DiVA - Academic Archive On-line

Professional support in childbearing : a challenging act of balance

2012-03-29T13:09:00.000+02:00

http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-22290

No abstract available.

Mental dynamisk prestation : påverkansprocessen utifrån ett idrottsligt perspektiv

2012-05-10T12:43:00.000+02:00

http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-22802

No abstract available.

A support group programme for family members : an interverntion during ongoing palliative care

2012-03-16T10:43:00.000+01:00

http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-22107

Family members are central in providing care for patients with lifethreatening illness, but they often experience a lack of necessary preparation and knowledge, with a need for information and psychosocial support. The overall aim of this thesis was to investigate participant’s experiences as well as effects of a support group programme for family members of patients with life-threatening illness during ongoing palliative care.

Methods: A mixed method design was used. Study I was retrospective descriptive and used a phenomenological method to analyse 10 face-to-face interviews about experiences of participating in the programme. Study II was retrospective descriptive and used qualitative content analysis to analyse 29 telephone interviews about experiences of the programme design. Study III was correlational and used a confirmatory factor analysis to psychometrically evaluate the preparedness for caregiving scale(PCS), caregiver competence scale(CCS) and rewards of caregiving scale(RCS) in 124 family members. Study IV was prospective quasi-experimental and used interferential statistics to investigate effects of the programme, assessing preparedness, competence, rewards, anxiety, depression, hope and health in 125 family members.

Results: The main experiences of participation in the programme were; a sense of safety and belonging, confirmation, insight into the gravity of the illness, and a moment of rest. The programme was experienced as covering topics of interest, structured to make participants feel invited by the caring team and using an open approach that fostered a warm atmosphere. The Swedish versions of PCS, CCS and RCS were shown to be valid and reliable. Family members who participated in the programme significantly increased in preparedness, competence and rewards in relation to caregiving. No significant changes were shown for anxiety, depression, hope and health.

Clinical implications: The results should provide encouragement in the challenging work to develop and deliverer interventions, with the explicit purpose of supporting family members in palliative care.

Applicability of the ICF-CY to describe functioning and environment of children with disabilities

2012-04-19T10:30:00.000+02:00

http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-22591

The aim of the thesis, with four empirical studies, was to explore the applicability of the International Classification of Functioning, Disability and Health, version for children and youth (ICF-CY) to describe functioning and environment of children with disabilities. The components and categories in the ICF-CY were explored by studying items in ICF-CY based questionnaires in studies I and II and by linking texts of individual habilitation plans to the ICF-CY in studies III and IV. Professionals’ perceptions of the applicability of the ICF-CY and the ICFCY questionnaire were investigated in study II. In study IV changes in focus on ICF-CY components in documentation of individual habilitation plans were explored after in-service training in the ICF-CY. Studies I and II found variations in ratings of questionnaire items based on the performance qualifier in component Activities and participation. The variations may be explained by the context in which ratings were made and by expectations and perceptions of those who made ratings. The results indicated challenges in constructing universal measures of the performance qualifier. The studies also indicated limitations in the use of items based on Environmental factors, when used separately from items in Activities and participation. Studies II and III found that the categories in the components Body functions and Activities and participation were interrelated. Study III indicated challenges in describing family situation and children’s psychosocial environment in the Environmental factors. In study II the professionals described advantages and challenges in the use of the ICFCY and suggested necessary changes to the ICF-CY questionnaire. Study IV found that the professionals in child and youth habilitation described children’s functioning more precisely and in more detail after in-service training. Overall, the results suggest both advantages and challenges of the ICFCY when used to describe functioning and environment of children with disabilities. The results call for a need of a combined use of the categories from all the ICF-CY the components.

I föränderliga och slutna rosa rum : En etnografisk studie av kön, ålder och andlighet i en svensk waldorfförskola

2012-03-23T08:59:00.000+01:00

http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-22217

The aim of this study is to generate new knowledge of the educationalpractice of a pre-school and of how it may contribute to the understandingof doing gender. The ethnographic study examines the place and practiceof a Steiner Waldorf pre-school, and it focuses specifically on materiality,age, spirituality and the intentions of the pre-school teachers. Fieldworkhas been conducted for a period of one and a half years in one pre-school.The methods used are mainly participant observation and interviews withthe pre-school teachers. The results highlight the importance of the materialand spatial dimensions of the pre-school for the constitution of children’sgender. The concepts of performativity and ritualization have beenused as the main analytical tools. The study draws on the scope of theseconcepts as understood by Judith Butler and Catherine Bell.

On the basis of the analysis of the empirical material, a theoretical concept,situated decoding of gender, is suggested. It is argued that what atfirst glance can be interpreted as a ‘female universe’, turns out to be a placewhere gender is made non-relevant through an unintentional, yet powerfulongoing process of naturalization. The situated decoding of gender is madepossible because of certain features in this pre-school. Firstly, a repetitivestructure characterizing educational practice has been observed. This isbased on a principle of rhythm reciprocally related to the alternations betweencontinuity and change. Secondly, there is a clear spatial and materialdemarcation that the study argues makes the pre-school an enclosed space,in the sense of being a place of nurturing and protection, where the boundariesbetween home and pre-school are maintained. Thirdly, the performativeforce of the ritualized preschool practices further enhances the decodingof gender. The ritualization highlights and supports the spiritual dimensionin the pedagogy, which sidelines the doing of gender. Fourthly, theteachers contributed to the decoding of gender through the consistency oftheir everyday actions.

Risc factors and complications of celiac disease

2012-03-16T12:09:00.000+01:00

http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-22136

Background: Celiac disease (CD) is an immune-mediated enteropathy induced by dietary gluten. CD is prevalent in some 1 % of the general population. In recent decades there has been a marked increase in CD prevalence that may be influenced by environmental risk factors. Aims: The aim of this thesis was to examine possible risk factors for CD and to gain information on associated disorders of CD.

Methods: In study I we used regional cohort-data from ~11,000 children to examine the association between psychological stress in early life and subsequent CD. In studies II-IV we used nationwide histopathology data to identify individuals with CD (i.e. villous atrophy). In study II we linked data on ~29,000 CD patients to the National patient register to examine the risk of hospital admission for influenza. In studies III-IV we linked data on ~11,000 CD patients to several Swedish registries, including the Medical birth register, to examine neonatal risk factors in CD (study III) and the risk of CD in patients with Down syndrome (study IV).

Results: Psychological stress in the first years of life was not associated with subsequent CD. We found a two-fold increased risk of hospital admission for influenza in patients with CD (95 % confidence interval [CI] = 1.6-2.7).While elective cesarean delivery was associated with an increased risk of later CD (adjusted Odds Ratio [OR] = 1.15; 95 % CI = 1.04-1.26), emergency cesarean delivery was not (adjusted OR = 1.02; 95 % CI = 0.92-1.13). Finally, in study IV we found a six-fold increased risk of CD in children with Down syndrome (95 % CI = 5.09-7.43).

Conclusion: This thesis supports the hypothesis that certain environmental risk factors, such as mode of delivery, but possibly not early psychological stress, influence the risk of CD. The increased risk of hospital admission for influenza indicate that individuals with CD may benefit from influenza immunization. The highly increased risk of CD in Down syndrome supports CD screening in Down syndrome patients.

Urinary catheter policies for short-term bladder drainage in hip surgery patients

2012-04-12T12:23:00.000+02:00

http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-22505

The overall aim of this thesis was to evaluate methods for urinary catheter handling in patients undergoing hip surgery. The intention was to gain knowledge in order to provide optimal and cost- effective care regarding urinary catheterisation in this group of patients.

In Study I , 45 of the 86 catheterised patients (52%) contracted nosocomial urinary tract infections (UTIs). Diabetes was a risk factor for developing UTI, and cloxacillin as a perioperative antibiotic prophylaxis seemed to offer a certain protection. Study II was a randomised controlled trial on the effect of clamping (n = 55) or not (n = 58) of the indwelling urinary catheter before removal. No significant differences were found between the groups with respect to time to normal bladder function, need for recatheterisation, or length of hospital stay. Study III was a randomised controlled trial among patients with hip fracture and hip arthroplasty, in which the patients were randomised to intermittent (n = 85) or indwelling (n = 85) urinary catheterisation. No significant differences in nosocomial UTIs (9% vs. 12%) or cost-effectiveness were shown. The patients in the intermittent group regained normal bladder function significantly sooner after surgery. Fourteen percent of the patients in the intermittent group did not need any catheterisation. In Study IV , 30 patients were interviewed about their experiences of bladder emptying and urinary catheterisation. The patients’ views were described through the main category ‘An issue but of varying impact’. Both bladder emptying through micturition and bladder emptying through catheterisation were described as convenient, but also as uncomfortable and an intrusion on dignity. The patients were aware of risks and complications of urinary catheterisation.

In conclusion, this thesis indicates that UTI is common in hip surgery patients. Clamping of indwelling catheters seems not necessary. There is no preference for either intermittent or indwelling urinary catheterisation according to the results of this thesis, either for the development of nosocomial UTI or, for cost-effectiveness, or from the patient perspective. Nurses should be aware that catheterisation might make the patients feel exposed, and it is essential that their practice reflect the best available evidence.

Civic experiences and public connection : media and young people in Estonia

2012-03-28T09:12:00.000+02:00

http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-22265

How do young people in Estonia experience the political, politics and citizenship? How are these civic experiences connected to young peoples’ experiences with the media? Anne Kaun’s thesis Civic Experiences and Public Connection presents a theoretical and empirical investigation of how civic experiences, particularly public connection, emerge in the context of contemporary Estonia. Employing open-ended online diaries and in-depth interviews, she aims to develop an in-depth understanding of how young people experience democracy today, and how they express themselves as citizens; expression not only through the physical performance of citizenship, but also through orientation, interest in, and reflection about issues that are of common concern or should be seen as such. The empirical investigation of public connection as critical media connection, playful public connection and historical public connection, is based on narrative analysis and embedded in a theoretical exploration of key concepts in the context of civic culture studies, namely the political, politics and citizenship.

Combining Chantal Mouffe’s conflict theory with Paul Ricoeur’s narrative identity, Kaun aims to shed light on contemporary democracy from the citizens’ perspective. The author proposes a holistic approach to both civic experiences and the role that media might play in relation to them. Following a non-media- centric approach, she shows that media, despite their ubiquity, are an important but not exclusive source of the civic experiences of young adults in Estonia.

Modulation of cellular innate immune responses

2012-03-16T13:08:00.000+01:00

http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-22138

No abstract available.

Optimization of the perioperative anaesthetic care for prostate cancer surgery : clinical studies on pain, stress response and immunomodulation

2012-05-10T15:36:00.000+02:00

http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-22804

No abstract available.

CYP26B1 as regulator of retinoic acid in vascular cells and atherosclerotic lesions

2012-05-10T11:33:00.000+02:00

http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-22799

No abstract available.

Atrial fibrillation : inflammatory and pharmacological studies

2012-04-19T10:11:00.000+02:00

http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-22590

No abstract available.

Mångfald som demokratins utmaning : en studie av hur socialtjänsten som välfärdsbyråkrati och moralisk samhällsinstitutiion förstår och hanterar kulturell mångfald

2012-04-25T15:53:00.000+02:00

http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-22674

No abstract available.

Spänning och motstånd : en studie av samtal i karaktärsämnet på ett elprogram

2012-05-11T11:59:00.000+02:00

http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-22807

No abstract available.