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- Berggren, Jan, 1965-, et al.
(författare)
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Education is my passport : experiences of institutional obstacles among immigrant youth in the Swedish upper secondary educational system
- 2021
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Ingår i: Journal of Youth Studies. - : Taylor & Francis Group. - 1367-6261 .- 1469-9680. ; :3, s. 340-354
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Tidskriftsartikel (refereegranskat)abstract
- In recent years, educational systems in Europe have experienced a rise in the number of immigrant youth. The experiences of immigrant youth facingthe challenges of an unfamiliar educational system is of continuous relevance in youth studies. This article aims to explore the schooling experiencesof 19 immigrant youth in Sweden, focusing on the institutional obstacles they encounter as students in the national educational system. It draws onsemi-structured interviews with immigrant youth attending upper secondary school or preparing for it by taking transitional classes. Findings are thatfamiliarity with the majority culture, how the educational system works and how to use the majority language for learning purposes in Swedenconstitute crucial knowledge for progress in upper secondary education. However, immigrant students state they have not been adequatelyprepared for these demands in their transitional classes. The authors suggest acknowledging students’ cultural backgrounds and argue for allowingEnglish parallel to Swedish as a transnational language of communication during a transition period, thereby improving students’ chances of havingtheir embodied cultural capital validated in the upper secondary school system.
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- Berggren, Lars, et al.
(författare)
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Labour Relations - the Swedish Model
- 2011
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Ingår i: Swedish Mining and Metalworking - Past and Present. National Atlas of Sweden. - 9789187760600 ; , s. 165-167
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Bokkapitel (refereegranskat)
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- Berggren, Lars, et al.
(författare)
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Partsrelationer - den svenska modellen
- 2011
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Ingår i: Bergsbruk - gruvor och metallframställning. Sveriges Nationalatlas. - 9789187760587 ; , s. 165-167
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Bokkapitel (refereegranskat)
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- Jildenstål, Pether, et al.
(författare)
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AAI-guided anaesthesia is associated with lower incidence of 24-hour MMSE<25 and may impact the IL-6 response
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- Introduction: Trauma stress and neuro-inflammation caused by surgery/anaesthesia releases cytokines. This study analysed impact of Auditory Evoked Potential Index (AAI) depth-of-anaesthesia titration on the early plasma IL-6 release after eye surgery under general anaesthesia.Method: This is a subgroup analysis of a prospective randomized study on the effect of auditory evoked potential guided anaesthesia for eye surgery. Plasma IL-6 levels taken before, 5 and 24 h after end of surgery from 450 patients undergoing elective ophthalmic surgery under desflurane anaesthesia were analysed. Minimal mental state examination (MMSE) was also tested at 24-hours.Results: IL- 6 increased significantly at both 5 and further at 24 hours after surgery (3.2, 4.5 and 5.1 base-line, 5 and 24- hours respectively), the IL-6 increase showed different patterns between the 2 groups; IL-6 was significantly increased in the control group of patients between preoperative baseline and 24 h after surgery (p= 0.008) also between 5 h and 24 h, (p= 0.006) after surgery while the AAI-group had only minor non-significant changes. The 18 patients that showed a 24-hour MMSE score less than 25 had a significant higher 24-hour IL-6 compared to the 390 patients with a MMSE score > 24 (p = 0.002).Conclusion: The IL-6 increase after surgery was less pronounced in patients where anaesthesia was titrated by AAI compared to anaesthesia adjusted on clinical signs only. IL-6 were also found to be higher in patients with a MMSE <25 at 24-hours. Further studies are warranted evaluating the role of depth of anaesthesia monitoring on the risk for early cognitive impairment and neuro-inflammation.
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- Jildenstål, Pether K., 1970-, et al.
(författare)
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AAI-guided anaesthesia is associated with lower incidence of 24-h MMSE < 25 and may impact the IL-6 response
- 2014
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Ingår i: International Journal of Surgery. - : Elsevier. - 1743-9191 .- 1743-9159. ; 12:4, s. 290-295
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Trauma stress and neuro-inflammation caused by surgery/anaesthesia releases cytokines. This study analysed impact of Auditory Evoked Potential Index (AAI) depth-of-anaesthesia titration on the early plasma IL-6 release after eye surgery under general anaesthesia.Method: This is a subgroup analysis of a prospective randomized study on the effect of auditory evoked potential guided anaesthesia for eye surgery. Plasma IL-6 levels taken before, 5 and 24 h after end of surgery from 450 patients undergoing elective ophthalmic surgery under desflurane anaesthesia were analysed. Minimal mental state examination (MMSE) was also tested at 24-h.Results: IL-6 increased significantly at both 5 and further at 24 h after surgery (3.2, 4.5 and 5.1 base-line, 5 and 24-h respectively), the IL-6 increase showed different patterns between the 2 groups; IL-6 was significantly increased in the control group of patients between preoperative baseline and 24 h after surgery (p = 0.008) also between 5 h and 24 h, (p = 0.006) after surgery while the AAI-group had only minor non-significant changes. The 18 patients that showed a 24-h MMSE score less than 25 had a significant higher 24-h IL-6 compared to the 390 patients with a MMSE score > 24 (p = 0.002).Conclusion: The IL-6 increase after surgery was less pronounced in patients where anaesthesia was titrated by AAI compared to anaesthesia adjusted on clinical signs only. IL-6 were also found to be higher in patients with a MMSE < 25 at 24-h. Further studies are warranted evaluating the role of depth of anaesthesia monitoring on the risk for early cognitive impairment and neuro-inflammation.
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- Jildenstål, Pether K, 1970-, et al.
(författare)
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Perioperative management in order to minimise postoperative delirium and postoperative cognitive dysfunction : Results from a Swedish web-based survey
- 2014
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Ingår i: Annals of Medicine and Surgery. - : Elsevier. - 2049-0801. ; 3:3, s. 100-107
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Tidskriftsartikel (refereegranskat)abstract
- Cognitive side-effects such as emergence agitation (EA), postoperative delirium (POD) and postoperative cognitive dysfunction (POCD) are not infrequently complicating the postoperative care especially in elderly and fragile patients. The aim of the present survey was to gain insight regarding concern and interest in prevention and treatment strategies for postoperative delirium and dysfunction, and the use of EEG-based depth-of-anaesthesia monitoring possibly reducing the risk for cognitive side effects among anaesthesia personnel.METHODS: A web-based validated questionnaire was sent to all Swedish anaesthesiologists and nurse anaesthetists during summer 2013. The questionnaire consisted of 3 sections, subjective preferences, routines and practices related to the perioperative handling of EA, POD, POCD.RESULTS: The response rate was 52%. Cardiovascular/pulmonary risks where assessed as importance by 98, 97% of responders while 69% considered the risk of neurocognitive side-effects important. When asked explicitly around cognitive side-effects 89%, 37% and 44% assessed awareness, POC and POD respectively of importance. EEG-based depth-of-anaesthesia monitors were used in 50% of hospitals. The responders were not convinced about the benefits of such monitors even in at-risk patients. Structured protocols for the management of postoperative cognitive side-effects were available only in few hospitals.CONCLUSION: Swedish anaesthesia personnel are concerned about the risk of postoperative cognitive side-effects but are more concerned about cardiovascular/pulmonary risks, pain, PONV and the rare event of awareness. Most respondents were not convinced about the use of depth-of-anaesthesia monitors. There is a need to improve knowledge around risk factors, prevention and management of postoperative cognitive side effects.
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- Jildenstål, Pether K., 1970-, et al.
(författare)
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Routines for reducing the occurrence of emergence agitation during awakening in children, a national survey
- 2014
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Ingår i: SpringerPlus. - : Springer. - 2193-1801. ; 3
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Tidskriftsartikel (refereegranskat)abstract
- Emergence agitation following anesthesia in children is not uncommon. It is, although generally self-limiting, associated with both patient and parents distress. We conducted a national survey around the management of behavioral and neurocognitive disturbances after surgery/anesthesia including a case scenario about a child at risk for emergence reaction. Premedication with clonidine or midazolam would have been used 58 and 37% of responders respectively. A propofol based anesthesia was the most common anesthetic technique, however sevoflurane or desflurane was an option for 45 and 8% of responders. Before awakening 65% would have administered an opioid, 48% a low-dose of propofol and 25% clonidine. Sign or symptoms of behavioral disturbance was not assessed by standardize assessment tools.A majority of Swedish anesthesia personnel would undertake some preventive action when handling a child at risk for an emergence reaction, the preventive measure differed and it seems as there is an obvious room for further improvements.
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- Jildenstål, Pether, et al.
(författare)
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Swedish anaesthesiologists and nurse anaesthetists routines for evaluation and management of cognitive function : a nationwide survey
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Annan publikation (populärvet., debatt m.m.)abstract
- Introduction: In clinical practice efforts have mainly been focused on cardiovascular and pulmonary risks, there is less attention on postoperative delirium (POD) and postoperative cognitive dysfunction (POCD).Methods: An online questionnaire regarding cognitive decline after anaesthesia and surgery was sent nationwide to a total of 2 626 anaesthesiologists and nurse anaesthetists. The questionnaire consisted of 3 parts, subjective preferences, routines and practices based on four typical case scenarios i.e. POCD, POD, emergence agitation (EA) and awareness.Results: The response rate was n=417 (45%) and n=669 (55%) for anaesthesiologists and nurse anaesthetists respectively. Only 10% of the responders consider cognitive function, assessment of preoperatively and risk for cognitive side-effects postoperatively important. The concern regarding awareness was far greater (90%) than for EA, POD and POCD, 30- 45%. EEG based depth of anaesthetic monitoring (DOA) is used regularly by 10% and in 22% in patients with increased risk. Regarding treatment, investigation and follow-up routines, less than 15% had written structured protocols. Sixty percent of the respondents do not consider POCD as an important outcome. Anaesthesiologists have a better knowledge of screening methods, management and follow-up routines and drug treatment for POD, POCD and EA compared to nurse anaesthetists.Conclusions: Our nationwide survey of anaesthesiologists and nurse anaesthetists shows that there is a general lack of knowledge about assessment and management of postoperative cognitive dysfunction. They are more concerned about awareness than the much more frequent and serious problems such as POD and POCD. In general DOA monitoring is not considered necessary. This survey shows that there is a clear need for improvement regarding knowledge of cognitive function.
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