (for nitrites, white blood cells, or both). Participants were also required to have an indication for intravenous antibiotic treatment. Participants were randomly assigned (1:1) to receive either 2 g temocillin or 1-2 g cefotaxime, by local investigators opening consecutive sealed randomisation envelopes that were generated centrally in advance. Both drugs were administered intravenously every 8 h. The trial was open label for investigators and patients, but those doing the microbiological analyses were masked to the groups. Participants were treated with antibiotics for 7-10 days (or up to 14 days if they had bacteraemia), at least 3 days of which were on the study drug; at day 4 and later, participants who were showing improvement could be given an oral antibiotic (ciprofloxacin, ceftibuten, cefixime, or co-trimoxazole). Patients not showing improvement were regarded as having treatment failures. Rectal swabs were collected at three timepoints: at baseline (before the first dose), after the last dose of study drug, and 7-10 days after treatment stopped. The composite primary outcome was colonisation with Enterobacterales with reduced susceptibility to third-generation cephalosporins, or colonisation with toxin-producing Clostridioides difficile, or both, to evaluate disturbance of the intestinal microbiota. The study is registered in the EU Clinical Trials Register (EudraCT 2015-003898-15).FINDINGS: Between May 20, 2016, and July 31, 2019, 207 patients were screened for eligibility, of whom 55 patients were excluded. 152 participants were randomly assigned to groups: 77 (51%) patients received temocillin, 75 (49%) patients received cefotaxime. The composite primary endpoint was met by 18 (26%) of 68 participants receiving temocillin versus 30 (48%) of 62 patients receiving cefotaxime (risk difference -22% [95% CI -42% to -3%]), showing superiority of temocillin versus cefotaxime (ie, less disturbance of the intestinal microbiota). 43 adverse events were reported in 40 (52%) of 77 patients in the temocillin group, versus 46 adverse events in 34 (45%) of 75 patients in the cefotaxime group. Most events were of mild to moderate severity. 21 (27%) patients in the temocillin and 17 (23%) patients in the cefotaxime group had an adverse event that was considered to be associated with the study drug.INTERPRETATION: Temocillin was found to be less selective than cefotaxime of Enterobacterales with reduced susceptibility to third-generation cephalosporins, and it could therefore be a favourable alternative in the empirical treatment of febrile UTI. Use of this antibiotic could reduce hospital transmission and health-care-associated infections by these pathogens.
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| 23. |
- Eriksson, Malin, et al.
(author)
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Utvärdering av insatser för ensamkommande barn och ungdomar i Umeå 2012-2013 : slutrapport
- 2014
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Reports (other academic/artistic)abstract
- I denna slutrapport redovisas en utvärdering av hur mottagningssystemet och samhällets insatser för ensamkommande barn och ungdomar har utformats och fungerat i Umeå kommun under perioden 2012-2013. Rapporten har utvecklats inom ramen för forskningsprojektet ”Hur fungerar samhällets insatser för ensamkommande flyktingungdomar?” och handlar om flyktingungdomars introduktion och etablering i det svenska samhället.En av slutsatserna är att det saknas en tydlig politisk styrning och vägledning av mottagandet av ensamkommande i Umeå och att aktörerna i hög grad själva har fått tolka sina uppdrag och samordna insatserna. En annan slutsats är att samhällets insatser har bidragit till att stödja, stärka och förbereda ungdomarna på att leva i Sverige och till att socialisera dem till vad som förväntas och krävs för att anpassa sig i det svenska samhället, men det finns stora utmaningar när det gäller ungdomarnas fortsatta integration i samhället.I rapporten presenteras också rekommendationer för hur mottagandet kan utvecklas. Bland annat rekommenderas att de olika aktörernas uppdrag förtydligas och att en mer utvecklad målsättning och vägledning för Umeå kommuns mottagande av ensamkommande arbetas fram. Aktörerna bör också utveckla och pröva nya sätt att främja ungdomarnas integration i samhället som bättre tillvaratar resurser i civilsamhället.Forskningsprojektet har utvecklats och genomförts av en tvärvetenskaplig forskargrupp vid Umeå universitet i samverkan med Umeå kommun och KFUM i Umeå. Projektet har medfinansierats av Europeiska Flyktingfonden.
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| 24. |
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| 25. |
- Fransson, Marcus, et al.
(author)
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Case Report : Subtherapeutic Vancomycin and Meropenem Concentrations due to Augmented Renal Clearance in a Patient With Intracranial Infection Caused by Streptococcus intermedius
- 2021
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In: Frontiers in Pharmacology. - : Frontiers Media SA. - 1663-9812. ; 12
-
Journal article (peer-reviewed)abstract
- Streptococcus intermedius occasionally causes brain abscesses that can be life-threatening, requiring prompt antibiotic and neurosurgical treatment. The source is often dental, and it may spread to the eye or the brain parenchyma. We report the case of a 34-year-old man with signs of apical periodontitis, endophthalmitis, and multiple brain abscesses caused by Streptococcus intermedius. Initial treatment with meropenem and vancomycin was unsuccessful due to subtherapeutic concentrations, despite recommended dosages. Adequate concentrations could be reached only after increasing the dose of meropenem to 16 g/day and vancomycin to 1.5 g x 4. The patient exhibited high creatinine clearance consistent with augmented renal clearance, although iohexol and cystatin C clearances were normal. Plasma free vancomycin clearance followed that of creatinine. A one-day dose of trimethoprim-sulfamethoxazole led to an increase in serum creatinine and a decrease in both creatinine and urea clearances. These results indicate that increased tubular secretion of the drugs was the cause of suboptimal antibiotic treatment. The patient eventually recovered, but his left eye needed enucleation. Our case illustrates that augmented renal clearance can jeopardize the treatment of serious bacterial infections and that high doses of antibiotics are needed to achieve therapeutic concentrations in such cases. The mechanisms for regulation of kidney tubular transporters of creatinine, urea, vancomycin, and meropenem in critically ill patients are discussed.
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| 26. |
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| 28. |
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| 29. |
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| 30. |
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| 31. |
- Hanberger, Anders, et al.
(author)
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Audit and Accountability
- 2017
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In: Blom, B., Evertsson, L. & Perlinski, M. (Eds.) Social and Caring Professions in European Welfare States.. - Bristol, UK. : Policy Press. - 9781447327196
-
Book chapter (peer-reviewed)
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| 32. |
- Hanberger, Anders, 1953-, et al.
(author)
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Auditing and accountability
- 2017
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In: Social and caring professions in European welfare states. - Bristol : Policy Press. - 9781447327196 ; , s. 83-97
-
Book chapter (peer-reviewed)abstract
- This chapter consists of two parts. First, two accountability dilemmas are identified, key concepts are defined, and a framework for exploring the interplay among democratic governance, audit systems, and accountability is presented. Second, two different but dominant audit systems used in Swedish eldercare are described and analysed in light of this framework, and consequences of auditing and accountability for key actors involved are discussed, as well as possible ways of resolving the two accountability dilemmas. In relation to the volume, this chapter explores conditions, trends, and challenges in today's audit society and their implications for welfare professions and other key actors. Swedish eldercare is an illustrative case of a phenomenon occurring in most policy sectors.
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| 33. |
- Hanberger, Anders, 1953-
(author)
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Bridging theory and practice: challenges to stakeholder evaluation applied to programmes for exposed groups
- 2014
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Conference paper (peer-reviewed)abstract
- This presentation addresses new challenges to evaluation of policies and programmes in multi-cultural societies. These include being responsive to stakeholders’ knowledge needs, informed about different perceptions of the issues at stake, being sensitive and respectful to exposed persons’ needs, feelings and cultural backgrounds and to actors designated official mandates (Stake, 2004). The presenter discusses the value of using an interpretive stakeholder evaluation approach (Hanberger, 2001) and bridging theory and practice to meet these challenges. He takes departure in deliberative democratic and multi-cultural theory (Banting & Kymlicka, 2006; Conner, 2004; House and Howe, 1999; Hanberger, 2006, 2010; Hood, 1999; SenGupta, Hopson, & Thompson-Robinson, 2004). As an example, the stakeholder evaluation approach, developed by the author and applied in a number of evaluations, is here applied on a local reception system for unaccompanied children in Sweden. Some actors engaged in the reception of unaccompanied children are prescribed or assume a caring role (caring homes and good man/trustee) whereas others are assigned an official mandate (Migration board, schools). It is argued that the evaluators should not only be sensitive to the exposed persons’ needs and situation, but also to the different roles and mandates of service-deliverers and the broader accountability environment (Behn, 2001). The evaluation of reception of unaccompanied children is an example of challenges that become visible in contested policies targeting exposed individuals and groups with varying needs and cultural backgrounds, involving many actors with individual and shared responsibility and where cooperation and network governance is critical. The case illustrates that evaluators need to be responsive to different perceptions of the issues at stake, develop different skills and competences including major notions of a multicultural society (Hanberger, 2010) to manage the challenges. A single evaluator can hardly do this alone, but an evaluation team can collectively manage these challenges. Hence, evaluation becomes relational work and a humanist enterprise when bridging theory and practice.
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| 34. |
- Hanberger, Anders, 1953-, et al.
(author)
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Can state supervision improve eldercare? : An analysis of the soundness of the Swedish supervision model
- 2018
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In: British Journal of Social Work. - Oxford : Oxford University Press. - 0045-3102 .- 1468-263X. ; 48:2, s. 371-389
-
Journal article (peer-reviewed)abstract
- This article examines the assumptions regarding how Swedish state supervision (SSV) ofeldercare is to achieve its intended effects. It explores how SSV is intended to work toensure and improve eldercare quality, and theoretically and empirically assesses the validityof its guiding assumptions with programme theory methodology. The theoreticalassessment suggests that most intended effects are partly achieved, though the qualityenhancingassumption finds little support in caring research. The assumption that thesupervised parties will improve their compliance with laws and regulations has some validity,but this compliance is temporary and confined to the aspects of eldercare beingsupervised. Twenty-four interviews with the chairs of Social Welfare Committees andcare unit managers provide empirical support for all but two intended effects. SSV hasnot increased ‘awareness of national regulative demands in eldercare’ or contributed to‘general quality improvement in eldercare’. Four unintended effects of SSV were also recognisedin the interviews—for example, unsupervised caring activities were less prioritised.The authors conclude that, although SSV does little to improve eldercare quality, itis needed for transparency and accountability as well as to hold local governments andpublic and private service providers to account for compliance with national statutes.
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| 35. |
- Hanberger, Anders, 1953-, et al.
(author)
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Can state supervision improve eldercare? An analysis of the assumptions of the Swedish supervision model
- 2015
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Conference paper (peer-reviewed)abstract
- Can state supervision improve eldercare? An analysis of the assumptions of the Swedish supervision modelBackground: Lately the supervision of Swedish eldercare has been reinforced to ensure better compliance with laws and regulations. Policy-makers express high expectation that this reform will improve quality in eldercare, and ensure older citizens a good and equal distribution of eldercare.Purpose: The aim of this paper is to unfold the underlying assumptions of how the supervision model (inspectorate) is intended to work to ensure and improve quality in Swedish eldercare, and to probe the validity of the assumptions.Method: A program theory analysis is carried out to describe how state supervision is assumed to work to achieve intended effects. These assumptions are referred to as the supervision’s program theory. A policy scientific method is applied to reconstruct the program theory. Once the program theory is described its consistence is analyzed and the validity is assessed against supervision theory and caring theory.Results: The assumption that the supervised will improve compliance with laws and regulations has some validity but confined to aspects of eldercare being supervised. The theories we used provide no support that supervision is an effective tool for improving quality in eldercare.Conclusions: Reinforced supervision cannot be justified with reference to supervision being an effective tool or mechanism to enhance quality in eldercare. However, some kind of supervision is necessary for transparency and holding local governments, and public and private service providers to account for compliance with the statues. Supervision also reinforce the national objectives and standards that should guide social service committees and eldercare service providers.
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| 36. |
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| 37. |
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| 38. |
- Hanberger, Anders, 1953-
(author)
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Democratic accountability in decentralised governance
- 2009
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In: Scandinavian Political Studies. - : Wiley. - 0080-6757 .- 1467-9477. ; 32:1, s. 1-22
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Journal article (peer-reviewed)abstract
- This article develops a conceptual framework for studying democratic accountability in decentralized governance, and discusses critical issues about democratic accountability from a citizen’s perspective. First, the concept is discussed and adapted to make it useful for studying democratic accountability in different governance structures. Second, the article scrutinises conditions for democratic accountability in decentralised governance based on three models. Third, democratic accountability is discussed with reference to a case study of public reviewers operating in four municipalities in Sweden. The study indicates that municipal auditors and the local media have the greatest impact on municipal policy. On the whole, auditors improve local governments’ internal control and systems for steering and monitoring municipal policy, whereas the media sometimes alter the policy agenda without changing the policy. Auditors maintain and support an elitist democratic orientation of democratic accountability, and the media maintain this democratic orientation and in addition promote democratic dialogue. Viewed from a citizen’s perspective, the traditional accountability system does not work satisfactorily. State inspectors and municipal auditors – two important public reviewers in the current system – could improve their work to make it more useful to citizens’ democratic control. Another way discussed to develop democratic accountability is to promote participatory policy and concrete means of accountability (e.g. on-site visits, conducted tours and different forms of democratic dialogue). The formal way to improve democratic accountability implies more transparency, monitoring and control, which may also lead to distrust and scapegoat thinking (i.e. a surveillance society), whereas concrete modes of accountability, more associated with participatory and deliberative democracy, imply mutual responsibility and trust building. Strengthening participatory policy, active citizens, collective responsibility and democratic dialogue could be an alternative to the emerging audit society.
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| 39. |
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| 40. |
- Hanberger, Anders, 1953-
(author)
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Democratic caring evaluation
- 2018
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In: Panel: Evaluation for a caring society.
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Conference paper (other academic/artistic)
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| 41. |
- Hanberger, Anders, 1953-
(author)
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Democratic caring evaluation for refugee children in Sweden
- 2018
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In: Evaluation for a caring society. - Charlotte, NC : Information Age Publishing. - 9781641131636 - 9781641131643 - 9781641131650 ; , s. 105-124
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Book chapter (peer-reviewed)abstract
- What is a democratic caring (DC) evaluator and what does it mean to be one, especially in terms of practicing responsibility for the stakeholders one works with in evaluation contexts? This chapter discusses the challenging issue of the responsibilities of evaluators, citing an evaluation of the reception of unaccompanied and separated children (UASC) in Umeå, a northern-Swedish community of over 100,000 residents. DC evaluation does not refer to a new evaluation approach. The notions of DC evaluation and the DC evaluator are used here in discussing what it means to be an evaluator who develops evaluation within a democratic and caring society. The discussion builds on both democratic evaluation and care theory. It is suggested that an enlightened DC evaluator is informed both by democratic evaluation and by research into good care, applying this knowledge reflectively during the evaluation process. This chapter discusses what is involved in developing a DC evaluation with a special focus on the evaluator's respon-sibilities and good care.The chapter continues with a brief presentation of the case: a democratic evaluation of care for a group of refugee children in Sweden. Subsequently, the theoretical underpinnings of democratic evaluation are presented. The next section discusses what DC awareness means and the responsibilities of a DC evaluator, illustrating this with examples from the case. The chapter concludes by considering what DC evaluation implies for the good care of refugee children.
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| 42. |
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| 43. |
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| 44. |
- Hanberger, Anders, 1953-
(author)
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Democratic implications of public organizations
- 2003
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In: Public Organization Review. - : Springer. - 1566-7170 .- 1573-7098. ; 3:1, s. 29-54
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Journal article (peer-reviewed)abstract
- The author suggests a Weberian methodology, based on theories of democracy and organization, for assessing normative implications of public organizations. How different organizational models contribute to (re)create democracy and legitimacy is scrutinized with reference to a Swedish IT program. The conclusion is that a system management organization will be an appropriate choice for dealing with "tame" problems, but it will at the same time promote an elitist democratization. In contrast, a development organization will be more appropriate in dealing with complex problems, and it will most likely promote discursive democratization.
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| 45. |
- Hanberger, Anders, 1953-
(author)
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Demokratisk utvärdering när polariseringen ökar
- 2017
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Conference paper (peer-reviewed)abstract
- Konferenstemat, utvärdering i en komplex värld, väcker många frågor. En komplexitet som uppmärksammas i detta papper är att utvärderingar initieras och genomförs i en alltmer polariserad värld där etablerade och nya politiska aktörer och olika typer av utvärderare interagerar. Detta ställer delvis nya krav på utvärderare särskilt de som vill verka för att utvärdering används för att upprätthålla och stärka demokratin. En del av komplexiteten handlar också om att etablerade mediers ställning som granskare av makten och den förda politiken utmanas av nya medier och att det finns fler fora för diskussion om utvärderingar och granskningar än tidigare. Detta kan både innebära hot och möjligheter för demokratin och utvärdering. Dessa förändringar aktualiserar grundläggande frågor om utvärderingars roll i samhällsförändringen och demokratin. Idag kan vi också se att några formella demokratier är på väg att nedrustas efter att auktoritära ledare och partier röstats fram av en majoritet. I maktställning avlövas demokratin successivt genom att urholka fri-och rättigheter, försämra förutsättningarna för fria medier och aktiva medborgare etc. Men demokratin kan också undermineras inifrån med hjälp av utvärdering som enbart görs när den kan förväntas tjäna makten och den förda politiken. Roberto Picciotto (2015) diskuterar hur demokratisk utvärdering kan och bör utvecklas i ett samhälle som inte längre är demokratiskt annat än på ytan. Han argumenterar för behovet av ett nytt approach, progressiv utvärdering, för att främja demokratisk utvärdering i sammanhang där demokratin åsidosätts eller där starka särintressen kontrollerar utvärdering. Detta gäller inte generellt för utvärdering i Sverige, men tendenser i omvärlden har börjat få fotfäste även här. Utvärderingars roll i samhällsförändringen och utvärderarens ansvar behöver diskuteras i en tid när demokratin utmanas och när utvärderingsresultat presenteras och används i ett hårdnande samhälls- och debattklimat.Syftet med detta papper är att diskutera demokratisk utvärdering mot bakgrund av förändringar i utvärderingssamhället och den ökade polariseringen i samhället. Hur kan olika demokratiska utvärderingsorienteringar främja demokratin? Vilket ansvar har demokratiska utvärderare idag?I pappret diskuteras frågorna utifrån olika demokratiska utvärderingsorienteringar bland annat elit-demokratisk, samtalsdemokratisk och progressiv utvärdering. Utvärderarens ansvar skiljer sig mellan olika orienteringar men alla utvärderare som vill främja demokratin har ett ansvar att påtala snedvriden användning av utvärderingar. Exempel på utvärderingars demokratiska implikationer och utvärderarens ansvar kommer att lyftas fram och diskuteras.
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| 46. |
- Hanberger, Anders, 1953-
(author)
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Den dolda utvärderingspolitiken
- 2003
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In: Studies in Educational Policy and Educational Philosophy. E-tidskrift. - Uppsala : STEP, The Research Unit for Studies in Educational Policy and Educational Philosophy, Uppsala universitet. - 1652-2729. ; :1, s. 1-14
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Journal article (peer-reviewed)abstract
- The main relations between evaluation and politics are, in this article, explored and discussed in relation to three ideal types. The types differ regarding the political-administrative functions of evaluations, the epistemology, and the implications for democracy. At present, Swedish evaluation policy is partly veiled because there is no open debate concerning the relation between evaluation and politics. The analysis suggests that the dominant evaluation policy is closest to the integrated ideal type, that is, the goal is to completely adjust evaluation to political needs.
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| 47. |
- Hanberger, Anders, 1953-
(author)
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Dialogue as Nuclear Waste Management Policy : Can a Swedish Transparency Programme Legitimise a Final Decision on Spent Nuclear Fuel?
- 2012
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In: Journal of Integrative Environmental Sciences. - : Taylor & Francis Group. - 1943-815X .- 1943-8168. ; 9:3, s. 181-196
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Journal article (peer-reviewed)abstract
- The purpose of this article is to discuss Swedish nuclear waste management policy and assess whether a transparency programme has affected the policy discourse and contributed to legitimatising the forthcoming government decision on a final solution for spent nuclear fuel. The transparency programme implemented by the National Council for Nuclear Waste (NW Council) consisted of two main activities: dialogue meetings and public hearings for deliberating on different aspects of the waste issue. Lessons are drawn from an evaluation of the programme. The article concludes that the NW Council has implemented the government's legitimatisation policy by its existence and through the transparency programme, but achieving long lasting legitimacy is a complicated matter. Dialogue meetings and public hearings are reasonable measures; whether these measures are sufficient to legitimatise the final decision also depends on how the appropriate state agencies and the government justify their assessments and decisions regarding the long-term safety, security and sustainability of the Swedish Nuclear Fuel and Waste Management Company's proposed final repository. The dialogue policy and transparency programme, however, has failed to influence the key decisions which remain in the control of the powerful interests, most notable Swedish Nuclear Fuel and Waste Management Company (SKB) and the government.
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| 48. |
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| 49. |
- Hanberger, Anders, 1953-, et al.
(author)
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Enhancing literacy through collegial learning? : Evaluation of a teachers’ training programme
- 2017
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Conference paper (peer-reviewed)abstract
- Programme for International Student Assessment (PISA) test of 15-year-olds’ reading skills is used to assess and benchmark the quality of national education systems, and PISA is a key pillar in the production of knowledge used to shape policy for steering educational systems (Carvalho, 2012; OECD, 2009). Although the validity of PISA for measuring quality in education systems has been questioned (Hanberger, 2014; Mangez & Hilgers, 2012), it is frequently used by policymakers for this purpose and OECD/PISA has a great influence on how quality in education systems is conceived. National education discourses and policies are significantly influenced by PISA tests and the Organisation for Economic Cooperation and Development’s (OECD’s) recommendations (Breakspear, 2012; Grek, 2010; 2012; Lawn, 2011). Sweden has a decade of declining PISA results and OECD has suggested that Sweden should take action to reform its education system to improve quality and equity (OECD, 2015). One example of the influence OECD and PISA have on Swedish education policy is a recently launched teacher training programme. The programme, initiated by the Swedish government in 2013 with explicit reference to the country’s failings in PISA, is supposed to enhance teachers’ collegial learning in literacy and aimed to improve teaching and student literacy, and Sweden’s performance in coming PISA tests (Ministry of Education, 2013).The programme, the Literacy Lift, is currently implemented on a full scale and evaluated during its course to fine-tune the implementation of the programme. On commission by the National Agency for Education (NAE) to evaluate the programme, the authors of this paper along with our colleagues have published two interim reports on the material used for collegial learning and the effects of the programme after the first year of implementation. In this paper we will analyse this programme with a purpose to unfold and probe the assumptions underpinning the Literacy Lift, a Swedish teacher training programme to enhance collegial learning in order to develop teaching that promotes literacy, in this case language-, reading- and writing-skills among the students. The paper will also explore what effects and consequences the programme has had so far.The paper integrates knowledge from evaluation and education research. Programme theory (PT) evaluation (Leeuw 2003) unfolds how programme makers (the government and NAE) intend to improve the quality in the Swedish education system with this programme, and probes the consistence of the programme’s PT. The PT refers to the assumptions as to how the intended effects can be achieved. Stakeholder evaluation assesses how the main target groups (school owners, principals, supervisors and teachers) perceive effects, intended and other effects, and consequences of the programme.Education research is used to analyse the programme’s contribution to improve quality in the education system and to probe the programme’s PT. Some education research used to inform policy underscores the importance of teaching quality in improving student learning and performance (Hattie 2009) and of holding schools accountable for learning outcomes (Atkinson et al. 2009; Hamilton, Stecher, Russell, Marsh & Miles 2008; Musset, 2012). School improvement research focuses on “change and problem-solving in educational practice” (Creemers & Reezigt 1997). School improvement does not occur if the “school culture” is not “favourable”, that is, schools “must have shared goals and feel responsible for success”. In addition, there must be a culture of “collegiality”, “risk taking”, “mutual respect and support”, and “openness” (Creemers & Reezigt 2005, 363).Methods: A programme theory analysis unfolds the programme theory and probes the assumptions. Programme theory is a well-established concept used in evaluation research referring to the assumptions as to how a programme achieves its intended effects. There are various approaches to reconstructing and articulating a PT. This paper adopts a policy-scientific approach (Leeuw, 2003). The PT analysis presented includes three main steps: reconstructing the programme’s PT; analysing the PT’s internal validity (i.e. the consistency of its assumptions); and analysing the PT’s external validity (i.e. whether it is supported by relevant research and provides feasible knowledge for resolving the problems it is intended to resolve). The stakeholder evaluation (Hanberger, 2001) collects data from target groups and assesses programme effects and consequences from the perspective of school owners, principals, supervisors and teachers. The assessment focuses on achievement of objectives, other effects and consequences of the program, as experienced by these target groups.A variety of data is used. Policy documents and interviews with senior administrators is usedto reconstruct the programme’s PT. The analysis of the stakeholder evaluation is based mainly on questionnaires to the four target groups with additional supplemental interviews with school owners and supervisors.Expected outcomes/results: Since the programme is continuing, being expanded and slightly revised during its course this paper can only present preliminary results. The paper demonstrates the programme’s PT and probes its consistency. The assumption that the training programme can enhance collegial learning can be expected to gain support, but the contribution to improve student’s performance in upcoming PISA cannot. The effects on collegial learning and literacy didactics improvement will vary between different groups of teachers and related to factors such teachers’ motivation and support from principals and supervisors. How teaching is affected and students’ literacy improved will vary according to a number of factors and conditions, e.g. what teachers have learned and how much of this is translated into teaching. The persistence of effects will depend on such as ongoing support from school owners and principals in providing time for collegial learning and applying the content of the programme in the classroom.
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