| 1. |
- Lindberg, Inger, et al.
(author)
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Patients’ and Healthcare Personnel’s Experiences of Health Coaching with Online Self-Management in the Renewing Health Project
- 2017
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In: International Journal of Telemedicine and Applications. - : Hindawi Publishing Corporation. - 1687-6415 .- 1687-6423. ; 2017
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Journal article (peer-reviewed)abstract
- Background. Telehealth applications have shown positive effects for people with chronic conditions and their awareness of health. Objective. To describe patients’ and healthcare personnel’s experiences of using health coaching with online self-management in primary health care. Method. A pragmatic randomised controlled trial was conducted. Patients in the intervention group measured and reported medical parameters such as blood pressure, blood glucose, prothrombin complex (PK) values, and 2-channel ECG. Data were collected through a questionnaire, individual interviews with patients, and focus group discussions with healthcare personnel. The questionnaire was analysed using statistics; texts from interviews and focus groups were analysed using content analysis. Findings. Patients were satisfied and believed that the intervention had enhanced their care and increased accessibility without causing concerns about privacy. Although being positive, patients commented the lack of support and feedback from healthcare personnel. Healthcare personnel regarded the intervention valuable for the patients’ abilities to perform self-management healthcare tasks but preferred that patients did so without them supporting the patients. Conclusion. Patients expressed satisfaction and acceptance regarding the use of the application. It seems that healthcare personnel are convinced about the benefits for patients and the potential for the intervention but are not convinced about its benefits for healthcare organisations.
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| 2. |
- Semb, Gunvor, et al.
(author)
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A Scandcleft randomised trials of primary surgery for unilateral cleft lip and palate: 1. Planning and management.
- 2017
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In: Journal of Plastic Surgery and Hand Surgery. - : Taylor & Francis. - 2000-656X .- 2000-6764. ; 51:1, s. 2-13
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Journal article (peer-reviewed)abstract
- BACKGROUND AND AIMS: Longstanding uncertainty surrounds the selection of surgical protocols for the closure of unilateral cleft lip and palate, and randomised trials have only rarely been performed. This paper is an introduction to three randomised trials of primary surgery for children born with complete unilateral cleft lip and palate (UCLP). It presents the protocol developed for the trials in CONSORT format, and describes the management structure that was developed to achieve the long-term engagement and commitment required to complete the project.METHOD: Ten established national or regional cleft centres participated. Lip and soft palate closure at 3-4 months, and hard palate closure at 12 months served as a common method in each trial. Trial 1 compared this with hard palate closure at 36 months. Trial 2 compared it with lip closure at 3-4 months and hard and soft palate closure at 12 months. Trial 3 compared it with lip and hard palate closure at 3-4 months and soft palate closure at 12 months. The primary outcomes were speech and dentofacial development, with a series of perioperative and longer-term secondary outcomes.RESULTS: Recruitment of 448 infants took place over a 9-year period, with 99.8% subsequent retention at 5 years.CONCLUSION: The series of reports that follow this introductory paper include comparisons at age 5 of surgical outcomes, speech outcomes, measures of dentofacial development and appearance, and parental satisfaction. The outcomes recorded and the numbers analysed for each outcome and time point are described in the series.TRIAL REGISTRATION: ISRCTN29932826.
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| 3. |
- Andersson Marchesoni, Maria, et al.
(author)
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Technologies in older people's care : Values related to a caring rationality
- 2017
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In: Nursing Ethics. - : Sage Publications. - 0969-7330 .- 1477-0989. ; 24:2, s. 125-137
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Journal article (peer-reviewed)abstract
- BACKGROUNDThe tension between care-based and technology-based rationalities motivates studies concerning how technology can be used in the care sector to support the relational foundation of care.OBJECTIVESThis study interprets values related to care and technologies connected to the practice of good care.RESEARCH DESIGNThis research study was part of a development project aimed at developing innovative work practices through information and communication technology. Participants and research context: All staff (n = 18) working at two wards in a care facility for older people were asked to participate in interviews, and 12 accepted. We analysed the data using latent content analysis in combination with normative analysis. Ethical considerations: The caregivers were informed that participation was voluntary and that they could drop out at any time without providing any explanation.FINDINGSFour values were identified: 'presence', 'appreciation', 'competence' and 'trust'. Caregivers wanted to focus on care receivers as unique persons, a view that they thought was compromised by time-consuming and beeping electronic devices. Appraising from next-of-kin and been seen as someone who can contribute together with knowledge to handle different situations were other desires. The caregivers also desired positive feedback from next-of-kin, as they wanted to be seen as professionals who have the knowledge and skills to handle difficult situations. In addition, the caregivers wanted their employer to trust them, and they wanted to work in a calm environment.DISCUSSIONCaregivers' desire for disturbance-free interactions, being valued for their skills and working in a trustful working environment were interpreted as their base for providing good care. The caregivers' arguments are based on caring rationality, and sometimes they felt the technological rationality interfered with their main mission, providing quality care.CONCLUSIONIntroducing new technology in caring should support the caring relationship. Although society's overall technology-based approach may have gained popularity as a problem solver, technology-based rationality may compromise a care-based rationality. A shift in attitudes towards care as a concept on all societal levels is needed.
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| 4. |
- Berggrund, Malin, et al.
(author)
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HPV viral load in self-collected vaginal fluid samples as predictor for presence of cervical intraepithelial neoplasia.
- 2019
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In: Virology Journal. - : Springer Science and Business Media LLC. - 1743-422X. ; 16
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Journal article (peer-reviewed)abstract
- OBJECTIVE: This study was performed to evaluate the use of high-risk HPV (hrHPV) viral load in screening tests for cervical cancer to predict persistent infection and presence of cervical intraepithelial neoplasia grade 2 or worse (CIN2+).METHODS: We followed women between 30 and 60 years of age who performed self-sampling of vaginal fluid and subsequently a hrHPV test. Women who were hrHPV positive in their screening test repeated the hrHPV test 3-6 months later and were included in the present study.RESULTS: Our results show that women with a persistent HPV16 infection had higher HPV viral load in their primary screening test than women with transient infections (p = 5.33e-03). This was also true for sum of viral load for all hrHPV types in the primary screening test (p = 3.88e-07). 48% of women with persistent HPV16 infection and CIN2+ had an increase in HPV16 titer in the follow-up test, as compared to only 20% of women with persistent infection but without CIN2+ lesions. For the sum of all hrHPV types, 41% of women with persistent infection and CIN2+ had an increase in titer as compared to 26% of women without CIN2 + .CONCLUSIONS: The results show that hrHPV viral load in the primary screening HPV test is associated with the presence of CIN2+ and could be used in triaging hrHPV positive women for different follow-up strategies or recall times. Serial testing of hrHPV viral load has the potential to distinguish women with CIN2+ lesions from women with persistent infection but without CIN2+ lesions.
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| 5. |
- Bigestans, Aina, 1953-
(author)
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Utmaningar och möjligheter för utländska lärare som återinträder i yrkeslivet i svensk skola
- 2015
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Doctoral thesis (other academic/artistic)abstract
- This doctoral dissertation investigates the challenges “foreign teachers” experience in the encounter with the Swedish school and the possibilities they have to manage challenges and to establish their legitimacy. The participants of this study were newly employed in the pre-school, the primary school and the secondary school.The material includes interviews with 21 teachers and complementing observations at the workplaces of five of these teachers. Principals and colleagues have also been interviewed as well as administrators and teacher educators of supplementary teacher training programs.The shift of language of instruction was reported as causing challenges and demanded time and energy from the teachers in preparing the lessons. Here the teachers mentioned knowledge and correct use of the subject specific vocabulary and the ability to use everyday language in the process of building a bridge to the language of the subjects. Difficulties in the interaction with colleagues and parents were reported; when being positioned as less competent due to their second language speaker status. Some examples also reveal that everyday interaction demands knowledge of social practices that are not always familiar to these teachers.The value of individual assets (e.g. professional experience, profound subject knowledge and multilingualism) is enhanced when school principals recognize the resources of these teachers and make use of them in the communities of practice at school.In using activity theory, difficulties in the interaction with students or problems with questioning parents could be analyzed with regard to communities of practice, rule systems or division of labor in the activities of the school.This thesis emphasizes the importance of a critical discussion of existing norms, values and hierarchies in local school contexts if schools in Sweden in general are to be seen as learning and working contexts for teachers as well as students of all backgrounds.
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| 6. |
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| 7. |
- Elf, Marie, 1962-, et al.
(author)
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The Swedish version of the Normalization Process Theory Measure S-NoMAD : translation, adaptation, and pilot testing
- 2018
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In: Implementation Science. - : Springer. - 1748-5908. ; 13:1
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Journal article (peer-reviewed)abstract
- BackgroundThe original British instrument the Normalization Process Theory Measure (NoMAD) is based on the four core constructs of the Normalization Process Theory: Coherence, Cognitive Participation, Collective Action, and Reflexive Monitoring. They represent ways of thinking about implementation and are focused on how interventions can become part of everyday practice.AimTo translate and adapt the original NoMAD into the Swedish version S-NoMAD and to evaluate its psychometric properties based on a pilot test in a health care context including in-hospital, primary, and community care contexts.MethodsA systematic approach with a four-step process was utilized, including forward and backward translation and expert reviews for the test and improvement of content validity of the S-NoMAD in different stages of development. The final S-NoMAD version was then used for process evaluation in a pilot study aimed at the implementation of a new working method for individualized care planning. The pilot was executed in two hospitals, four health care centres, and two municipalities in a region in northern Sweden. The S-NoMAD pilot results were analysed for validity using confirmatory factor analysis, i.e. a one-factor model fitted for each of the four constructs of the S-NoMAD. Cronbach’s alpha was used to ascertain the internal consistency reliability.ResultsIn the pilot, S-NoMAD data were collected from 144 individuals who were different health care professionals or managers. The initial factor analysis model showed good fit for two of the constructs (Coherence and Cognitive Participation) and unsatisfactory fit for the remaining two (Collective Action and Reflexive Monitoring) based on three items. Deleting those items from the model yielded a good fit and good internal consistency (alphas between 0.78 and 0.83). However, the estimation of correlations between the factors showed that the factor Reflexive Monitoring was highly correlated (around 0.9) with the factors Coherence and Collective Action.ConclusionsThe results show initial satisfactory psychometric properties for the translation and first validation of the S-NoMAD. However, development of a highly valid and reliable instrument is an iterative process, requiring more extensive validation in various settings and populations. Thus, in order to establish the validity and reliability of the S-NoMAD, additional psychometric testing is needed.
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| 8. |
- Eriksson, Inger, 1952-, et al.
(author)
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Enriching ‘learning activity’ with ‘epistemic practices’ – enhancing students’ epistemic agency and authority
- 2016
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In: Nordic Journal of Studies in Educational Policy. - Uppsala : Informa UK Limited. - 2002-0317. ; 2:1, s. 82-97
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Journal article (peer-reviewed)abstract
- This article is an unchanged, re-published version of: Inger Eriksson & Viveca Lindberg, ‘Enriching learning activities with epistemic practices – enhancing students’ epistemic agency and authority’, with Maja Elmgren, Maria Folke-Fichtelius, Stina Hallsén, Henrik Román (2016), Att ta utbildningens komplexitet på allvar. En vänskrift till Eva Forsberg, Uppsala Universitet: Uppsala Studies in Education 138.
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| 9. |
- Eriksson, Inger, 1952, et al.
(author)
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The expansive learning cycle transformed into a tool for educational design
- 2017
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In: ISCAR 5th International Congress August 28th - September 1st 2017 Quebec, Canada.
-
Conference paper (other academic/artistic)abstract
- The aim of this presentation is to give an empirical example of what can be an indicator of transformative agency in a Change Laboratory (CL). The idea of a CL is to empower the participants to enable transformative agency and changes in their activity. The researchers are supposed to both provoke and sustain the work of the participants. We argue that the issue of agency – both relational and transformative – is of great importance in a CL but that sustaining participants’ agency is a demanding task. Furthermore, participants’ agency must be analysed empirically. A CL-project at the Swedish Manilla-school (grades 1-10), a special school for students with impaired hearing aimed at qualifying math-teaching. The team consisted of teachers in all grades and a group of researchers. The researchers produced mirror data. The teachers prepared themselves by reading the epistemology underpinning the national curriculum. At the end of the project, teachers created a new way of using the expansive learning cycle and the process of change laboratory, fit for their purposes, for designing, developing and assessing their math-teaching. This we see as an indicator of a transformative agency
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| 10. |
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| 11. |
- Eriksson, Lina, et al.
(author)
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The meaning of occupation for patients in palliative care when in hospital
- 2016
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In: Palliative & Supportive Care. - : Oxford University Press. - 1478-9515 .- 1478-9523. ; 14:5, s. 541-552
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Journal article (peer-reviewed)abstract
- The aim of this study was to describe how patients in palliative care relate to occupation during hospitalization and to define the meaning it has for them. Eight inpatients in palliative care with various cancer diagnoses were interviewed one time. These interviews were transcribed and analyzed using qualitative content analysis. Patients experience occupations as meaningful when in hospital during the last period of their lives. They would like to be able to handle their own needs as much as possible. Staff behavior, the design of the environment, the lack of accessible occupations, and the degree to which patients can decide whether to receive or decline visits affect the possibility to make their wishes a reality. Our results also revealed that patients experience a sense of loss of their role, as well as a lack of control and participation. Our results confirm the importance of occupation and of patients having the option to and being given opportunities to take care of themselves when in palliative care. Further studies are needed to enable us to understand how organized occupations might influence patients' experience of being in a hospital during the final period of life.
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| 12. |
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| 13. |
- Fischl, Caroline, et al.
(author)
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Kontinuitet i uppgifter inom år 3 arbetsterapeutprogrammet
- 2015
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In: Universitetspedagogiska konferensen 2015. ; , s. 66-66
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Conference paper (other academic/artistic)abstract
- Syftet med vår poster är att illustrera kontinuitet i examinationsuppgifterna och progression i lärandet under kurserna i år 3 arbetsterapeutprogrammet.Under höstterminen 2014 till och med vårterminen 2015 genomfördes för första gången kurser i det tredje och sista året inom det reviderade arbetsterapeutprogrammet. Dessa kurser handlar om praktiska tillämpningar av kunskaper om projektledning och förändringsarbete, vetenskaplig metod samt arbetsterapeutiska teorier och modeller inom traditionella och nya arenor. Studenterna förväntas utveckla ett reflekterande förhållningssätt och arbetsterapeutisk professionalitet i samverkan med andra samt beredskap att uppfylla olika roller i arbetslivet.Kontinuitet uppnås när studenten under den första kursen skriver en plan för examensarbete (kurs 2) och/eller förändringsarbete (kurs 4). Studenten kan också välja att skriva en plan för verksamhetsutveckling (kurs 3) och implementera planen i den sista kursen. Under examensarbete får studenten välja kvantitativ eller kvalitativ metod, eller litteraturstudie efter intresseområde och koppla arbetet mot innovationskursen. Att kunna arbeta vidare med en idé genom uppgifterna i olika kurser kan göra studenten mer engagerad i sitt lärande. Studenten genomgår också en process genom att utveckla och testa idéer under ett antal iterationer.Progression i lärandet sker även vid upprepning av pedagogiska metoder. Till exempel, har lärandekontraktet under verksamhetsförlagd utbildning (kurs 3) fokus på identifiering och formulering av lärandemål, medan under innovationskursen (kurs 4) har uppgiften fokus på identifiering av handlingar och stöd som behövs för att uppnå lärandemålen.
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| 14. |
- Gustavsson, Inger M., et al.
(author)
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Clinical validation of the HPVIR high-risk HPV test on cervical samples according to the international guidelines for human papillomavirus DNA test requirements for cervical cancer screening
- 2019
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In: Virology Journal. - : Springer Science and Business Media LLC. - 1743-422X. ; 16:1
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Journal article (peer-reviewed)abstract
- BackgroundThe indicating FTA card is a dry medium used for collection of cervical samples. HPVIR is a multiplex real-time PCR test that detects 12 high-risk human papillomavirus types (hrHPV) and provides single genotype information for HPV16, − 31, − 35, − 39, − 51, − 56, and − 59 and pooled type information for HPV18/45 and HPV33/52/58. The aim of this study was to evaluate whether a strategy with cervical samples collected on the FTA card and subsequently analysed with the HPVIR test complies with the criteria of the international guidelines for a clinically validated method for cervical screening.MethodsWe performed a non-inferiority test comparing the clinical sensitivity and specificity of the candidate test (FTA card and HPVIR) with a clinically validated reference test (Cobas® HPV test) based on liquid-based cytology (LBC) samples. Two clinical samples (LBC and FTA) were collected from 896 participants in population-based screening. For evaluation of the specificity we used 799 women without ≥ CIN2, and for clinical sensitivity we used 67 women with histologically confirmed ≥ CIN2. The reproducibility was studied by performing inter- and intra-laboratory tests of 558 additional clinical samples.ResultsThe clinical sensitivity and specificity for samples collected on the FTA card and analysed using the HPVIR test were non-inferior to samples analysed with the Cobas® HPV test based on LBC samples (non-inferiority test score, p = 1.0 × 10− 2 and p = 1.89 × 10− 9, respectively). Adequate agreement of > 87% was seen in both the intra- and inter-laboratory comparisons.ConclusionsSamples collected on the indicating FTA card and analysed with HPVIR test fulfil the requirements of the international guidelines and can therefore be used in primary cervical cancer screening.
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| 15. |
- Gustavsson, Inger M., et al.
(author)
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Randomised study of HPV prevalence and detection of CIN2+ in vaginal self-sampling compared to cervical specimens collected by medical personnel.
- 2019
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In: International Journal of Cancer. - : Wiley. - 0020-7136 .- 1097-0215. ; 144:1, s. 89-97
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Journal article (peer-reviewed)abstract
- We conducted a randomised study to compare vaginal self-sampling with assisted sampling by medical personnel on the cervix for HPV testing in primary screening. The first aim was to determine if the HPV prevalence is independent of sampling location (vagina versus cervix) and the person performing the sampling. The second aim was to evaluate if the two sampling strategies differed in the detection rate of CIN2+. In total, 19,523 women were randomised into two groups, with 9926 invited to perform self-sampling (SS arm) using the Rover VIBA-brush and 9597 offered assisted sampling using the cytobrush (AS arm). All samples were applied to the indicating FTA elute card and analysed for high-risk HPV using the hpVIR real-time PCR assay. The outcome for the first aim was HPV prevalence and for the second aim the number of CIN2+ based on histology. In the SS arm, 52.7% of invited women participated in the study, as compared to 34.2% in the AS arm. All samples contained sufficient amount of nuclear DNA for a valid HPV result, with vaginal samples having a higher DNA amount than cervical samples (p < 4.62 × 10-11 ). HPV prevalence was 4.6% in the SS arm and 4.1% in the AS arm (p = 5.5 × 10-2 ), and the distribution of HPV types similar between arms. There was no difference in the prevalence of CIN2+ per 1000 women screened between arms (p = 0.86). The results show that vaginal self-sampling is an equivalent alternative to sampling by medical personnel for HPV typing and identification of CIN2+.
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| 16. |
- Gustavsson, Inger M., et al.
(author)
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Randomised study shows that repeated self-sampling and HPV test has more than two-fold higher detection rate of women with CIN2+ histology than Pap smear cytology
- 2018
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In: British Journal of Cancer. - : Springer Science and Business Media LLC. - 0007-0920 .- 1532-1827. ; 118:6, s. 896-904
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Journal article (peer-reviewed)abstract
- Background:This randomised study compared the detection rate of cervical intraepithelial neoplasia-positive (CIN2+) based on histology in women performing repeated self-sampling of vaginal fluid (VF) for human papillomavirus (HPV) test with a control group following the ordinary screening by Pap smear cytology.Methods:36390 women aged 30–49 years scheduled for invitation to organised screening were randomised in two groups, one to perform self-sampling of VF for HPV test (n=17 997, HPV arm) and the other group to perform screening by PAP smear cytology (n=18 393, control arm). HPV positive women in the HPV arm repeated the self-sampling and the HPV test on average 4.4 months later and those with two consecutive positive HPV tests were referred to colposcopy. Outcome was CIN2+ based on histology during 18-month follow-up.Results:Participation rate was 47% in the HPV arm and 39% in the control arm. The HPV prevalence in the first self-sampling was 6.9%, and 71% of these women were HPV positive in their second test. For the per-protocol approach, cumulative prevalence of histological CIN2+ in the HPV arm was 20.2 per 1000 women screened as compared to 10.8 in the control arm. The cumulative prevalence of CIN2+ diagnosed per 1000 years screened was 160.8 in the HPV arm as compared with 25.4 in the control arm.Conclusions:Repeated self-sampling of VF and HPV test had more than a two-fold higher discovery rate of CIN2+ per 1000 women screened as compared with PAP smear cytology.
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| 17. |
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| 18. |
- Johansson, Annette, et al.
(author)
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Healthcare personnel's experiences using video consultation in primary healthcare in rural areas
- 2017
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In: Primary Health Care Research and Development. - : Cambridge University Press. - 1463-4236 .- 1477-1128. ; 18:1, s. 73-83
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Journal article (peer-reviewed)abstract
- Background Patients living in rural areas often need to travel long distances for access to specialist care. To increase access to specialist care, video consultation between patients in primary healthcare and specialist care has been used. In order for this new method to be developed and used to the fullest, it is important to understand healthcare personnel's experiences with this intervention. Objective The aim of this study was to describe healthcare personnel's experiences using video consultation in their work in primary healthcare. Method A mixed methods design was used, and the data were analysed using qualitative and quantitative analysis methods. Interviews were conducted with eight general practitioners and one district nurse, all of whom had conducted a video consultation with a patient and a specialist physician or a cardiac specialist nurse. After each video consultation, the participants completed a consultation report/questionnaire. Results Healthcare personnel considered video consultation to provide quicker access to specialist care for the patient, and greater security when the video consultation encounter was conducted at their own primary healthcare centre. They considered video consultation an opportunity to provide education and for the patients to ask questions. Conclusion Video consultation is a satisfactory tool for healthcare personnel, and the technology is a new, useful method, especially for the district nurses. Further, video consultation is an opportunity for healthcare personnel to learn. However, for it to work as an accepted method, the technology must function well and be user friendly. It must also be clear that it is beneficial for the patients and the healthcare personnel.
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| 19. |
- Johansson, Sofie, 1969, et al.
(author)
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The Development of Swedish Receptive Vocabulary in CLIL: A Multilingual Perspective
- 2019
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In: Investigating content and language integrated learning : insights from Swedish high schools / edited by Liss Kerstin Sylvén.. - Bristol. UK : Multilingual Matters. - 9781788922401 ; , s. 236-258
-
Book chapter (peer-reviewed)abstract
- The fact that parallel English and Swedish data were collected on two consecutive occasions in the CLISS project offers a unique opportunity to compare the effects of CLIL in terms of English as well as Swedish language development on a longitudinal basis. A substantial proportion of the students taking part in the CLISS project were second language (L2) speakers of Swedish, which from a multilingual perspective makes such comparisons even more interesting. This chapter concerns vocabulary development with a special focus on L2 Swedish students in CLIL. Before turning to the field of L2 vocabulary development and the actual study, we will give a brief background of English in multilingual Sweden, the recently adopted Swedish Language Act, and multilingual students in CLIL.
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| 20. |
- Johansson, Ulrica, et al.
(author)
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Protein-Reduced Complementary Foods Based on Nordic Ingredients Combined with Systematic Introduction of Taste Portions Increase Intake of Fruits and Vegetables in 9 Month Old Infants : A Randomised Controlled Trial
- 2019
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In: Nutrients. - : MDPI. - 2072-6643. ; 11:6
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Journal article (peer-reviewed)abstract
- Fruits and vegetables are healthy foods but under-consumed among infants and children. Approaches to increase their intake are urgently needed. This study investigated the effects of a systematic introduction of taste portions and a novel protein-reduced complementary diet based on Nordic foods on fruit and vegetable intake, growth and iron status to 9 months of age. Healthy, term infants (n = 250) were recruited and randomly allocated to either a Nordic diet group (NG) or a conventional diet group (CG). Infants were solely breast- or formula-fed at study start. From 4 to 6 months of age, the NG followed a systematic taste portions schedule consisting of home-made purées of Nordic produce for 24 days. Subsequently, the NG was supplied with baby food products and recipes of homemade baby foods based on Nordic ingredients but with reduced protein content compared to the CG. The CG was advised to follow current Swedish recommendations on complementary foods. A total of 232 participants (93%) completed the study. The NG had significantly higher intake of fruits and vegetables than the CG at 9 months of age; 225 ± 109 g/day vs. 156 ± 77 g/day (p < 0.001), respectively. Energy intake was similar, but protein intake was significantly lower in the NG (−26%, p < 0.001) compared to the CG. This lower protein intake was compensated for by higher intake of carbohydrate from fruits and vegetables. No significant group differences in growth or iron status were observed. The intervention resulted in significantly higher consumption of fruits and vegetables in infants introduced to complementary foods based on Nordic ingredients.
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| 21. |
- Johnson, Christina, 1964-
(author)
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Telephone advice nursing : communication, patient satisfaction and tool development
- 2018
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Licentiate thesis (other academic/artistic)abstract
- Background: Telenursing has rapidly expanded in many countries. In Sweden, a national telephone advisory nursing service reaches the entire nation and receives approximately 4,5 million calls per year. The six phase nursing process – assessment, nursing diagnosis, setting goals, planning, implementation and evaluation – can be used when managing a caller’s health problem. In telenursing, a person-centred approach makes for more satisfied and appreciative callers. The core component of interaction is the verbal communication between the telenurse and caller. Several studies have revealed the need for the development of communication competence in telenursing. Structured analyses of conversations between telenurses and callers is one way to increase telenurses’ awareness of their communication and interpersonal competence. This type of analysis requires a valid formative self-assessment tool. To evaluate communicative effectiveness, the patient perspective of the interpersonal aspects of interaction are described as a necessary component, and satisfaction surveys designed for a telenursing context are recommended. Therefore, a questionnaire is needed that evaluates the effects of telenurse communication training from the caller’s perspective.Aims: The overall aim of these two studies was to develop tools to enable improvements and evaluations in communication and interpersonal competence in telenursing from the perspective of both the telenurse and the caller.Study 1: To develop a self-assessment tool aiming to raise telenurses’ awareness of their communication and interpersonal competence and highlight areas in need of improvement.Study 2: To develop and assess content validity of a theoretically anchored questionnaire that explores caller satisfaction in TAN as a result of the interaction between the caller and the telenurse.Methods: Study 1: The development and the evaluation of content validity of the Telenursing Self-Assessment Tool (TSAT) started with a literature search and domain identification, which were used to generate the items. The assessment of the content validity was performed in two steps. First, an expert group completed two rounds of assessments using Content Validity Index (CVI). Second, telenurses tested the tool and assessed the content validity using CVI. Thereafter, the telenurses participated in consensus discussions. Refinements of the tool were done after every assessment.Study 2: The development and the evaluation of content validity of the Telenursing Interaction and Satisfaction Questionnaire (TISQ) started with a literature search and domain identification, which were used to generate the items. The assessment of the content validity was performed in two steps. First, cognitive interviews were performed with the callers, the target population. Next, experts evaluated the content validity using CVI. Refinements of the tool were done after every assessment. The Interaction Model of Client Health Behavior (IMCHB) provided theoretical guidance and support.Results:Study 1: The TSAT with 58 items was developed. The items were structured according to the nursing process and the tool was judged as having good content validity.Study 2: The TISQ consisting of 60 items based on the IMCHB was developed. The questionnaire was found to exhibit good content validity.Conclusions: This thesis describes the development and assessment of content validity of two theoretically anchored tools aimed to improve and evaluate communication and interpersonal competence in telenursing from the perspective of both the telenurse and the caller. The TSAT is meant to create learning opportunities, to provide self-direction, feedback, and coaching, and to guide the telenurse through the nursing process using a person-centred approach. The TISQ aims to explore the callers’ satisfaction and the callers’ perceptions of the interaction with the telenurse. With better knowledge about this, communication improvement and education in telenursing can be tailored to enhance caller satisfaction.
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| 22. |
- Lind, Torbjörn, 1966-, et al.
(author)
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Study protocol : optimized complementary feeding study (OTIS): a randomized controlled trial of the impact of a protein-reduced complementary diet based on Nordic foods
- 2019
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In: BMC Public Health. - : BioMed Central. - 1471-2458. ; 19
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Journal article (peer-reviewed)abstract
- Background: What we eat as infants and children carries long-term consequences. Apart from breastfeeding, the composition of the complementary diet, i.e. the foods given to the infant during the transition from breast milk/infant formula to regular family foods affects the child's future health. A high intake of protein, a low intake of fruits, vegetables and fish and an unfavorable distribution between polyunsaturated and saturated fats are considered to be associate with health risks, e.g. obesity, type 2 diabetes and dyslipidemia later in life.Methods: In a randomized, controlled study from 6 to 18months of age we will compare the currently recommended, Swedish complementary diet to one based on Nordic foods, i.e. an increased intake of fruits, berries, vegetables, tubers, whole-grain and game, and a lower intake of sweets, dairy, meat and poultry, with lower protein content (30% decrease), a higher intake of vegetable fats and fish and a systematic introduction of fruits and greens. The main outcomes are body composition (fat and fat-free mass measured with deuterium), metabolic and inflammatory biomarkers (associated with the amount of body fat) in blood and urine, gut microbiota (thought to be the link between early diet, metabolism and diseases such as obesity and insulin resistance) and blood pressure.We will also measure the participants' energy and nutrient intake, eating behavior and temperament through validated questionnaires, acceptance of new and unfamiliar foods through video-taped test meals and assessment of cognitive development, which we believe can be influenced through an increased intake of fish and milk fats, notably milk fat globule membranes (MFGM).Discussion: If the results are what we expect, i.e. improved body composition and a less obesogenic, diabetogenic and inflammatory metabolism and gut microbiota composition, a more sustainable nutrient intake for future health and an increased acceptance of healthy foods, they will have a profound impact on the dietary recommendations to infants in Sweden and elsewhere, their eating habits later in life and subsequently their long-term health.Trial registration: NCT02634749. Registration date 18 December 2015.
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| 23. |
- Lindahl, Camilla, 1969-
(author)
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Tecken av betydelse : En studie av dialog i ett multimodalt, teckenspråkigt tvåspråkigt NO-klassrum.
- 2015
-
Doctoral thesis (other academic/artistic)abstract
- Ett gemensamt meningsskapande i skolans naturvetenskapliga klassrum förutsätter en interaktion som i allt högre grad kommer att präglas av ett naturvetenskapligt språkbruk. Utvecklingen av ett naturvetenskapligt ämnesspråk innebär ofta en stor utmaning för flerspråkiga elever som lär sig naturvetenskap på sitt andraspråk och vars behov av stöttning därför är särskilt stort. Denna studie utforskar döva och hörselskadade elevers lärande naturvetenskap i ett tvåspråkigt NO-klassrum där meningsskapandet sker genom svenskt teckenspråk och skriven svenska. Avhandlingens övergripande frågor är hur svenskt teckenspråk och svenska används i dialogen och hur dessa språk, i interaktion med andra modaliteter, bidrar till meningsskapandet i naturvetenskap. En grupp på två lärare och åtta elever, alla döva och teckenspråkig tvåspråkiga, filmades i totalt sjutton NO-lektioner. Klassrumskommunikation i denna teckenspråkigt tvåspråkiga miljö med naturvetenskapliga artefakter som modeller, tabeller och övrig naturvetenskaplig utrustning analyseras sedan från ett multimodalt socialsemiotiskt perspektiv där språk och modaliteter diskuteras som potentiella resurser i meningsskapandet. Resultaten visar en komplex dialog där språk och modaliteter hela tiden växlar på ett sätt som starkt bidrar till att driva dialogen framåt. Vidare framstår det visuella-gestuella teckenspråket som en kraftfull modalitet. I synnerhet spelar avbildande tecken en framträdande roll i dialogen och i det naturvetenskapliga meningsskapandet. Språkväxlingar i den teckenspråkiga dialogen sker dynamiskt i form av sömlösa och spontana växlingar men utnyttjas även som pedagogiskt verktyg. Teckenspråkets kontextbundenhet kräver dessutom ibland tvärspråkliga resonemang på metanivå där oklarheter såväl som likheter och skillnader mellan olika språkliga uttryck kan redas ut. Resultaten uppmärksammar också lärarnas viktiga roll för att stötta eleverna i det naturvetenskapliga meningsskapandet liksom för utvecklingen av ett naturvetenskapligt språk. I diskussionen lyfts behovet av pedagogiska strategier som stärker stöttningen av döva och hörselskadade elevers teckenspråkiga tvåspråkiga meningsskapande i naturvetenskap.
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| 24. |
- Lindberg, Inger, et al.
(author)
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Conflicting Agendas in Swedish Adult Second Language Education
- 2017
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In: Entangled discourses. - New York : Routledge. - 9781138192263 ; , s. 119-136
-
Book chapter (peer-reviewed)abstract
- This chapter describes margins as a lens through which to interrogate some forms of political emancipation of marginal(ized) individuals and groups through voice and visibility. It concentrates on some instances of activism on issues of sexual politics in South Africa. The chapter seeks to contribute to theoretical discussions around Christopher Stroud's linguistic citizenship approach, itself grounded on Nancy Fraser's (1995) distinction between affirmation and transformation as tools of social justice. Quite the contrary, colonies and metropoles were mutually constitutive, creating entangled relations of social, cultural, economic, and epistemological interdependency. In contrast, transformative strategies redress inequities by unsettling and dismantling the very structures that underpin social and economic divisions. As post-structuralism taught that dyadic thinking is intrinsically reductionist for several reason. It is bound up with processes of epistemological power whereby one element of the binary is recast as better, more suitable, or academically 'cooler' than the other.
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| 25. |
- Lindberg, Inger, et al.
(author)
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Telemonitoring and Health Counseling for Self-Management Support of Patients With Type 2 Diabetes : A Randomized Controlled Trial
- 2017
-
In: JMIR Diabetes. - : JMIR Publications. - 2371-4379. ; 2:1
-
Journal article (peer-reviewed)abstract
- Background: The prevalence of diabetes is increasing among adults globally, and there is a need for new models of health care delivery. Research has shown that self-management approaches encourage persons with chronic conditions to take a primary role in managing their daily care. Objective: The objective of this study was to investigate whether the introduction of a health technology-supported self-management program involving telemonitoring and health counseling had beneficial effects on glycated hemoglobin (HbA1c), other clinical variables (height, weight, body mass index, blood pressure, blood lipid profile), and health-related quality of life (HRQoL), as measured using the Short Form Health Survey (SF-36) version 2 in patients with type 2 diabetes. Methods: This was a pragmatic randomized controlled trial of patients with type 2 diabetes. Both the control and intervention groups received usual care. The intervention group also participated in additional health promotion activities with the use of the Prescribed Healthcare Web application for self-monitoring of blood glucose and blood pressure. About every second month or when needed, the general practitioner or the diabetes nurse reviewed the results and the health care activity plan. Results: A total of 166 patients with type 2 diabetes were randomly assigned to the intervention (n=87) or control (n=79) groups. From the baseline to follow-up, 36 patients in the intervention group and 5 patients in the control group were lost to follow-up, and 2 patients died. Additionally, HbA1c was not available at baseline in one patient in the intervention group. A total of 122 patients were included in the final analysis after 19 months. There were no significant differences between the groups in the primary outcome HbA1c level (P=.33), and in the secondary outcome HRQoL as measured using SF-36. A total of 80% (67/87) of the patients in the intervention group at the baseline, and 98% (47/50) of the responders after 19-month intervention were familiar with using a personal computer (P=.001). After 19 months, nonresponders (ie, data from baseline) reported significantly poorer mental health in social functioning and role emotional subscales on the SF-36 (P=.03, and P=.01, respectively). Conclusions: The primary outcome HbA1c level and the secondary outcome HRQoL did not differ between groups after the 19-month follow-up. Those lost to follow-up reported significantly poorer mental health than did the responders in the intervention group.
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| 26. |
- Lindberg, Viveca, 1954-, et al.
(author)
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Formativ bedömning : Utmaningar för undervisningen
- 2019
-
Book (other academic/artistic)abstract
- Under 2000-talet har frågan om formativ bedömning förts fram som ett av de mer kraftfulla pedagogiska/didaktiska redskapen för att främja elevers lärande. Fler och fler forskare, skolpolitiker, utbildningsledare och lärare framställer formativ bedömning som nästintill en mirakelkur.Det går nästan att säga att formativ bedömning idag uteslutande ses som en central del för och av elevers lärande. Men det som vanligen glöms bort eller i alla fall inte framhävs lika ofta och tydligt är att formativ bedömning också utgör en viktig förutsättning för lärares utveckling av undervisningen.I boken Formativ bedömning – utmaningar för undervisningen tar författarna på sig uppgiften att problematisera och utmana den dominerande relativt snäva uppfattningen om formativ bedömning. En del av kapitlen förhåller sig till formativ bedömning som ett gemensamt didaktiskt fenomen för all undervisning. Andra kapitel bygger på ämnesdidaktiska exempel. Boken syftar till att både kvalificera diskussionen om formativ bedömning och att diskutera vikten av en kvalificerad undervisning, därav titeln Formativ bedömning – utmaningar för undervisningen.
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| 27. |
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| 28. |
- Lindberg, Viveca, et al.
(author)
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Lärares bedömningsarbete : en inramning
- 2018
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In: Lärares bedömningsarbete. - Stockholm : Natur och kultur. - 9789127823020 ; , s. 5-16
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Book chapter (other academic/artistic)
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| 29. |
- Lindberg, Viveca, 1954-, et al.
(author)
-
Sextio år av formativ bedömning
- 2019
-
In: Formativ bedömning. - Stockholm : Natur och kultur. - 9789127824874 ; , s. 18-34
-
Book chapter (other academic/artistic)abstract
- Utgångspunkten för kapitlet är tidig utveckling av och forskning om formativ bedömning – den historiska bakgrunden till ett intresse för annan information om elevers prestationer än ett betygsresultat eller ett poängresultat. Centralt i kapitlet är att den information läraren får genom elevers prestationer också behöver användas för att utvärdera och utveckla undervisningen. Kapitlet syftar till att betona den dubbla funktionen hos feedback och utgör samtidigt en kritik mot den utbredda uppfattningen att återkoppling formuleras till eleverna för att de ska veta var de står i förhållande till målen och hur de ska arbeta för att nå målen. Författarna menar att innan feedback till eleven formuleras ska läraren först försäkra sig om att det inte är undervisningen som i första hand behöver utvecklas.
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| 30. |
- Lindqvist, Maria, et al.
(author)
-
'A worse nightmare than expected' - a Swedish qualitative study of women's experiences two months after obstetric anal sphincter muscle injury
- 2018
-
In: Midwifery. - London, United Kingdom : ELSEVIER SCI LTD. - 0266-6138 .- 1532-3099. ; 61, s. 22-28
-
Journal article (peer-reviewed)abstract
- Objective: this study explores women's experiences of the first two months after obstetric anal sphincter injury ( OASIS) during childbirth with a focus on problematic recovery. Methods: this qualitative study used inductive qualitative content analysis to investigate open-ended responses from 1248 women. The data consists of short and comprehensive written responses to open-ended questions focusing on recovery in the national quality register, the Perineal Laceration Register, two months after OASIS at childbirth. Results: the theme 'A worse nightmare than expected' illustrated women's experiences of their life situation. Pain was a constant reminder of the trauma, and the women had to face physical and psychological limitations as well as crushed expectations of family life. Furthermore, navigating healthcare services for help added further stress to an already stressful situation. Conclusions: we found that women with problematic recovery two months after OASIS experienced their situation as a worse nightmare than expected. Extensive pain resulted in physical and psychological limitations, and crushed expectations of family life. Improved patient information for women with OASIS regarding pain, psychological and personal aspects, sexual function, and subsequent pregnancy delivery is needed. Also, there is a need for clear organizational structures and information to guide help-seeking women to needed care.
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| 31. |
- Lindqvist, Maria, et al.
(author)
-
“Struggling to settle with a damaged body” : a Swedish qualitative study of women’s experiences one year after obstetric anal sphincter muscle injury (OASIS) at childbirth
- 2019
-
In: Sexual & Reproductive HealthCare. - : Elsevier. - 1877-5756 .- 1877-5764. ; 19, s. 36-41
-
Journal article (peer-reviewed)abstract
- ObjectiveThis study aimed to explore women’s experiences related to recovery from obstetric anal sphincter muscle injuries (OASIS) one year after childbirth.MethodThis is a qualitative study based on written responses from 625 women approximately one year after childbirth in which OASIS occurred. Data was obtained from a questionnaire distributed by the national Perineal Laceration Register (PLR) in Sweden. Inductive qualitative content analysis was applied for analysis.ResultsThe theme “Struggling to settle with a damaged body “indicated that the first year after OASIS involved a struggle to settle to and accept living with a changed and sometimes still-wounded body. Many participants described problems related to a non-functional sexual life, physical and psychological problems that left them feeling used and broken, and increased worries for their future health and pregnancies. However, some women had adjusted to their situation, had moved on with their lives, and felt recovered and strong. Encountering a supportive and helpful health care professional was emphasized as vital for recovery after OASIS.ConclusionThis study provides important insights on how women experience their recovery approximately one year after having had OASIS at childbirth, wherein many women still struggled to settle into their damaged bodies. Clear pathways are needed within health care organizations to appropriate health care services that address both physical and psychological health problems of women with prolonged recovery after OASIS.
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| 32. |
- Lindström, Annika K., 1953-, et al.
(author)
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Cervical dysplasia in elderly women performing repeated self-sampling for HPV testing
- 2018
-
In: PLOS ONE. - : Public Library of Science. - 1932-6203. ; 13:12
-
Journal article (peer-reviewed)abstract
- BACKGROUND: About 30% of the cervical cancer cases in Sweden occur in women older than 60. The primary aim was to evaluate the acceptability of repeated self-sampling at home for HPV-testing in elderly women. The prevalence of HPV and HPV related dysplasia as well as the sensitivity of cytology was evaluated.METHODS: Repeated self-sampling at home for HPV testing was offered 375 women in each of the four age groups 60, 65, 70 and 75 years. Women with two consecutive positive HPV tests were examined with sampling for histology and cytology.FINDINGS: A self-sample was provided by 59.5% (893/1500) of the invited women. The overall prevalence of HPV was 4.4% (95% CI 3.2-6.0, n = 39) in the first test, and 2.5% were persistent positive in the second test (95% C 1.6-3.8, n = 22) collected on average 5.5 months later. Dysplasia, was found in 1.8% (16/893) (95% CI 1.1-3.0) and CIN 2+ in 1.0% (9/893) (95%CI 0.5-2.0) of the women. Of the 16 women with dysplasia in histology, 13 (81.2%) had a normal cytology.INTERPRETATION: Repeated self-sampling at home combined with HPV testing was well accepted among elderly women. A high prevalence of CIN was diagnosed by histology. Cytology showed extremely low sensitivity and should not be recommended for this age group.
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| 33. |
-
Lärares bedömningsarbete
- 2018
-
Editorial collection (other academic/artistic)abstract
- Sverige hör till de länder i världen som bytt betygssystem oftast, vilket inneburit att vi vid ett flertal tillfällen satt rättssäkerheten gällande bedömning ur spel. Forskning visar nämligen att det tar lång tid att utveckla den förtrogenhet med betygsskala, mål, kriterier, kunskapsområden och nationella prov, som behövs för en välgrundad, likvärdig bedömning. Eftersom lärare vid betygsreformerna i praktiken gjorts till nybörjare i bedömningsarbetet, har utomstående aktörer fått utrymme att dominera debatten. Kritiken gällande felaktiga bedömningar och bristande likvärdighet har då oftast ensidigt riktats mot lärares bedömningsarbete, utan hänsyn till det sammanhang och system som arbetet ingår i. Boken Lärares bedömningsarbete vill balansera bedömningsdebatten genom att öka förståelsen för hur arbetet påverkas av avgörande faktorer som ligger utanför klasslärarens inflytande och ansvar. Boken vänder sig till lärare, lärarstudenter och beslutsfattare i syfte att belysa lärares förutsättningar och villkor för agens att bedriva ett professionellt bedömningsarbete.
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| 34. |
-
Lärares bedömningsarbete : förutsättningar, villkor, agens
- 2018
-
Editorial collection (other academic/artistic)abstract
- Sverige hör till de länder i världen som bytt betygssystem oftast, vilket inneburit att vi vid ett flertal tillfällen satt rättssäkerheten gällande bedömning ur spel. Forskning visar nämligen att det tar lång tid att utveckla den förtrogenhet med betygsskala, mål, kriterier, kunskapsområden och nationella prov, som behövs för en välgrundad, likvärdig bedömning. Eftersom lärare vid betygsreformerna i praktiken gjorts till nybörjare i bedömningsarbetet, har utomstående aktörer fått utrymme att dominera debatten. Kritiken gällande felaktiga bedömningar och bristande likvärdighet har då oftast ensidigt riktats mot lärares bedömningsarbete, utan hänsyn till det sammanhang och system som arbetet ingår i. Boken Lärares bedömningsarbete vill balansera bedömningsdebatten genom att öka förståelsen för hur arbetet påverkas av avgörande faktorer som ligger utanför klasslärarens inflytande och ansvar. Boken vänder sig till lärare, lärarstudenter och beslutsfattare i syfte att belysa lärares förutsättningar och villkor för agens att bedriva ett professionellt bedömningsarbete.
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| 35. |
- Marchesoni, Maria Andersson, et al.
(author)
-
Going from “paper and pen” to ICT systems : Perspectives on managing the change process
- 2017
-
In: Informatics for Health and Social Care. - : Taylor & Francis. - 1753-8157 .- 1753-8165. ; 42:2, s. 109-121
-
Journal article (peer-reviewed)abstract
- Background: Lack of participation from staff when developing information and communication technologies (ICT) has been shown to lead to negative consequences and might be one explanation for failure. Management during development processes has rarely been empirically studied, especially when introducing ICT systems in a municipality context. Objective: To describe and interpret experiences of the management during change processes where ICT was introduced among staff and managers in elderly care. Design: A qualitative interpretive method was chosen for this study and content analysis for analyzing the interviews. Results: “Clear focus–unclear process” demonstrated that focus on ICT solutions was clear but the process of introducing the ICT was not. “First-line managers receiving a system of support” gave a picture of the first-line manager as not playing an active part in the projects. First-line managers and staff described “Low power to influence” when realizing that for some reasons, they had not contributed in the change projects. “Low confirmation” represented the previous and present feelings of staff not being listened to. Lastly, “Reciprocal understanding” pictures how first-line managers and staff, although having some expectations on each other, understood each other’s positions. Conclusions: Empowerment could be useful in creating an organization where critical awareness and reflection over daily practice becomes a routine.
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| 36. |
- Nilsson, Kerstin, et al.
(author)
-
54 forskare: Inte alla klarar höjd pensions-ålder
- 2017
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In: Svenska Dagbladet, Stockholm. - 1101-2412.
-
Journal article (pop. science, debate, etc.)abstract
- Ett hållbart och acceptabelt pensionssystem måste utformas utifrån personliga förutsättningar och förhållanden i arbetslivet, så att fler klarar att arbeta i högre ålder. Att enbart genom ekonomiska åtgärder höja pensionsåldern är inte långsiktigt hållbart, skriver 54 forskare.DEBATT | PENSIONForskning visar att cirka var fjärde har en diagnos eller skada orsakad av sitt arbete. Detta gör arbetsorsakad sjukdom och skada till ett betydelsefullt folkhälsoproblem. Att då enbart genom ekonomiska åtgärder höja pensionsåldern för samtliga (yrkes)grupper utifrån deras kronologiska ålder är inte långsiktigt hållbart när individers biologiska ålder är så olika bland annat till följd av arbetslivet. Detta är en demokratifråga. Forskning om äldre i arbetslivet och hållbart arbete visar att man då främst flyttar individer från pensionssystemet till sjukförsäkringssystemet och ökar klyftorna i samhället.Debatt Det här är en argumenterande text med syfte att påverka. Åsikterna som uttrycks är skribentens egna.Vi är 54 forskare som nu gemensamt har skrivit denna debattartikel. Anledningen är att vi är oroade över att cirka var fjärde blir sjuk av sitt arbete samtidigt som man i det förslag som ligger om att senarelägga ålderspensionen i princip utgår ifrån att arbetskraftsdeltagande enbart styrs av ekonomin. Vi vill trycka på betydelsen av åtgärder i arbetslivet för att komma tillrätta med ohälsan, det vill säga inte enbart ekonomiska restriktioner som tvingar folk som inte kan, vill och orkar att stanna kvar i arbetslivet till en högre kronologisk ålder.Pensionssystemet bygger på att vi ska arbeta en viss del av våra liv för att förtjäna möjligheter till pension. Vi bör dock inte enbart utgå ifrån antalet år sedan en person föddes, då korttidsutbildade generellt träder in på arbetsmarknaden tidigare än långtidsutbildade. De har alltså varit en del av arbetskraften från en yngre ålder. Människor med kortare utbildning har oftare ett arbete som innebär påfrestningar som kan inverka negativt på hälsotillståndet och som till och med kan påskynda det biologiska åldrandet. Dessutom lever korttidsutbildade generellt sett inte lika länge som långtidsutbildade, vilket delvis även avspeglar skilda livs- och arbetsvillkor.Den svenska sjukförsäkringsreformen 2008 avsåg att få tillbaka människor i arbete. Men studien fann att den faktiskt bidrog till att fler gick i tidig ålderspension av dem som var i åldern 55–64 år. Ökningen var störst bland korttidsutbildade. Mer än 5 procent fler gick i tidig ålderspension då det blev svårare att få sjukpenning och sjukersättning. Vi kan notera att det är vanligare att manliga chefer tar ut tidig ålderspension, jämfört med kvinnliga maskinskötare inom tillverkningsindustrin. I vissa yrken är det dessutom vanligare att människor, trots pension, både orkar och faktiskt ges möjlighet att arbeta vidare om de har en specialkompetens som efterfrågas. Om vi endast kombinerar ekonomiska morötter med piskor finns en stor risk att vi ökar klyftan mellan grupper som både kan och vill fortsätta att yrkesarbeta och personer som av olika skäl inte längre kan eller orkar.Ta nytta av den forskning som vi har tagit fram. Ett hållbart och acceptabelt pensionssystem måste utformas utifrån personliga förutsättningar och förhållanden i arbetslivet. Ett hållbart arbetsliv för allt fler i vår åldrande befolkning fordrar att vi samtidigt beaktar faktorer som relaterar till biologisk/kroppslig ålder, mental/kognitiv ålder samt social ålder/livsloppsfas och våra attityder som är kopplade till ålder. Vi måste ta större hänsyn till olika förutsättningar och varierande funktionsförmåga och utifrån detta anpassa de åtgärder som gör att arbetslivet blir möjligt och hållbart för allt fler även i högre ålder.”Morötter” är viktigare för en god arbetshälsa och hög produktivitet än en piska i form av oron för en dålig ekonomi.Forskning visar att pedagogik som bygger på ”morötter” oftast är betydligt bättre än ”piskor” för att nå framgångsrika och långsiktiga mål. ”Morötter” i samhället, för organisationer, företag och individer är därför viktiga för god arbetshälsa och fortsatt produktivitet och kan bidra till ett längre arbetsliv även för grupper som tidigare inte ens klarat av att arbeta fram till pensionsåldern. Genom forskning inom området har bland annat swage-modellen utarbetats. Detta är ett verktyg som visar på komplexiteten i ett hållbart arbetsliv och tillsammans med systematiskt arbetsmiljöarbete, handlingsplaner och åtgärder syftar till ett mer hållbart arbetsliv. Morötter är enligt forskningen i detta sammanhang åtgärder för en god fysisk och mental arbetsmiljö, avpassad arbetsbelastning, stödjande teknik, att man kan anpassa arbetstakten, alternativa arbetstidsmodeller vid behov. Det är viktigt att man känner sig trygg och förväntas och tillåts vara delaktig, att man blir sedd av chefen och arbetskamraterna. Att de egna arbetsuppgifterna upplevs som meningsfulla och behövda av andra skapar självförverkligande och tillfredsställelse i arbetet. Att man känner att ens arbetsuppgifter och man själv är viktig för organisationen och företaget. Att man trots högre ålder inkluderas i olika nysatsningar och får tillgång till kompetensutveckling och inte blir åsidosatt eller åldersdiskriminerad. Utvärderingar visar att de äldre medarbetarna som fick några av dessa anpassningar och möjligheter var mer effektiva, utvilade, stimulerade när de var på arbetet samtidigt som sjukfrånvaron minskade. Vilket i sin tur bidrar till ett längre arbetsliv för grupper som tidigare inte klarat av att arbeta fram till pensionsåldern. I organisationer som bygger på en deltagar- och lärandekultur rustas de anställda för att klara omställningar, nya arbetsuppgifter och vid behov även yrkesbyten.Med en åldrande befolkning där allt fler lever allt längre behöver vi arbeta till en högre ålder i framtiden för att pensionssystemet ska hålla. Men ”morötter” är viktigare för en god arbetshälsa och hög produktivitet än en piska i form av oron för en dålig ekonomi. Det kräver också att vi ändrar våra attityder och förhållningssätt till äldre på arbetsmarknaden, vilket vi bäst gör genom att organisationer och företag får incitament till och erbjuder mer individanpassade arbetsvillkor, särskilt för personer i högre ålder. Låt oss därför använda den framtagna kunskapen i praktiken för att göra arbetslivet friskt och hållbart för alla åldrar.
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| 37. |
- Nilsson, Kerstin, et al.
(author)
-
Vi är oroade över senare ålderspension
- 2017
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In: Dagens Samhälle. - 1652-6511.
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Journal article (pop. science, debate, etc.)abstract
- Var fjärde person blir i dag sjuk till följd av sitt arbete. Att höja pensionsåldern för alla yrkesgrupper, utan konkreta åtgärder för att minska ohälsan, är därför problematiskt och mycket oroande. Det är, enligt forskarna, inte långsiktigt samhällsekonomiskt lönsamt att utan andra åtgärder höja pensionsåldern för alla. Vi – 54 forskare – är mycket oroade över konsekvenserna av att, som föreslagits, senarelägga ålderspensionen.Förslaget utgår i princip från arbetskraftsdeltagande i princip enbart styrs av ekonomin, medan forskningen visar att det bara är en av flera faktorer som styr hur länge och hur mycket människor väljer att arbeta.Det här sättet att lösa problemet med en åldrande befolkning och ett sviktande pensionssystem är inte samhällsekonomiskt lönsamt på lång sikt, utan riskerar bara att flytta runt folk mellan olika ersättningssystem. Pensionssystemet bygger på att vi ska arbeta en viss del av våra liv för att tjäna in vår pension. Vi bör dock inte enbart utgå ifrån ålder eller antalet år sedan en person föddes då korttidsutbildade generellt träder in på arbetsmarknaden tidigare än långtidsutbildade. De med kortare utbildningstid har alltså varit en del av arbetskraften från en yngre ålder. Människor med kortare utbildning har också oftare ett arbete som innebär påfrestningar som kan inverka negativt på hälsotillståndet och som till och med kan påskynda det biologiska åldrandet. Dessutom lever korttidsutbildade generellt sett inte lika länge som långtidsutbildade, vilket delvis även avspeglar skilda livs- och arbetsvillkor.Ta nytta av den forskning som vi har tagit fram. Ekonomin är självklart viktigt för att vi ska vilja arbeta, men den är som sagt enbart en av flera faktorer med betydelse vårt arbetsliv.Hälsotillståndet, både det fysiska och det mentala, har en avgörande betydelse för hur länge och hur mycket vi orkar arbeta. Ett fysiskt och mentalt belastande arbete är en stark riskfaktor för en nedsatt hälsa i slutet av arbetslivet. Arbetstid, arbetstakt och möjlighet till återhämtning spelar en allt större roll ju äldre vi blir. Andra aspekter är arbetsinnehåll, hur meningsfulla och stimulerande arbetsuppgifterna är, balansen mellan arbete och familjesituation och fritidsaktiviteter. Organisationskultur, ledarskapet, stöd i arbetet och kompetens har stor betydelse för om vi ska kunna och vilja arbeta till en högre ålder. Vi måste ta större hänsyn till olika förutsättningar och varierande funktionsförmåga och utifrån detta anpassa de åtgärder som gör att arbetslivet blir möjligt och hållbart för allt fler även i högre ålder.Ett hållbart och acceptabelt pensionssystem måste därför utformas utifrån personliga förutsättningar och förhållanden i arbetslivet. Ett hållbart arbetsliv för allt fler i vår åldrande befolkning fordrar att vi samtidigt beaktar faktorer som relaterar till biologisk/kroppslig ålder, mental/kognitiv ålder samt social ålder/livsloppsfas samt de attityder som är kopplade till ålder.
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| 38. |
- Nordmark, Sofi, et al.
(author)
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Experiences and Views of the Discharge Planning Process Among Swedish District Nurses and Home Care Organizers : A Qualitative Study
- 2015
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In: Home Health Care Management & Practice. - : SAGE Publications. - 1084-8223 .- 1552-6739. ; 27:3, s. 108-118
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Journal article (peer-reviewed)abstract
- Discharge planning is an important care process, but deficits in planning are common. The aim of this study was to explore district nurses’ (DNs) and home care organizers’ (HCOs) experiences and views of the workflow during the discharge planning process (DPP). Demands, workload, time, collaboration, and engagement, together with knowledge and professional confidence, are factors that influence workflow and outcome of the DPP for DNs and HCOs. Strengths and obstacles at the organization, group, and individual levels affect the workflow during the discharge planning. Knowledge of these strengths and obstacles should help care providers in their practice as well as help management and politicians become more aware of prerequisites needed to achieve a safe and efficient workflow for securing the patient’s discharge.
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| 39. |
- Nordmark, Sofi, et al.
(author)
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Process evaluation of discharge planning implementation in healthcare using normalization process theory
- 2016
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In: BMC Medical Informatics and Decision Making. - : Springer Science and Business Media LLC. - 1472-6947. ; 16:1
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Journal article (peer-reviewed)abstract
- BackgroundDischarge planning is a care process that aims to secure the transfer of care for the patient at transition from home to the hospital and back home. Information exchange and collaboration between care providers are essential, but deficits are common. A wide range of initiatives to improve the discharge planning process have been developed and implemented for the past three decades. However, there are still high rates of reported medical errors and adverse events related to failures in the discharge planning. Using theoretical frameworks such as Normalization Process Theory (NPT) can support evaluations of complex interventions and processes in healthcare. The aim of this study was to explore the embedding and integration of the DPP from the perspective of registered nurses, district nurses and homecare organizers.MethodsThe study design was explorative, using the NPT as a framework to explore the embedding and integration of the DPP. Data consisted of written documentation from; workshops with staff, registered adverse events and system failures, web based survey and individual interviews with staff.ResultsUsing the NPT as a framework to explore the embedding and integration of discharge planning after 10 years in use showed that the staff had reached a consensus of opinion of what the process was (coherence) and how they evaluated the process (reflexive monitoring). However, they had not reached a consensus of opinion of who performed the process (cognitive participation) and how it was performed (collective action). This could be interpreted as the process had not become normalized in daily practice.ConclusionThe result shows necessity to observe the implementation of old practices to better understand the needs of new ones before developing and implementing new practices or supportive tools within healthcare to reach the aim of development and to accomplish sustainable implementation. The NPT offers a generalizable framework for analysis, which can explain and shape the implementation process of old practices, before further development of new practices or supportive tools.
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| 40. |
- Sandberg, Ylva, 1968-
(author)
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Bilingual subject-specific literacies? Teachers’ and learners’ views and experiences of two school languages in biology, civics, history and mathematics : Case studies from the Swedish upper secondary school
- 2018
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Licentiate thesis (other academic/artistic)abstract
- This licentiate thesis investigates teachers’ and students’ cognitions of bilingual subject-specific literacies. The thesis builds on three different studies, referred to as case studies, conducted in Content and Language Integrated Learning (CLIL) study programmes in the Swedish upper secondary school. Participants’ views and experiences of two languages of schooling, English and Swedish, were elicited in interviews, and analysed thematically. To gain understanding of the three studies in combination, a further analytical framework was developed and tested. In this analysis, participants’ descriptions, explanations and reflections on teaching and learning curriculum content bilingually emerged as three-dimensional discourses.In the first study, new and experienced teachers’ challenges and strategies were in focus. The biology and civics teachers, who were new teachers, and new to CLIL, found teaching through the second language of schooling, English, time-consuming and demanding. They expressed concern about limited communication and learning in the classroom. The mathematics teachers, who had long teaching experience, and of teaching in the CLIL programme, had developed strategies to meet perceived challenges, for example, they had designed parts of lessons in a monolingual mode, and parts of lessons in a bilingual mode.The second study explored intermediate CLIL teachers’ rationales for language choice in teaching. The biology and history teachers found that access to English, as afforded through the CLIL framework, coincided well with the new syllabi for their school subjects. For instance, the history teachers could use web-based study materials in English in class, and found teaching and learning more authentic than in the mainstream, Swedish-speaking, study programmes. The biology teachers mentioned that access to English terminology facilitated the teaching and learning of complex subject-specific content areas. It functioned as a potential source to enhance students’ understanding.The third study documented students ́cognitionsof CLIL. The views of upper secondary students studying curriculum content through English were overall positive. However, results showed that their experiences of CLIL varied with school subject. Whereas studying mathematics through English was reported to be conducive to learning and understanding, learning civics through English only, or trying to listen to lectures in civics, where teachers would change languages seemingly without a rationale, were perceived as less conducive to learning.
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| 41. |
- Sanner, Karin, et al.
(author)
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Daily self-sampling for high-risk human papillomavirus (HR-HPV) testing.
- 2015
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In: Journal of Clinical Virology. - : Elsevier BV. - 1386-6532 .- 1873-5967. ; 73, s. 1-7
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Journal article (peer-reviewed)abstract
- BACKGROUND: Self-sampling for HPV as part of primary screening is a well-tolerated method for women not attending organized Pap smear screening and could increase coverage of cervical cancer screening.OBJECTIVE: To investigate if the prevalence of HR-HPV varies from day to day in infected women and if one single sample is reliable for detecting an ongoing infection.STUDY DESIGN: This is a prospective cohort study on 12 premenopausal and 13 postmenopausal women performing daily self-sampling for HR-HPV testing. They were all HR-HPV-positive 1-3 months ago. Postmenopausal women were sampled for 28 days and premenopausal women sampled during bleeding-free days in one menstrual cycle. A possible difference in viral load between the estrogen-dominated proliferative phase and the progesterone-dominated secretory phase was analyzed.RESULTS AND CONCLUSIONS: Consistent results throughout the sampling period were observed for 19 women, with either a daily presence of HPV (14 women) or no HPV at all during the sampling period (5 women). Of 607 samples from 25 women, 596 were consistently positive or negative for HPV during the sampling period and 11 were inconsistent (2%). There was no difference in HPV copy number between the estrogen dominated proliferative or progesterone dominated secretory menstrual cycle phases. The major finding was a high degree of consistency concerning HR-HPV positivity and negativity of HR-HPV in vaginal fluid during a sustained period of daily self-sampling. It does not appear to matter whether the sample is collected in the proliferative or secretory phase.
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| 42. |
- Tegelberg, Saara, et al.
(author)
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Respiratory chain complex III deficiency due to mutated BCS1L : A novel phenotype with encephalomyopathy, partially phenocopied in a Bcs1l mutant mouse model
- 2017
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In: Orphanet Journal of Rare Diseases. - : Springer Science and Business Media LLC. - 1750-1172. ; 12:1
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Journal article (peer-reviewed)abstract
- Background: Mitochondrial diseases due to defective respiratory chain complex III (CIII) are relatively uncommon. The assembly of the eleven-subunit CIII is completed by the insertion of the Rieske iron-sulfur protein, a process for which BCS1L protein is indispensable. Mutations in the BCS1L gene constitute the most common diagnosed cause of CIII deficiency, and the phenotypic spectrum arising from mutations in this gene is wide. Results: A case of CIII deficiency was investigated in depth to assess respiratory chain function and assembly, and brain, skeletal muscle and liver histology. Exome sequencing was performed to search for the causative mutation(s). The patient's platelets and muscle mitochondria showed respiration defects and defective assembly of CIII was detected in fibroblast mitochondria. The patient was compound heterozygous for two novel mutations in BCS1L, c.306A > T and c.399delA. In the cerebral cortex a specific pattern of astrogliosis and widespread loss of microglia was observed. Further analysis showed loss of Kupffer cells in the liver. These changes were not found in infants suffering from GRACILE syndrome, the most severe BCS1L-related disorder causing early postnatal mortality, but were partially corroborated in a knock-in mouse model of BCS1L deficiency. Conclusions: We describe two novel compound heterozygous mutations in BCS1L causing CIII deficiency. The pathogenicity of one of the mutations was unexpected and points to the importance of combining next generation sequencing with a biochemical approach when investigating these patients. We further show novel manifestations in brain, skeletal muscle and liver, including abnormality in specialized resident macrophages (microglia and Kupffer cells). These novel phenotypes forward our understanding of CIII deficiencies caused by BCS1L mutations.
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| 43. |
- Waermö, Mimmi, 1970-
(author)
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Dialectics of Negotiagency : Micro Mechanisms in Children’s Negotiation in Play Activity
- 2017
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Doctoral thesis (other academic/artistic)abstract
- This study is about the children in a fourth and fifth grade Swedish primary school class and their play during breaktimes. The study takes the theoretical point of departure in seeing children’s breaktime play as a cultural historical activity. The overarching research problem concerns breaktime play emphasising the phenomena of children’s negotiation, participation and agency. It concerns how breaktime play takes shape and which capacities children possess, who are breaktime play literate, to participate and to uphold play. What is the significance of children’s capacity to negotiate rules and roles? How do they use culturally, historically developed objects and motives to transform and expand established versions of play and games? The research problem foregrounds how the play activity emerges, is carried out and how participation is enabled through negotiation. The aim of the study is to explore the phenomena of children’s negotiation and agency in dialectical change processes in breaktime play activity. The questions explored are: RQ: What are the mechanisms in dialectical processes of collectividual action and collective object transformation in children’s play activity? How does the play activity emerge?How does the object of the play activity transform?The data consists of field notes from participant observations and of audio memos. Audio memos, short smartphone recordings of the children’s verbal reflections on aspects of their actions and experiences, were continuously produced to get the children’s verbal reflections in the immediacy of acting. Various documents and interviews form additional data. The findings show how the children negotiate involvement, rules, role set-up and the hierarchy of demands as a continuous elaboration of the conditions to establish and maintain boundaries of playfully accomplished activity. The notion of negotiagency is introduced, uncovering that breaktime play literacy does not occur in the children’s minds apart from social interaction but develops in and through negotiation. Negotiagency emerges and is realised when the children are engaged in a playfully accomplished activity. The dialectical processes of collectividual action and collective object transformation in playfully accomplished activity are enabled through negotiation. This whole mechanism is referred to as Dialectics of Negotiagency.
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