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  • Fornander, Louise
    Linköpings universitet, Institutionen för klinisk och experimentell medicin.
    Upper Airway Mucosal Inflammation: Proteomic Studies after Exposure to Irritants and Microbial Agents2015Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    People are, in their daily lives, exposed to a number of airborne foreign compounds that do not normally affect the body. However, depending on the nature of these compounds, dose and duration of exposure, various airway symptoms may arise. Early symptoms are often manifested as upper airway mucosal inflammation which generates changes in protein composition in the airway lining fluid.

    This thesis aims at identifying, understanding mechanisms and characterizing protein alterations in the upper airway mucosa that can be used as potential new biomarkers for inflammation in the mucosa. The protein composition in the mucosa was studied by sampling of nasal lavage fluid that was further analyzed with a proteomic approach using twodimensional gel electrophoresis and mass spectrometry. Additionally, by studying factors on site through environmental examination, health questionnaires and biological analyses, we have tried to understand the background to these protein alterations and their impact on health.

    Respiratory symptoms from the upper airways are common among people who are exposed to irritative and microbial agents. This thesis have focused on personnel in swimming pool facilities exposed to trichloramine, metal industry workers exposed to metalworking fluids, employees working in damp and moldy buildings and infants diagnosed with respiratory syncytial virus infection. The common denominator in these four studies is that the subjects experience upper airway mucosal inflammation, which is manifested as cough, rhinitis, phlegm etc. In the three occupational studies, the symptoms were work related. Notably, a high prevalence of perceived mucosal symptoms was shown despite the relatively low levels of airborne irritants revealed by the environmental examination. Protein profiling verified an ongoing inflammatory response by identification of several proteins that displayed altered levels. Interestingly, innate immune proteins dominated and four protein alterations occurred in most of the studies; SPLUNC1, protein S100A8 and S100A9 and alpha-1-antitrypsin. Similarly, these proteins were also found in nasal fluid from children with virus infection and in addition a truncated form of SPLUNC1 and two other S100 proteins (S100A7-like 2 and S100A16), not previously found in nasal secretion, were identified.

    Altogether, the results indicate the potential use of a proteomic approach for identifying new biomarkers for the upper respiratory tract at an early stage in the disease process after exposure to irritant and microbial agents. The results indicate an effect on the innate immunity system and the proteins; SPLUNC1, protein S100A8 and S100A9 and alpha-1-antitrypsin are especially promising new biomarkers. Moreover, further studies of these proteins may help us to understand the molecular mechanisms involved in irritant-induced airway inflammation.

  • Rask, Peter
    Umeå universitet, Klinisk fysiologi, Umeå, Sweden.
    Aortic stenosis: diagnostic use and hemodynamic effects of dipyridamole1995Doctoral thesis, comprehensive summary (Other academic)
  • Szabo, Eva
    Uppsala universitet, Institutionen för kirurgiska vetenskaper, Uppsala, Sweden.
    Molecular and clinical genetic studies of a novel variant of familial hypercalcemia2002Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Familial primary hyperparathyroidism (HPT) is a rare disorder that is treated surgically and mostly occurs in association with tumor-susceptibility syndromes, like multiple endocrine neoplasia and the hyperparathyroidism-jaw tumor syndrome. Familial hypercalciuric hypercalcemia (FHH) is another cause of hereditary hypercalcemia that generally is considered to require no treatment and is genetically and pathophysiologically distinct from HPT. Inactivating mutations in the calcium receptor gene cause FHH, whereas the down-regulated expression of the CaR in HPT never has been coupled to CaR gene mutations.

    Family screening revealed a hitherto unknown familial condition with characteristics of both FHH and HPT. The hypercalcemia was mapped to a point mutation in the intracellular domain of the CaR gene that was coupled to relative calcium resistance of the PTH release by transient expression in HEK 294 cells. Unusually radical excision of parathyroid glands was required to normalise the hypercalcemia. The mildly enlarged parathyroid glands displayed hyperplasia with nodular components. Frequent allelic loss on especially 12q was found and contrasts to findings in HPT. Allelic loss was also seen in loci typical for primary HPT like 1p, 6q and 15q, but not 11q13. Quantitative mRNA analysis showed that the glands had mild increase in a proliferation index (PCNA/GAPDH mRNA ratio) and mild reduction in genes important to parathyroid cell function, like CaR, PTH, VDR and LRP2.

    A previously unrecognized variant of hypercalcemia is explored that could be one explanation for persistent hypercalcemia after apparently typical routine operations for HPT. It also raises the issue of possibilities to treat FHH with parathyroidectomy provided it is radical enough.

  • Dieleman, Joseph L.
    et al.
    Institute for Health Metrics and Evaluation, University of Washington, Seattle WA, USA .
    Dalal, Koustuv
    Örebro University, School of Health Sciences. Centre for Injury Prevention and Safety Promotion.
    Murray, Christopher J. L.
    Institute for Health Metrics and Evaluation, University of Washington, Seattle WA, USA .
    Future and potential spending on health 2015-40: development assistance for health, and government, prepaid private, and out-of-pocket health spending in 184 countries2017In: The Lancet, ISSN 0140-6736, E-ISSN 1474-547X, Vol. 389, no 10083, 2005-2030 p.Article in journal (Refereed)
    Abstract [en]

    Background: The amount of resources, particularly prepaid resources, available for health can affect access to health care and health outcomes. Although health spending tends to increase with economic development, tremendous variation exists among health financing systems. Estimates of future spending can be beneficial for policy makers and planners, and can identify financing gaps. In this study, we estimate future gross domestic product (GDP), all-sector government spending, and health spending disaggregated by source, and we compare expected future spending to potential future spending.

    Methods: We extracted GDP, government spending in 184 countries from 1980-2015, and health spend data from 1995-2014. We used a series of ensemble models to estimate future GDP, all-sector government spending, development assistance for health, and government, out-of-pocket, and prepaid private health spending through 2040. We used frontier analyses to identify patterns exhibited by the countries that dedicate the most funding to health, and used these frontiers to estimate potential health spending for each low-income or middle-income country. All estimates are inflation and purchasing power adjusted.

    Findings: We estimated that global spending on health will increase from US$9.21 trillion in 2014 to $24.24 trillion (uncertainty interval [UI] 20.47-29.72) in 2040. We expect per capita health spending to increase fastest in upper-middle-income countries, at 5.3% (UI 4.1-6.8) per year. This growth is driven by continued growth in GDP, government spending, and government health spending. Lower-middle income countries are expected to grow at 4.2% (3.8-4.9). High-income countries are expected to grow at 2.1% (UI 1.8-2.4) and low-income countries are expected to grow at 1.8% (1.0-2.8). Despite this growth, health spending per capita in low-income countries is expected to remain low, at $154 (UI 133-181) per capita in 2030 and $195 (157-258) per capita in 2040. Increases in national health spending to reach the level of the countries who spend the most on health, relative to their level of economic development, would mean $321 (157-258) per capita was available for health in 2040 in low-income countries.

    Interpretation: Health spending is associated with economic development but past trends and relationships suggest that spending will remain variable, and low in some low-resource settings. Policy change could lead to increased health spending, although for the poorest countries external support might remain essential.

  • Dieleman, Joseph
    et al.
    Institute for Health Metrics and Evaluation, University of Washington, Seattle WA, USA.
    Dalal, Koustuv
    Örebro University, School of Health Sciences. Centre for Injury Prevention and Safety Promotion.
    Murray, Christopher, J. L.
    Institute for Health Metrics and Evaluation, University of Washington, Seattle WA, USA.
    Evolution and patterns of global health financing 1995-2014: development assistance for health, and government, prepaid private, and out-of-pocket health spending in 184 countries2017In: The Lancet, ISSN 0140-6736, E-ISSN 1474-547X, Vol. 389, no 10083, 1981-2004 p.Article in journal (Refereed)
    Abstract [en]

    Background: An adequate amount of prepaid resources for health is important to ensure access to health services and for the pursuit of universal health coverage. Previous studies on global health financing have described the relationship between economic development and health financing. In this study, we further explore global health financing trends and examine how the sources of funds used, types of services purchased, and development assistance for health disbursed change with economic development. We also identify countries that deviate from the trends.

    Methods: We estimated national health spending by type of care and by source, including development assistance for health, based on a diverse set of data including programme reports, budget data, national estimates, and 964 National Health Accounts. These data represent health spending for 184 countries from 1995 through 2014. We converted these data into a common inflation-adjusted and purchasing power-adjusted currency, and used non-linear regression methods to model the relationship between health financing, time, and economic development.

    Findings: Between 1995 and 2014, economic development was positively associated with total health spending and a shift away from a reliance on development assistance and out-of-pocket (OOP) towards government spending. The largest absolute increase in spending was in high-income countries, which increased to purchasing power-adjusted $5221 per capita based on an annual growth rate of 3.0%. The largest health spending growth rates were in upper-middle-income (5.9) and lower-middle-income groups (5.0), which both increased spending at more than 5% per year, and spent $914 and $267 per capita in 2014, respectively. Spending in low-income countries grew nearly as fast, at 4.6%, and health spending increased from $51 to $120 per capita. In 2014, 59.2% of all health spending was financed by the government, although in low-income and lower-middle-income countries, 29.1% and 58.0% of spending was OOP spending and 35.7% and 3.0% of spending was development assistance. Recent growth in development assistance for health has been tepid; between 2010 and 2016, it grew annually at 1.8%, and reached US$37.6 billion in 2016. Nonetheless, there is a great deal of variation revolving around these averages. 29 countries spend at least 50% more than expected per capita, based on their level of economic development alone, whereas 11 countries spend less than 50% their expected amount.

    Interpretation: Health spending remains disparate, with low-income and lower-middle-income countries increasing spending in absolute terms the least, and relying heavily on OOP spending and development assistance. Moreover, tremendous variation shows that neither time nor economic development guarantee adequate prepaid health resources, which are vital for the pursuit of universal health coverage.

  • Dalal, Koustuv
    Örebro University, School of Health Sciences.
    Healthcare Access and Quality Index based on mortality from causes amenable to personal health care in 195 countries and territories, 1990-2015: a novel analysis from the Global Burden of Disease Study 20152017In: The LancetArticle in journal (Refereed)
  • Koski, Pasi
    et al.
    University of Turku, Turku, Finland.
    Matarma, Tanja
    University of Turku, Turku, Finland.
    Pedisic, Zeljko
    Victoria University, Melbourne, Australia.
    Kokko, Sami
    University of Jyväskylä, Jyväskylä, Finland.
    Lane, Aoife
    Waterford Institute of Technology, Waterford, Ireland .
    Hartmann, Herbert
    German gymnastic federation, Frankfurt am Main, Germany.
    Geidne, Susanna
    Örebro University, School of Health Sciences.
    Hämäläinen, Timo
    Finnish Olympic Committee, Helsinki, Finland; Finnish Sports Confederation, Helsinki, Finland;.
    Nykänen, Ulla
    Finnish Olympic Committee, Helsinki, Finland.
    Rakovac, Marija
    University of Zagreb, Zagreb, Croatia.
    Livson, Matleena
    Finnish Olympic Committee, Helsinki, Finland.
    Savola, Jorma
    Finnish Sport for All Association, , Finland.
    Sports Club for Health (SCforH): updated guidelines for health-enhancing sports activities in a club setting2017Book (Other academic)
  • Hämberg, Eva
    Örebro University, School of Law, Psychology and Social Work, Örebro University, Sweden. Högskolan Dalarna, Socialt arbete.
    Supervision as control system: the design of supervision as a regulatory instrument in the social services sector in Sweden2013In: Offentlig Förvaltning. Scandinavian Journal of Public Administration, ISSN 2000-8058, E-ISSN 2001-3310, Vol. 17, no 3, 45-63 p.Article in journal (Refereed)
    Abstract [en]

    In this article, the prevailing official view of supervision as a regulatory instrument is examined as it applies to the social services sector in Sweden. The study is based on a comparison of the views expressed on the design of supervision as a regulatory instrument by two government commissions, the Supervision Commission and the Commission on Supervision within the Social Services (UTIS), and on the positions taken by the Government regarding the definitions of the concept of supervision proposed by these commissions. The view of supervision as a regulatory instrument expressed in these policy documents is analysed with the help of a theoretical framework describing the components, their functions and the governance characteristics of control systems. In the framework separate interrelated characteristics of the components are identified and summarized into two models of control systems. The analysis shows that supervision in the Swedish social services sector can be described in terms of both a disciplinary and non-disciplinary system. By its system theoretical basis and the identification of interrelated characteristics the study contributes to a broadened understanding of the construction and functions of supervision as a regulatory instrument and of how supervision within the Swedish social sector is meant to be designed.

  • Hämberg, Eva
    et al.
    Örebro University, School of Law, Psychology and Social Work, Örebro University, Sweden. Högskolan Dalarna, Socialt arbete.
    Sedelius, Thomas
    Högskolan Dalarna, Statsvetenskap.
    Inspection of social services in Sweden: a comparative analysis of the use and adjustment of standards2016In: Nordic Social Work Research, ISSN 2156-857X, E-ISSN 2156-8588, Vol. 6, no 2, 138-151 p.Article in journal (Refereed)
    Abstract [en]

    Inspection has increasingly been regarded as a safeguard for promoting quality of social services. Little attention has, however, been given to the impact of standards used in inspections, i.e. the written norms, rules and principles used for identification and judgment. The aim of this study is to empirically contribute to an improved understanding of how standards in inspection of social service are designed, and to what extent the design is adjusted in relation to different kind of social services. We employ a systematic and comparative analysis of the content (in terms of input, process, output and outcome aspects) and precision (low, medium and high) of 186 paragraphs derived from legislation and referred to as standards in inspection decisions concerning two types of social work: Investigation, Assessment and Decision-Making (IAD); and Treatment Intervention (TI) in Sweden 2012. Contrary to expectations based on an inspection ideal, our findings show that paragraphs covering outcome aspects are not more commonly referred to as standards in TI than in IAD inspection. The analysis of the precision also indicates that the standards used in inspection of TI are not more adjusted to complex and subjectively experienced aspects than are the standards used in IAD. Our overall results indicate that the policy instrument is primarily adapted to IAD inspection rather than to TI inspection.

  • Blanc, Mélanie
    et al.
    Örebro University, School of Science and Technology, Örebro University, Sweden.
    Kärrman, Anna
    Örebro University, School of Science and Technology, Örebro University, Sweden.
    Kukučka, Petr
    Örebro University, School of Science and Technology, Örebro University, Sweden.
    Scherbak, Nikolai
    Örebro University, School of Science and Technology, Örebro University, Sweden.
    Keiter, Steffen
    Örebro University, School of Science and Technology, Örebro University, Sweden.
    Mixture-specific gene expression in zebrafish (Danio rerio) embryos exposed to perfluorooctane sulfonic acid (PFOS), perfluorohexanoic acid (PFHxA) and 3,3′,4,4′,5-pentachlorobiphenyl (PCB126)2017In: Science of the Total Environment, ISSN 0048-9697, E-ISSN 1879-1026, Vol. 590-591, 249-257 p.Article in journal (Refereed)
    Abstract [en]

    Perfluorooctane sulfonic acid (PFOS) and 3,3′,4,4′,5-pentachlorobiphenyl (PCB126) are persistent organic pollutants of high concern because of their environmental persistence, bioaccumulation and toxic properties. Besides, the amphiphilic properties of fluorinated compounds such as PFOS and perfluorohexanoic acid (PFHxA) suggest a role in increasing cell membrane permeability and solubilizing chemicals. The present study aimed at investigating whether PFOS and PFHxA are capable of modifying the activation of PCB126 toxicity-related pathways. For this purpose, zebrafish embryos were exposed in semi-static conditions to 7.5 μg/L of PCB126 alone, in the presence of 25 mg/L of PFOS, 15.7 mg/L of PFHxA or in the presence of both PFOS and PFHxA. Quantitative PCR was performed on embryos aged from 24 h post fertilization (hpf) to 96 hpf to investigate expression changes of genes involved in metabolism of xenobiotics (ahr2, cyp1a), oxidative stress (gpx1a, tp53), lipids metabolism (acaa2, osbpl1a), and epigenetic mechanisms (dnmt1, dnmt3ba). Cyp1a and ahr2 expression were significantly induced by the presence of PCB126. However, after 72 and 78 h of exposure, induction of cyp1a expression was significantly lower when embryos were co-exposed to PCB126 + PFOS + PFHxA when compared to PCB126-exposed embryos. Significant upregulation of gpx1a occurred after exposure to PCB126 + PFHxA and to PCB126 + PFOS + PFHxA at 30 and 48 hpf. Besides, embryos appeared more sensitive to PCB126 + PFOS + PFHxA at 78 hpf: acaa2 and osbpl1a were significantly downregulated; dnmt1 was significantly upregulated. While presented as environmentally safe, PFHxA demonstrated that it could affect gene expression patterns in zebrafish embryos when combined to PFOS and PCB126, suggesting that such mixture may increase PCB126 toxicity. This is of particular relevance since PFHxA is persistent and still being ejected into the environment. Moreover, it provides additional information as to the importance to integrate mixture effects of chemicals in risk assessment and biomonitoring frameworks.

  • Nilsson, Andreas
    et al.
    Örebro University, School of Health Sciences.
    Wåhlin-Larsson, Britta
    Örebro University, School of Health Sciences.
    Kadi, Fawzi
    Örebro University, School of Health Sciences.
    Physical activity and not sedentary time per se influences on clustered metabolic risk in elderly community-dwelling women2017In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 12, no 4, e0175496Article in journal (Refereed)
    Abstract [en]

    Introduction: Whether amount of time spent in sedentary activities influences on clustered metabolic risk in elderly, and to what extent such an influence is independent of physical activity behavior, remain unclear. Therefore, the aim of the study was to examine cross-sectional associations of objectively assessed physical activity and sedentary behavior on metabolic risk outcomes in a sample of elderly community-dwelling women.

    Methods: Metabolic risk outcomes including waist circumference, systolic and diastolic blood pressures, fasting levels of plasma glucose, HDL-cholesterol and triglycerides were assessed in 120 community-dwelling older women (65-70 yrs). Accelerometers were used to retrieve daily sedentary time, breaks in sedentary time, daily time in light (LPA) and moderate-to-vigorous physical activity (MVPA), and total amount of accelerometer counts. Multivariate regression models were used to examine influence of physical activity and sedentary behavior on metabolic risk outcomes including a clustered metabolic risk score.

    Results: When based on isotemporal substitution modeling, replacement of a 10-min time block of MVPA with a corresponding time block of either LPA or sedentary activities was associated with an increase in clustered metabolic risk score (beta = 0.06 to 0.08, p < 0.05), and an increase in waist circumference (beta = 1.78 to 2.19 p < 0.01). All associations indicated between sedentary time and metabolic risk outcomes were lost once variation in total accelerometer counts was adjusted for.

    Conclusions: Detrimental influence of a sedentary lifestyle on metabolic health is likely explained by variations in amounts of physical activity rather than amount of sedentary time per se. Given our findings, increased amounts of physical activity with an emphasis on increased time in MVPA should be recommended in order to promote a favorable metabolic health profile in older women.

  • Aghanavesi, Somayeh
    et al.
    Computer Engineering, School of Technology and Business Studies, Dalarna University, Sweden.
    Nyholm, Dag
    Dept. of Neuroscience, Neurology, Uppsala University, Sweden.
    Senek, Marina
    Dept. of Neuroscience, Neurology, Uppsala University, Sweden.
    Bergquist, Filip
    Dept. of Pharmacology, University of Gothenburg, Sweden.
    Memedi, Mevludin
    Örebro University, Orebro University School of Business, Örebro University, Sweden. Computer Engineering, School of Technology and Business Studies, Dalarna University, Sweden.
    A smartphone-based system to quantify dexterity in Parkinson's disease patients2017In: Informatics in Medicine Unlocked, ISSN 2352-9148Article in journal (Refereed)
    Abstract [en]

    Objectives

    The aim of this paper is to investigate whether a smartphone-based system can be used to quantify dexterity in Parkinson's disease (PD). More specifically, the aim was to develop data-driven methods to quantify and characterize dexterity in PD.

    Methods

    Nineteen advanced PD patients and 22 healthy controls participated in a clinical trial in Uppsala, Sweden. The subjects were asked to perform tapping and spiral drawing tests using a smartphone. Patients performed the tests before, and at pre-specified time points after they received 150% of their usual levodopa morning dose. Patients were video recorded and their motor symptoms were assessed by three movement disorder specialists using three Unified PD Rating Scale (UPDRS) motor items from part III, the dyskinesia scoring and the treatment response scale (TRS). The raw tapping and spiral data were processed and analyzed with time series analysis techniques to extract 37 spatiotemporal features. For each of the five scales, separate machine learning models were built and tested by using principal components of the features as predictors and mean ratings of the three specialists as target variables.

    Results

    There were weak to moderate correlations between smartphone-based scores and mean ratings of UPDRS item #23 (0.52; finger tapping), UPDRS #25 (0.47; rapid alternating movements of hands), UPDRS #31 (0.57; body bradykinesia and hypokinesia), sum of the three UPDRS items (0.46), dyskinesia (0.64), and TRS (0.59). When assessing the test-retest reliability of the scores it was found that, in general, the clinical scores had better test-retest reliability than the smartphone-based scores. Only the smartphone-based predicted scores on the TRS and dyskinesia scales had good repeatability with intra-class correlation coefficients of 0.51 and 0.84, respectively. Clinician-based scores had higher effect sizes than smartphone-based scores indicating a better responsiveness in detecting changes in relation to treatment interventions. However, the first principal component of the 37 features was able to capture changes throughout the levodopa cycle and had trends similar to the clinical TRS and dyskinesia scales. Smartphone-based scores differed significantly between patients and healthy controls.

    Conclusions

    Quantifying PD motor symptoms via instrumented, dexterity tests employed in a smartphone is feasible and data from such tests can also be used for measuring treatment-related changes in patients.

  • Graff, Pål
    et al.
    Örebro University, School of Medical Sciences. Orebro University Hospital. Department of Occupational and Environmental Medicine.
    Ståhlbom, Bengt
    Occupational and Environmental Medicine Center, Linköping University, Linköping, Sweden.
    Nordenberg, Eva
    Siemens Industrial Turbomachinery AB, in Finspång, Sweden.
    Graichen, Andreas
    Siemens Industrial Turbomachinery AB, in Finspång, Sweden.
    Johansson, Pontus
    Occupational and Environmental Medicine Center, Linköping University.
    Karlsson, Helen
    Occupational and Environmental Medicine Center, Linköping University.
    Evaluating Measuring Techniques for Occupational Exposure during Additive Manufacturing of Metals: A Pilot Study2016In: Journal of Industrial Ecology, ISSN 1088-1980, E-ISSN 1530-9290Article in journal (Refereed)
    Abstract [en]

    Additive manufacturing that creates three-dimensional objects by adding layer uponlayer of material is a new technique that has proven to be an excellent tool for themanufacturing of complex structures for a variety of industrial sectors. Today, knowl-edge regarding particle emissions and potential exposure-related health hazards forthe operators is limited. The current study has focused on particle numbers, masses,sizes, and identities present in the air during additive manufacturing of metals. Mea-surements were performed during manufacturing with metal powder consisting es-sentially of chromium, nickel, and cobalt. Instruments used were Nanotracer (10 to300 nanometers [nm]), Lighthouse (300 nm to 10 micrometers), and traditional filter-basedparticle mass estimation followed by inductively coupled plasma mass spectrometry. Resultsshowed that there is a risk of particle exposure at certain operations and that particle sizestended to be smaller in recycled metal powder compared to new. In summary, nanosizedparticles were present in the additive manufacturing environment and the operators wereexposed specifically while handling the metal powder. For the workers’ safety, improvedpowder handling systems and measurement techniques for nanosized particles will possiblyhave to be developed and then translated into work environment regulations. Until then,relevant protective equipment and regular metal analyses of urine is recommended.

  • Gustavsson, Eva
    et al.
    Örebro University, School of Humanities, Education and Social Sciences, Örebro University, Sweden.
    Elander, Ingemar
    Örebro University.
    Social hållbarhet i stadsutveckling?: Uppföljning av tio projekt i svenska städer2014Report (Other academic)
  • Deniz, Fuat
    Örebro University, Department of Social and Political Sciences.
    En minoritets odyssé1999Book (Other academic)
  • Zovko, Davor
    Örebro University, School of Law, Psychology and Social Work, Örebro University, Sweden.
    Rapportering och kontroll i fokus: En studie av Arbetsförmedlingens utvärderingsverksamhet2017Licentiate thesis, comprehensive summary (Other academic)
    Abstract [en]

    The aim of this study was to explore evaluation in the Swedish Public Employment Service, with particular focus on how the use of evaluations looks like. The study consists of two studies. The first one is an analysis of the Employment Service’s all policy documents that describe or mention evaluation as well as an interview-study with all the management staff in one of the Employment Service’s local labor market units. The second study is a comparative study with analysis of the Employment Service’s entire evaluation production for the years 2010 and 2015. The results show that the Swedish Public Employment Service is a hierarchically controlled governmental organization with routines for effective communication of management's messages to all levels in the organization. Employment Service's evaluation is governed and implemented centrally and communicated from the top, down through the organization. Evaluations are mainly used as a routine for checking and reporting, as well as accounting to the government. Managers on a middle and local level find that much of the evaluation is about control, and that control is not adapted to needs of the everyday business on the local level. Evaluation activities are extensive. Evaluations seems to have become an end in itself, used in legitimizing purposes rather than as a tool for developing of the service to the clients. Half of the evaluations that the Employment Service carried out by their own, is regular evaluations. Almost all evaluations carried out by the European Social Fund Council in Sweden and “Samordningsförbund” (associations for coordination of social projects) are single occasion-evaluations. Legitimizing dominates the use of evaluation, both 2010 and 2015 in evaluating production. Evaluation for improving of the service to the clients is mentioned only in a small number of policy documents. Evaluations that includes the client’s perspective as well as proposals for change occurs to a limited extent in both 2010 and 2015. The Organization of the Employment Service's evaluation activities are heavily influenced by New Public Management's management philosophy.

    List of papers
    1. Användning av utvärderingar inom Arbetsförmedlingen
    Open this publication in new window or tab >>Användning av utvärderingar inom Arbetsförmedlingen
    2016 (Swedish)In: Arbetsmarknad & Arbetsliv, ISSN 1400-9692, Vol. 22, no 1, 6-26 p.Article in journal (Refereed) Published
    Abstract [sv]

    Arbetsförmedlingen använder utvärdering huvudsakligen för kontroll och återrapportering till regeringen och inte för verksamhetsutveckling avseende förbättring av stödet till de arbetssökande. Det visar en analys av policydokument och kvalitativa intervjuer med ledningspersonal inom ett lokalt arbetsmarknadsområde. Arbetsförmedlingens utvärderingar genomförs centralt och kommuniceras nedåt i organisationen. New public management-modellen i organisationen tycks vara överordnad Arbetsförmedlingens funktion som människobehandlande organisation.

    Place, publisher, year, edition, pages
    Karlstad: Karlstads universitet, 2016
    National Category
    Social Work Public Administration Studies Work Sciences
    Identifiers
    urn:nbn:se:oru:diva-57587 (URN)
    Available from: 2017-05-08 Created: 2017-05-08 Last updated: 2017-06-13Bibliographically approved
    2. Arbetsförmedlingens utvärderingsproduktion 2010 och 2015: En jämförande studie
    Open this publication in new window or tab >>Arbetsförmedlingens utvärderingsproduktion 2010 och 2015: En jämförande studie
    (Swedish)Manuscript (preprint) (Other academic)
    National Category
    Social Work Public Administration Studies Work Sciences
    Identifiers
    urn:nbn:se:oru:diva-57588 (URN)
    Available from: 2017-05-08 Created: 2017-05-08 Last updated: 2017-06-13Bibliographically approved
  • Pettersson, Camilla
    et al.
    Örebro University, School of Health Sciences.
    Larsson, Madelene
    Örebro University, School of Health Sciences.
    Geidne, Susanna
    Örebro University, School of Health Sciences.
    Petersén, Anna
    Örebro University, School of Law, Psychology and Social Work, Örebro University, Sweden.
    TB United: Ett projekt om ensamkommande ungdomars behov av fritidsaktiviteter samt attityder till och erfarenheter av alkohol, narkotika, dopning och tobak2017Report (Other academic)
    Abstract [sv]

    Tegelbruket i Örebro är en föreningsdriven mötesplats, öppen för alla, men med fokus på ungdomar och unga vuxna. Under 2016 beviljades Tegelbruket medel från Folkhälsomyndigheten för projektet TB United. TB Uniteds övergripande mål var att skapa ett arbetssätt för ANDT-förebyggande arbete med ensamkommande ungdomar utifrån fritiden som arena. Denna rapport är en beskrivning av projektets genomförande och resultat. Studiens innehåll är baserat på tidigare forskning, beprövad erfarenhet, intervjuer med ensamkommande ungdomar och vuxna inom mottagningsstrukturen samt röster från en avslutande workshop med nyckelpersoner.

  • Warnicke, Camilla
    Örebro University, School of Health Sciences.
    Tolkning vid förmedlade samtal via Bildtelefoni.net: interaktion och gemensamt meningsskapande2017Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The Swedish Bildtelefoni.net is a service that people who use Swedish Sign Language (SSL) through a video phone can call in order to get in touch with people who speak through a telephone, or vice versa. In relayed calls via the Swedish video relay service (FBT), the interlocutors have different access to the visual arena and the auditive space. They are also physically separated from each other. An interpreter, working in a studio, enables the interaction across the different media, and the interpreter is the only person who has direct contact with both users of the service. FBT has been provided in Sweden since 1996, and is administrated by The Swedish Post and Telecom Authority (PTS).

    The overall aim of the dissertation is to describe, analyse and discuss participants’ interaction and their joint construction of meaning within FBT. The theoretical and methodological frameworks for the dissertation are dialogism and Conversation Analysis (CA). The dissertation is based on twenty-five authentic calls from FBT, recorded during two periods of time: in the years 2009–2010, and in 2013. One stimulated recall is also made with one interpreter, concerning a call from the second collection. The project has been ethically approved by the Swedish Ethical Review Board.

    The interaction within FBT is dynamic and dependent on different media, modalities, resources, and also related to several conventions specific for the setting. All this influences the interlocutors, their actions as well as the entire activity. This kind of complexity has not previously been studied in the regular service. Analysis of the recordings focuses on the actions and activities of the participants who interact in the FBT, on a moment-to-moment basis. As results of the research, four phenomena are addressed, and presented as papers: I: the organisation of turns; II: the headset as an interactional resource; III: positioning and bimodal mediation with a focus on the interpreter; IV: the co-creation of communicative projects among the interlocutors. A main conclusion of the results is that the interaction is a joint construction of meaning among all of the interlocutors, although, the interpreter has a key function.

    Further research of interaction within FBT needs to be conducted, since investigations on this institutional interaction are rare despite the fact that this kind of service is widespread all over the world.

    List of papers
    1. Turn-organisation in mediated phone interaction using Video Relay Service (VRS)
    Open this publication in new window or tab >>Turn-organisation in mediated phone interaction using Video Relay Service (VRS)
    2012 (English)In: Journal of Pragmatics, ISSN 0378-2166, Vol. 44, no 10, 1313-1334 p.Article in journal (Refereed) Published
    Abstract [en]

    Technical development has created new arenas of communication for people. One such arena is the Video Relay Service (VRS). The VRS facilitates interaction between people who use visual/gestual sign language on a video phone, and people who use verbal/auditive language on the telephone/mobile phone. The interaction is mediated by a sign language interpreter. The interpreter is the only person in the setting who is directly linked to the others, and all participants are physically separated fromeach other. The interpreter plays a key role in the interaction, administratingandco-ordinatingthe talk. In order to doso, the interpreter usesarange of different techniques andstrategies. It is the purpose of the current article to describe, analyse and discuss the turn-organisation of the VRS. The article demonstrates how the interpreter is a power figure, who may sanction or not sanction an utterance. The interpreter also manages the turn-taking machinery by means of visible and audible techniques, as well as rendition strategies. The interpreter is not only a mediator, but a co-creator of the interaction; a part that relates dynamically, and makes the participants relate dynamically, to the specific setting of the service.

    Place, publisher, year, edition, pages
    Amsterdam, Netherlands: Elsevier, 2012
    Keyword
    Sign language interpreting, turn-organisation, turn-taking, computer-mediated communication, language and technology, video relay service (VRS)
    National Category
    Humanities Communication Studies
    Research subject
    Linguistics
    Identifiers
    urn:nbn:se:oru:diva-40311 (URN)10.1016/j.pragma.2012.06.004 (DOI)000307686200012 ()
    Available from: 2015-01-08 Created: 2015-01-08 Last updated: 2017-05-24Bibliographically approved
    2. The headset as an interactional resource in a Video Relay Interpreting (VRI) service setting
    Open this publication in new window or tab >>The headset as an interactional resource in a Video Relay Interpreting (VRI) service setting
    (English)Manuscript (preprint) (Other academic)
    National Category
    Other Health Sciences
    Identifiers
    urn:nbn:se:oru:diva-57833 (URN)
    Available from: 2017-05-24 Created: 2017-05-24 Last updated: 2017-05-24Bibliographically approved
    3. The positioning and bimodal mediation of the interpreter in a Video Relay Interpreting (VRI) service setting
    Open this publication in new window or tab >>The positioning and bimodal mediation of the interpreter in a Video Relay Interpreting (VRI) service setting
    2016 (English)In: Interpreting, ISSN 1384-6647, E-ISSN 1569-982X, Vol. 18, no 2, 198-230 p.Article in journal (Refereed) Published
    Abstract [en]

    This study explores the interpreter’s positioning in a Video Relay Interpreting (VRI) service that offers bimodal mediation between people using Swedish Sign Language (SSL) and people using spoken Swedish. Positioning subsumes the ways in which interpreters orient themselves to the contingencies of the setting on a moment-by-moment basis, in relation to the impact of technology, participants’ knowledge asymmetries (e.g., prior experience of VRI), their physical separation, and the need for two arenas (visual and auditive). The interpreting is bimodal, each of the two users being in direct contact with the interpreter through a different medium (telephone for one, videophone for the other). Nine excerpts from two calls within the VRI service serve as examples to show how the interpreter’s positioning emerges dynamically in relation to contingent variables of the setting, such as the initial importance of briefing users on the service, temporary loss of sound and image, the perceived need to inform either user of extralinguistic items, or situational awareness that it is time to conclude the interaction. This new research perspective on VRI can afford a better understanding of its moment-by-moment complexity and specificities, thus helping improve it and train interpreters better for it.

    Place, publisher, year, edition, pages
    Amsterdam, Netherlands: John Benjamins Publishing Company, 2016
    Keyword
    Video Relay Service (VRS), positioning, signed language, role, Video Relay Interpreting (VRI)
    National Category
    Media and Communications
    Identifiers
    urn:nbn:se:oru:diva-53659 (URN)10.1075/intp.18.2.03war (DOI)000392926700003 ()2-s2.0-84992747290 (Scopus ID)
    Note

    Funding Agencies:

    bildtelefoni.net Region Örebro County

    University Health Care Research Center, Region Örebro County

    Available from: 2016-11-28 Created: 2016-11-28 Last updated: 2017-05-24Bibliographically approved
    4. The co-creation of communicative projects within the Swedish Video Relay Service (VRS)
    Open this publication in new window or tab >>The co-creation of communicative projects within the Swedish Video Relay Service (VRS)
    (English)Manuscript (preprint) (Other academic)
    National Category
    Other Health Sciences
    Identifiers
    urn:nbn:se:oru:diva-57834 (URN)
    Available from: 2017-05-24 Created: 2017-05-24 Last updated: 2017-05-24Bibliographically approved
  • Hämberg, Eva
    Örebro University, School of Law, Psychology and Social Work, Örebro University, Sweden.
    Tillsyn i teori och praktik: om statlig styrning och kontroll av socialtjänstens individ- och familjeomsorg2017Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The aim of this thesis is to deepen the understanding about the function of control in the inspection process and to increase the knowledge about the legitimacy and impact from inspection on different types of social and welfare services. In the thesis the form and legitimacy of the inspection process are studied in two types of social services in Sweden: a less complex service where the task to investigate and make decisions about social care dominates (IAD), and a more complex service where the task to provide treatment interventions dominates (TI). The data consists of policy documents, inspection reports, casefile documentation, and interviews with inspectors, politicians, managers and social workers. The inspection process is discussed in relation to theories about control systems and legitimacy processes. Inspection is a policy instrument whose standards are derived from legislations and where those subject to the inspection are obliged to meet the demands made by the inspectorates. This form of disciplinary control has been questioned given that its complexity makes it hard to regulate the practice of social work through detailed rules. By including a less disciplinary form of control the instrument’s ability to impact on more complex aspects of social services are expected to increase. The results show a difference in how the inspection process is set up in the two types of services. In the IAD services the process takes the form of a disciplinary control system, whereas the process in TI services initially takes the form of a non-disciplinary system. In spite of the differences observed in the initial stages of the process, the results show that the judgments of inspectors in both types of services are almost exclusively based on information about concrete and detailed aspects. This entails that the judgements of inspectors in both types of services mostly take the form of statements on simple observable and concrete conditions, whereas judgments about more complex aspects are rarely made. The study also shows that although the propriety and relevance of the inspectors’ judgements are questioned more in TI organisations inspections seem to have greater validity and impact on TI than on IAD organisations. The results of the thesis point to two explanations. One explanation is that the costs of dealing with the problems underlying the identified deficiencies are lower for TI than IAD organisations. This in turn leads to greater acceptance of carrying out the proposed measures in TI than in IAD organisations. Another possible explanation is that the potential sanctions are greater for TI than IAD organisations.

    List of papers
    1. Supervision as control system: the design of supervision as a regulatory instrument in the social services sector in Sweden
    Open this publication in new window or tab >>Supervision as control system: the design of supervision as a regulatory instrument in the social services sector in Sweden
    2013 (English)In: Offentlig Förvaltning. Scandinavian Journal of Public Administration, ISSN 2000-8058, E-ISSN 2001-3310, Vol. 17, no 3, 45-63 p.Article in journal (Refereed) Published
    Abstract [en]

    In this article, the prevailing official view of supervision as a regulatory instrument is examined as it applies to the social services sector in Sweden. The study is based on a comparison of the views expressed on the design of supervision as a regulatory instrument by two government commissions, the Supervision Commission and the Commission on Supervision within the Social Services (UTIS), and on the positions taken by the Government regarding the definitions of the concept of supervision proposed by these commissions. The view of supervision as a regulatory instrument expressed in these policy documents is analysed with the help of a theoretical framework describing the components, their functions and the governance characteristics of control systems. In the framework separate interrelated characteristics of the components are identified and summarized into two models of control systems. The analysis shows that supervision in the Swedish social services sector can be described in terms of both a disciplinary and non-disciplinary system. By its system theoretical basis and the identification of interrelated characteristics the study contributes to a broadened understanding of the construction and functions of supervision as a regulatory instrument and of how supervision within the Swedish social sector is meant to be designed.

    Place, publisher, year, edition, pages
    Förvaltningshögskolan Göteborgs Universitet, 2013
    Keyword
    supervision, regulatory instrument., social services, control systems, oversight
    National Category
    Social Sciences
    Identifiers
    urn:nbn:se:oru:diva-57797 (URN)
    Projects
    Tillsyn i retorik och praktik
    Funder
    Forte, Swedish Research Council for Health, Working Life and Welfare
    Available from: 2017-05-23 Created: 2017-05-23 Last updated: 2017-06-13Bibliographically approved
    2. Inspection of social services in Sweden: a comparative analysis of the use and adjustment of standards
    Open this publication in new window or tab >>Inspection of social services in Sweden: a comparative analysis of the use and adjustment of standards
    2016 (English)In: Nordic Social Work Research, ISSN 2156-857X, E-ISSN 2156-8588, Vol. 6, no 2, 138-151 p.Article in journal (Refereed) Published
    Abstract [en]

    Inspection has increasingly been regarded as a safeguard for promoting quality of social services. Little attention has, however, been given to the impact of standards used in inspections, i.e. the written norms, rules and principles used for identification and judgment. The aim of this study is to empirically contribute to an improved understanding of how standards in inspection of social service are designed, and to what extent the design is adjusted in relation to different kind of social services. We employ a systematic and comparative analysis of the content (in terms of input, process, output and outcome aspects) and precision (low, medium and high) of 186 paragraphs derived from legislation and referred to as standards in inspection decisions concerning two types of social work: Investigation, Assessment and Decision-Making (IAD); and Treatment Intervention (TI) in Sweden 2012. Contrary to expectations based on an inspection ideal, our findings show that paragraphs covering outcome aspects are not more commonly referred to as standards in TI than in IAD inspection. The analysis of the precision also indicates that the standards used in inspection of TI are not more adjusted to complex and subjectively experienced aspects than are the standards used in IAD. Our overall results indicate that the policy instrument is primarily adapted to IAD inspection rather than to TI inspection.

    Place, publisher, year, edition, pages
    Taylor & Francis, 2016
    Keyword
    inspection, standard, social service, service technology
    National Category
    Social Work
    Identifiers
    urn:nbn:se:oru:diva-57796 (URN)10.1080/2156857X.2016.1156015 (DOI)
    Funder
    Forte, Swedish Research Council for Health, Working Life and Welfare
    Available from: 2017-05-23 Created: 2017-05-23 Last updated: 2017-06-13Bibliographically approved
    3. What kind of information is collected and how are judgements formed in social services inspections? A comparative study of inspection design
    Open this publication in new window or tab >>What kind of information is collected and how are judgements formed in social services inspections? A comparative study of inspection design
    (English)Manuscript (preprint) (Other academic)
    National Category
    Social Work
    Identifiers
    urn:nbn:se:oru:diva-57798 (URN)
    Available from: 2017-05-23 Created: 2017-05-23 Last updated: 2017-06-13Bibliographically approved
    4. The legitimacy and implications of inspection in social services organisations in Sweden
    Open this publication in new window or tab >>The legitimacy and implications of inspection in social services organisations in Sweden
    (English)Manuscript (preprint) (Other academic)
    National Category
    Social Work
    Identifiers
    urn:nbn:se:oru:diva-57799 (URN)
    Available from: 2017-05-23 Created: 2017-05-23 Last updated: 2017-06-13Bibliographically approved
  • Jonhed, Anna L.
    Örebro University, School of Law, Psychology and Social Work, Örebro University, Sweden.
    Utvärdering av Barnahus Skaraborg: Samverkan över kommun- och myndighetsgränser2016Report (Other academic)
  • Zetterlund, Christina
    Örebro University, School of Medical Sciences.
    Visual, musculoskeletal, and balance symptoms in people with visual impairments2017Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Background: Worldwide, about 300 million people have some kind of visual impairment (VI). Most people with VI are in the older age range, as visual deficits increase with age. It is not unusual that people with VI suffer both from neck pain or scapular area symptoms and reduced balance, which they consider to be symptoms of old age. However, their symptoms may not be attributable to age, but rather to poor vision.

    Aims: First, to identify associations between visual, musculoskeletal and balance symptoms in people engaging in near work every day and in people with VI. Second, to design and validate a suitable instrument for gathering information about visual, musculoskeletal and balance symptoms in people with VI. Third, to explore differences in perceived symptoms between VI patients and people with normal vision in cross-sectional studies and by following a group of age-related macular degeneration (AMD) patients in a longitudinal study. Fourth, to identify the most specific predictors of higher levels of visual, musculoskeletal and balance symptoms.

    Methods: A specific instrument was developed: the Visual, Musculoskeletal and Balance symptoms (VMB) questionnaire. Patients with VI were compared to an age-matched reference group with normal vision in three different studies in order to detect differences in self-reported symptoms between the groups. In addition, a follow-up was conducted in a group of AMD patients.

    Results: Patients with VI reported higher levels of VMB symptoms than controls, and this increased over time. Visual deficits and the need for visual enhancement increased the risk of VMB symptoms.

    Conclusion: People with VI run a potentially higher risk of VMB symptoms than age-matched controls.

    List of papers
    1. Eye-neck interactions triggered by visually deficient computer work
    Open this publication in new window or tab >>Eye-neck interactions triggered by visually deficient computer work
    2011 (English)In: Work: A journal of Prevention, Assesment and rehabilitation, ISSN 1051-9815, E-ISSN 1875-9270, Vol. 39, no 1, 67-78 p.Article in journal (Refereed) Published
    Abstract [en]

    Objectives: To study the joint occurrence of eye-and-neck/scapular area symptoms and their association with occupational risk factors in a cross-sectional sample of professional information technology users.

    Study population: The participants consisted of 3,971 employees who worked with computers for a minimum of one hour a day. 2,551 (73%) were men and 945 (27%) women, with an age range of 18 up to 64 years. The mean age was 38.1 (SD = 10.7) for men and 37.6 (SD = 12.0) for the women. The measures were obtained via a self-administered survey in combination with a visual examination conducted by an optometrist.

    Methods: Two complementary logistic regression analyses with forced entry was conducted on n = 3,496 (88% adjusted response rate) cases. The effect of ocular symptoms on the risk of reporting musculoskeletal symptoms, or vice versa, was examined first in two separate binominal logistic regression analyses. Age, Gender, Near work variable and Visual functioning variables were included in these analyzes. Variables associated with the risk of developing an increase in either symptom category were also examined in two additional binomial logistic regression analyses.

    Results: Exposure to spectacles (single vision, multifocal, or progressive correction) in combination with a visual acuity < 1 surfaced as a key mediator of symptoms from the neck/scapular area (p < 0.01). A vergence disparity (uncompensated vergence error) similarly was associated with an augmented risk of developing an increase in neck/scapular area symptoms (p < 0.05). The most influential risk factor for neck/scapular area symptoms were ocular symptoms and vice versa (p < 0.0001).

    Conclusions: The results support the hypothesis which postulates that eye-neck/scapular area symptoms interaction may be due to a functional coupling from and between the eye-neck/scapular area muscles [28].

    Place, publisher, year, edition, pages
    IOS Press, 2011
    Keyword
    Asthenopia, eyestrain, gaze-control, musculoskeletal, neck pain
    National Category
    Environmental Health and Occupational Health
    Identifiers
    urn:nbn:se:oru:diva-57576 (URN)10.3233/WOR-2011-1152 (DOI)000292543000009 ()21673430 (PubMedID)2-s2.0-79960774196 (Scopus ID)
    Available from: 2017-05-08 Created: 2017-05-08 Last updated: 2017-05-08Bibliographically approved
    2. Reliability and Validity of the Visual, Musculoskeletal, and Balance Complaints Questionnaire
    Open this publication in new window or tab >>Reliability and Validity of the Visual, Musculoskeletal, and Balance Complaints Questionnaire
    2016 (English)In: Optometry and Vision Science, ISSN 1040-5488, E-ISSN 1538-9235, Vol. 93, no 9, 1147-1157 p.Article in journal (Refereed) Published
    Abstract [en]

    Purpose: To evaluate the reliability and validity of the 15-item Visual, Musculoskeletal, and Balance Complaints Questionnaire (VMB) for people with visual impairments, using confirmatory factor analysis (CFA) and with Rasch analysis for use as an outcome measure.

    Methods: Two studies evaluated the VMB. In Study 1, VMB data were collected from 1249 out of 3063 individuals between 18 and 104 years old who were registered at a low vision center. CFA evaluated VMB factor structure and Rasch analysis evaluated VMB scale properties. In Study 2, a subsample of 52 individuals between 27 and 67 years old with visual impairments underwent further measurements. Visual clinical assessments, neck/scapular pain, and balance assessments were collected to evaluate the convergent validity of the VMB (i.e. the domain relationship with other, theoretically predicted measures).

    Results: CFA supported the a priori three-factor structure of the VMB. The factor loadings of the items on their respective domains were all statistically significant. Rasch analysis indicated disordered categories and the original 10-point scale was subsequently replaced with a 5-point scale. Each VMB domain fitted the Rasch model, showing good metric properties, including unidimensionality (explained variances ≥66% and eigenvalues <1.9), person separation (1.86 to 2.29), reliability (0.87 to 0.94), item fit (infit MnSq's >0.72 and outfit MnSq's <1.47), targeting (0.30 to 0.50 logits), and insignificant differential item functioning (all DIFs but one <0.50 logits) from gender, age, and visual status. The three VMB domains correlated significantly with relevant visual, musculoskeletal, and balance assessments, demonstrating adequate convergent validity of the VMB.

    Conclusions: The VMB is a simple, inexpensive, and quick yet reliable and valid way to screen and evaluate concurrent visual, musculoskeletal, and balance complaints, with contribution to epidemiological and intervention research and potential clinical implications for the field of health services and low vision rehabilitation.

    Place, publisher, year, edition, pages
    Philadelphia, USA: Lippincott Williams & Wilkins, 2016
    Keyword
    Visual complaints, musculoskeletal complaints, balance complaints, reliability, validity, confirmatory factor analysis, Rasch analysis, ergonomy
    National Category
    Ophthalmology
    Identifiers
    urn:nbn:se:oru:diva-50953 (URN)10.1097/OPX.0000000000000902 (DOI)000383908700021 ()27309524 (PubMedID)2-s2.0-84975166324 (Scopus ID)
    Note

    Funding Agencies:

    REHSAM Research Program at the Swedish Social Insurance Agency 99368-2009/RS11

    Swedish Council for Working Life & Social Research 2009-1761

    Available from: 2016-06-20 Created: 2016-06-20 Last updated: 2017-05-08Bibliographically approved
    3. Visual, musculoskeletal and balance symptoms in individuals with visual impairment and with age-normal vision
    Open this publication in new window or tab >>Visual, musculoskeletal and balance symptoms in individuals with visual impairment and with age-normal vision
    (English)Manuscript (preprint) (Other academic)
    National Category
    Family Medicine
    Identifiers
    urn:nbn:se:oru:diva-57584 (URN)
    Available from: 2017-05-08 Created: 2017-05-08 Last updated: 2017-05-08Bibliographically approved
    4. The relationship between low vision and musculoskeletal complaints: a case control study between age-related macular degeneration patients and age-matched controls with normal vision
    Open this publication in new window or tab >>The relationship between low vision and musculoskeletal complaints: a case control study between age-related macular degeneration patients and age-matched controls with normal vision
    2009 (English)In: Journal of optometry, ISSN 1989-1342, Vol. 2, no 3, 127-133 p.Article in journal (Refereed) Published
    Abstract [en]

    INTRODUCTION: Age-related Macular Degeneration (ARMD) patients often describe complaints from neck and scapula area muscles and a decreased postural control. In clinical assessment, these complaints are considered to be due to old age.PURPOSE: This study focuses on low-vision patients with ARMD, comparing them to age-matched controls without any eye disease, in order to evaluate if the linkage between self-rated visual complaints and musculoskeletal complaints is more prominent when low vision is present.METHODS: In a cross-sectional study, 24 ARMD patients, aged 65 to 85, were compared to a group of 24 controls without visual problems having a similar age distribution. Visual acuity, the need for magnification plus other optical and visual parameters were assessed. Visual, musculoskeletal and balance/proprioceptive complaints were collected by means of a self-rating questionnaire. The Visual Functioning Questionnaire - Near Activities Subscale (VFQ–NAS) was used to evaluate visual function and related complaints.RESULTS: The correlation between visual complaints and musculoskeletal complaints yielded significant values of the correlation coefficient when performed separately within each group, as well as when calculated on the entire data set [ARMD, Spearman’s rho (ρ)=0.60, P=0.002; control group ρ=0.59, P=0.004; both groups together ρ=0.50 P<0.001]. Stepwise multiple regression analysis supported the hypothesized effect of vision (Visual complaints + Minimum readable typefaces) on musculoskeletal complaints, (r2=0.42, P<0.05). CONCLUSIONS: The results in this study support the hypothesis that a relationship exists between visual and musculoskeletal problems.

    Place, publisher, year, edition, pages
    Barcelona: , 2009
    Keyword
    low vision, age related maculopathy, musculoskeletal complaints
    National Category
    Medical and Health Sciences Ophthalmology
    Research subject
    Medicine
    Identifiers
    urn:nbn:se:oru:diva-12394 (URN)10.3921/joptom.2009.127 (DOI)
    Available from: 2010-11-02 Created: 2010-11-02 Last updated: 2017-05-08Bibliographically approved
    5. Visual, Musculoskeletal, and Balance Complaints in AMD: A Follow-Up Study
    Open this publication in new window or tab >>Visual, Musculoskeletal, and Balance Complaints in AMD: A Follow-Up Study
    2016 (English)In: Journal of Ophthalmology, ISSN 2090-004X, E-ISSN 2090-0058, 2707102Article in journal (Refereed) Published
    Abstract [en]

    Purpose: To investigate whether patients with age-related macular degeneration (AMD) run a potentially higher risk of developing visual, musculoskeletal, and balance complaints than age-matched controls with normal vision.

    Methods: Visual assessments, self-rated visual function, self-rated visual, musculoskeletal, and balance complaints, and perceived general health were obtained in 37 AMD patients and 18 controls, at baseline and after an average of 3.8 years later.

    Results: At follow-up both groups reported decreased visual acuity (VA) and visual function, but only AMD patients reported significantly increased visual, musculoskeletal, and balance complaints. Decreased VA, need for larger font size when reading, need for larger magnification, and decreased self-rated visual function were identified as risk markers for increased complaints in AMD patients. These complaints were also identified as risk markers for decreased health. For controls, decreased VA and self-reported visual function were associated with increased visual and balance complaints.

    Conclusions: Visual deterioration was a risk marker for increased visual, musculoskeletal, balance, and health complaints in AMD patients. Specifically, magnifying visual aids, such as CCTV, were a risk marker for increased complaints in AMD patients. This calls for early and coordinated actions to treat and prevent visual, musculoskeletal, balance, and health complaints in AMD patients.

    Place, publisher, year, edition, pages
    New York, USA: Hindawi Publishing Corporation, 2016
    National Category
    Ophthalmology
    Identifiers
    urn:nbn:se:oru:diva-53647 (URN)10.1155/2016/2707102 (DOI)000386813600001 ()2-s2.0-84994403329 (Scopus ID)
    Note

    Funding Agency:

    Research Committee of Region Örebro County

    Available from: 2016-11-28 Created: 2016-11-25 Last updated: 2017-05-08Bibliographically approved
  • Westberg, Johannes
    Örebro University, School of Humanities, Education and Social Sciences, Örebro University, Sweden.
    En förskola för alla?: Rationaliteten bakom den svenska förskolans expansion2017In: Utbildningens revolutioner: Till studiet av utbildningshistorisk förändring / [ed] Anne Berg, Esbjörn Larsson, Madeleine Michaëlsson, Johannes Westberg & Andreas Åkerlund, Uppsala: Uppsala: Uppsala Studies of History and Education (SHED , 2017, 211-232 p.Chapter in book (Other academic)
  • Westberg, Johannes
    et al.
    Örebro University, School of Humanities, Education and Social Sciences, Örebro University, Sweden.
    Larsson, EsbjörnUppsala universitet.Berg, AnneUppsala universitet.Michaëlsson, MadeleineUppsala universitet.Åkerlund, AndreasUppsala universitet.
    Utbildningens revolutioner: Till studiet av utbildningshistorisk förändring2017Collection (editor) (Other academic)
    Abstract [sv]

    Ordet revolution avser i allmänhet en omvälvande eller grundläggande förändring som, i jämförelse med långsammare processer, sker under en kortare tid. I utbildningshistoriska sammanhang är ordet revolution användbart eftersom det riktar fokus på de övergripande och omvälvande förändringar som karaktäriserat utbildningsväsendet under de senaste trehundra åren. I vår bok presenteras analyser av ett brett urval av förändringar inom det svenska utbildningsväsendet. Antologin inkluderar kapitel om förändringar i 1800-talets skola och utbildning, däribland införandet av Läsebok för folkskolan, arbetarorganisationers fostran av demokrater, och en kritisk analys av föreställningen om 1800-talets skola som en del av en demokratiseringsprocess. Dessutom ges inblickar i 1900-talets utbildningsrevolutioner med kapitel som ägnar sig åt allt från rökrutans införande, den Nya matematiken, förskolesektorns expansion och 1990-talets utbildningsreformer.Boken har publicerats för att ge en översikt över den omfattande utbildningshistoriska forskningsmiljö som vuxit fram i Uppsala under de senaste tio åren. Den riktar sig till såväl den utbildningshistoriskt intresserade läsaren, som till en bredare historisk och utbildningsvetenskaplig läsekrets.

  • Rajan, Kanna
    et al.
    Department of Engineering Cybernetics, Center for Autonomous Marine Operations and Systems (AMOS), Norges teknisk-naturvitenskapelige universitet (NTNU), Trondheim, Norway.
    Saffiotti, Alessandro
    Örebro University, School of Science and Technology, Örebro University, Sweden.
    Towards a science of integrated AI and Robotics2017In: Artificial Intelligence, ISSN 0004-3702, E-ISSN 1872-7921, Vol. 247, 1-9 p.Article in journal (Refereed)
    Abstract [en]

    The early promise of the impact of machine intelligence did not involve the partitioning of the nascent field of Artificial Intelligence. The founders of AI envisioned the notion of embedded intelligence as being conjoined between perception, reasoning and actuation. Yet over the years the fields of AI and Robotics drifted apart. Practitioners of AI focused on problems and algorithms abstracted from the real world. Roboticists, generally with a background in mechanical and electrical engineering, concentrated on sensori-motor functions. That divergence is slowly being bridged with the maturity of both fields and with the growing interest in autonomous systems. This special issue brings together the state of the art and practice of the emergent field of integrated AI and Robotics, and highlights the key areas along which this current evolution of machine intelligence is heading.

  • Englund, Ulrika
    Örebro University, School of Health Sciences.
    Samverkansprojekt, och sen då?: en uppföljande studie av samverkansprocessen kring barn och unga som far illa eller riskerar att fara illa2017Doctoral thesis, monograph (Other academic)
    Abstract [en]

    Satisfactory collaboration regarding children and youth in need of a comprehensive support is particularly important. Despite extensive research on collaborative work, knowledge of long term development of the collaboration process is lacking. The present thesis concerns inter-organizational collaboration within the framework of a former Swedish policy effort – focusing collaboration between schools, social services, police and the child and youth psychiatry – for the benefit of children and young people in distress or at risk. Applying a critical realist perspective, the overall aim of the thesis is to describe how former collaboration projects develop over time, and to identify significant mechanisms within this development. Through three questionnaire studies, the collaborative process development within the same collaborative settings is described (n=66) over a period of close to seven years. Estimations of 58 collaboration quality indicators within three categories *rules and regulations, *structural aspects and *shared perspectives/ consensus were collected at baseline in 2008, after one year at the final project stage in 2009, as well as five years after the project period (and the policy effort) ended, in 2014 (n=38). Two developmental trends occur: I) an overall positive trend and II) a negative trend on a comprehensive level. I) Collaboration on the target group has increased over time, are mainly incorporated into permanent organizational structures and is judged to have worked well/very well over time. II) Overall deteriorations of high estimates of the 58 quality indicators for collaborations is seen over the five year period, following the project period. However, less dramatic changes is noted on quality indicators concerning shared perspectives/consensus than on matters regarding rules and regulations and structural aspects. Five mechanisms of particular importance for the collaboration development are identified: anchoring, holistic perspectives, engagement, knowledge and clarity.

  • Lidskog, Rolf
    Örebro University, School of Humanities, Education and Social Sciences, Örebro University, Sweden.
    The role of music in ethnic identity formation in diaspora: A research review2017In: International Social Science Journal, ISSN 0020-8701, E-ISSN 1468-2451, Vol. 66Article in journal (Refereed)
    Abstract [en]

    In many countries, multicultural citizenship has run into difficulties. The relation between immigrant groups and the larger society has come to the fore, and different strategies have been proposed for how to better integrate immigrants in their new surroundings. This paper focuses on how ethnic identities and cultures are maintained and transformed in diasporic situations, namely though music. Through a systematic review of academic articles published in the last 20 years, this paper investigates the role of music in cultural identity formation among ethnic groups. The review finds that the literature stresses four particular areas: context (the diasporic situation), space for recognition and resistance, time and memory to allow identity maintenance and transformation, and politics (social subordination or resistance). The paper concludes by stressing the importance of further studies on identity formation in diaspora, not least about diasporic consciousness as a resource and restriction in the social positioning and orientation of groups. A world characterized by migration, transnational networks and global flows, as well as by a reorientation of migration and integration policies, implies new conditions for identity-formation, and music will continue to be an important way for immigrants and refugees to negotiate and develop their identities in their new setting.

  • Nhavoto, José António
    Örebro University, Orebro University School of Business, Örebro University, Sweden.
    Integration of Mobile Technologies with Routine Healthcare Services in Mozambique2017Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Mobile technologies are emerging as one way to help address health challenges in many countries, including in Least Developed Countries. Mobile technology can reach a large share of the population but in order to provide effective support to healthcare services, technology, information collection and dissemination, and work processes need to be well aligned. The thesis uses a design science methodological approach and mixes qualitative and quantitative data analysis to address the question of, How can mobile technologies be effectively integrated with routine healthcare services?

    The study concerns the design, implementation, and evaluation of a mobile technology-based system, called SMSaúde, with the aim of improving the care of patients with HIV/AIDS and tuberculosis in Mozambique. The work started with the elicitation of functional and user requirements, based on focus group discussions. An important challenge, as in many mHealth interventions, was the integration with routine healthcare services and the existing IT systems, as well as developing a scalable technical structure. The system has now been in routine use since 2013 in more than 16 healthcare clinics in Mozambique. Evaluation was done by a randomised controlled study. Analysis of patient records showed that retention in care in urban areas was significantly higher in the intervention group than in the control group. In a user study both patients and health professionals were very positive to the system. The thesis contributes to research by demonstrating how information system artefacts can be constructed and successfully implemented in resource-constrained settings. The practical contributions include the designed artefact itself as well as improved healthcare practices and mHealth policy recommendations.

    List of papers
    1. Mobile Technologies and Geographic Information Systems to Improve Health Care Systems: A Literature Review
    Open this publication in new window or tab >>Mobile Technologies and Geographic Information Systems to Improve Health Care Systems: A Literature Review
    2014 (English)In: JMIR mhealth and uhealth, E-ISSN 2291-5222, Vol. 2, no 2, e21Article in journal (Refereed) Published
    Abstract [en]

    Background: A growing body of research has employed mobile technologies and geographic information systems (GIS) for enhancing health care and health information systems, but there is yet a lack of studies of how these two types of systems are integrated together into the information infrastructure of an organization so as to provide a basis for data analysis and decision support. Integration of data and technical systems across the organization is necessary for efficient large-scale implementation.

    Objective: The aim of this paper is to identify how mobile technologies and GIS applications have been used, independently as well as in combination, for improving health care.

    Methods: The electronic databases PubMed, BioMed Central, Wiley Online Library, Scopus, Science Direct, and Web of Science were searched to retrieve English language articles published in international academic journals after 2005. Only articles addressing the use of mobile or GIS technologies and that met a prespecified keyword strategy were selected for review.

    Results: A total of 271 articles were selected, among which 220 concerned mobile technologies and 51 GIS. Most articles concern developed countries (198/271, 73.1%), and in particular the United States (81/271, 29.9%), United Kingdom (31/271, 11.4%), and Canada (14/271, 5.2%). Applications of mobile technologies can be categorized by six themes: treatment and disease management, data collection and disease surveillance, health support systems, health promotion and disease prevention, communication between patients and health care providers or among providers, and medical education. GIS applications can be categorized by four themes: disease surveillance, health support systems, health promotion and disease prevention, and communication to or between health care providers. Mobile applications typically focus on using text messaging (short message service, SMS) for communication between patients and health care providers, most prominently reminders and advice to patients. These applications generally have modest benefits and may be appropriate for implementation. Integration of health data using GIS technology also exhibit modest benefits such as improved understanding of the interplay of psychological, social, environmental, area-level, and sociodemographic influences on physical activity. The studies evaluated showed promising results in helping patients treating different illnesses and managing their condition effectively. However, most studies use small sample sizes and short intervention periods, which means limited clinical or statistical significance.

    Conclusions: A vast majority of the papers report positive results, including retention rate, benefits for patients, and economic gains for the health care provider. However, implementation issues are little discussed, which means the reasons for the scarcity of large-scale implementations, which might be expected given the overwhelmingly positive results, are yet unclear. There is also little combination between GIS and mobile technologies. In order for health care processes to be effective they must integrate different kinds of existing technologies and data. Further research and development is necessary to provide integration and better understand implementation issues.

    Keyword
    health care, mobile technology, mobile phone, SMS, text messaging, geographic information systems, GIS
    National Category
    Information Systems, Social aspects
    Research subject
    Informatics
    Identifiers
    urn:nbn:se:oru:diva-40865 (URN)10.2196/mhealth.3216 (DOI)25099368 (PubMedID)
    Available from: 2015-01-12 Created: 2015-01-12 Last updated: 2017-05-17Bibliographically approved
    2. SMSaude: design, development and implementation of a remote/mobile patient management system to improve retention in care for HIV/AIDS and tuberculosis patients
    Open this publication in new window or tab >>SMSaude: design, development and implementation of a remote/mobile patient management system to improve retention in care for HIV/AIDS and tuberculosis patients
    2015 (English)In: Journal of Medical Internet Research, ISSN 1438-8871, E-ISSN 1438-8871, Vol. 3, no 1, e26Article in journal (Refereed) Published
    Abstract [en]

    Background: The widespread and low cost of mobile phones and the convenience of short message service (SMS) text messaging suggest potential suitability for use with alternative strategies for supporting retention in care and adherence to the treatment of various chronic diseases, such as HIV and tuberculosis (TB). Despite the growing body of literature reporting positive outcomes of SMS text message-based communication with patients, there is yet very little research about the integration of communication technologies and electronic medical records or electronic patient tracking systems.

    Objective: To design, develop, and implement an integrated mobile phone text messaging system used to follow up with patients with HIV and TB in treatment in Mozambique.

    Methods: Following the design science research methodology, we developed a Web-based system that provides support to patients. A case study involving three health care sites in Mozambique was a basis for discussing design issues for this kind of system. We used brainstorming techniques to solicit usability requirements, focus group meetings to discuss and define system architecture, and prototyping to test in real environments and to improve the system.

    Results: We found six sets of system requirements that need to be addressed for success: data collection, telecommunication costs, privacy and data security, text message content, connectivity, and system scalability. A text messaging system was designed and implemented in three health facilities. These sites feed data into a central data repository, which can be used for analysis of operations and decision support. Based on the treatment schedule, the system automatically sent SMS text message appointment reminders, medication reminders, as well as motivational and educational messages to patients enrolled in antiretroviral therapy and TB treatment programs.

    Conclusions: We successfully defined the requirements for, designed, and implemented a mobile phone text messaging system to support HIV and TB treatments. Implementation of this system could improve patients' self-management skills and strengthen communication between patients and health care providers.

    Place, publisher, year, edition, pages
    Toronto, Canada: J M I R Publications, Inc., 2015
    Keyword
    Mobile health, text messaging, SMS system, patient management, design science research, Mozambique
    National Category
    Information Systems
    Research subject
    Informatics
    Identifiers
    urn:nbn:se:oru:diva-42527 (URN)10.2196/mhealth.3854 (DOI)000359791000019 ()25757551 (PubMedID)
    Available from: 2015-02-06 Created: 2015-02-06 Last updated: 2017-05-17Bibliographically approved
    3. SMSaude: Evaluating Mobile Phone Text Reminders to Improve Retention in HIV Care for Patients on Antiretroviral Therapy in Mozambique
    Open this publication in new window or tab >>SMSaude: Evaluating Mobile Phone Text Reminders to Improve Retention in HIV Care for Patients on Antiretroviral Therapy in Mozambique
    Show others...
    2016 (English)In: Journal of Acquired Immune Deficiency Syndromes, ISSN 1525-4135, E-ISSN 1944-7884, Vol. 73, no 2, E23-E30 p.Article in journal (Refereed) Published
    Abstract [en]

    Objective: We evaluated whether regular mobile phone text reminders improved patients' retention in antiretroviral therapy (ART) care in Mozambique.

    Design: SMSaude was a randomized control trial of HIV-infected patients on ART who received regular text message reminder vs. standard of care at 3 public health facilities in Maputo Province, Mozambique. The primary outcome was retention in HIV care. Between November 2011 and March 2012, 830 eligible HIV-infected patients on ART were randomized 1: 1 to the text reminder intervention or standard of care.

    Methods: We used Kaplan-Meier estimators and log-rank tests to compare proportions of patients who received SMS reminders who were retained in HIV care compared to the control group who received standard of care. Post hoc analyses were performed using Cox proportional hazards models stratified by urban/rural facility and when initiated ART (<= 3 months vs. >3 months). Hazard ratios and confidence intervals (CIs) are reported. Analysis was with intention to treat.

    Results: Patients who received text messages had lower attrition from HIV care at 12 months, though the difference was nonsignificant (RR: 0.68, 95% CI: 0.41 to 1.13). Among urban patients, text messages improved retention in HIV care (RR: 0.54, 95% CI: 0.31 to 0.95). Intervention patients newly initiated on ART (<3 months) had lower attrition than control patients (HR: 0.54; 95% CI: 0.23 to 0.91), especially urban newly initiated patients (HR: 0.20, 95% CI: 0.06 to 0.64). Text messages had no effect on retention among rural patients.

    Conclusions: Text messages did not improve retention in HIV care for all patients on ART but improved retention in care of urban patients and those who recently started ART and received text reminders compared with standard of care.

    Place, publisher, year, edition, pages
    Lippincott Williams & Wilkins, 2016
    Keyword
    SMS reminders, text messages, retention in care, Mozambique, ART
    National Category
    Infectious Medicine Immunology in the medical area
    Research subject
    Infectious Diseases; Immunology
    Identifiers
    urn:nbn:se:oru:diva-53172 (URN)10.1097/QAI.0000000000001115 (DOI)000384109800002 ()2-s2.0-84988336269 (Scopus ID)
    Note

    Funding Agencies:

    Ark

    Vodacom Mozambique

    UCLA Postdoctoral Fellowship Training Program in Global HIV Prevention Research T32MH080634

    Available from: 2016-10-24 Created: 2016-10-24 Last updated: 2017-05-17Bibliographically approved
    4. Mobile health treatment support intervention for HIV and tuberculosis in Mozambique: Perspectives of patients and healthcare workers
    Open this publication in new window or tab >>Mobile health treatment support intervention for HIV and tuberculosis in Mozambique: Perspectives of patients and healthcare workers
    2017 (English)In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 12, no 4, e0176051Article in journal (Refereed) Published
    Abstract [en]

    Background: Studies have been conducted in developing countries using SMS to communicate with patients to reduce the number of missed appointments and improve retention in treatment, however; very few have been scaled up. One possible reason for this could be that patients or staff are dissatisfied with the method in some way. This paper reports a study of patients' and healthcare workers' (HCW) views on an mHealth intervention aiming to support retention in antiretroviral therapy (ART) and tuberculosis (TB) treatment in Mozambique.

    Methods: The study was conducted at five healthcare centres in Mozambique. Automated SMS health promotions and reminders were sent to patients in a RCT. A total of 141 patients and 40 HCWs were interviewed. Respondents rated usefulness, perceived benefits, ease of use, satisfaction, and risks of the SMS system using a Likert scale questionnaire. A semi-structured interview guide was followed. Interviews were transcribed and thematic analysis was conducted.

    Results: Both patients and HCW found the SMS system useful and reliable. Most highly rated positive effects were reducing the number of failures to collect medication and avoiding missing appointments. Patients' confidence in the system was high. Most perceived the system to improve communication between health-care provider and patient and assist in education and motivation. The automatic recognition of questions from patients and the provision of appropriate answers (a unique feature of this system) was especially appreciated. A majority would recommend the system to other patients or healthcare centres. Risks also were mentioned, mostly by HCW, of unintentional disclosure of health status in cases where patients use shared phones.

    Conclusions: The results suggest that SMS technology for HIV and TB should be used to transmit reminders for appointments, medications, motivational texts, and health education to increase retention in care. Measures must be taken to reduce risks of privacy intrusion, but these are not a main obstacle for scaling up systems of this kind.

    Place, publisher, year, edition, pages
    Public Library of Science, 2017
    National Category
    Information Systems, Social aspects
    Identifiers
    urn:nbn:se:oru:diva-57686 (URN)10.1371/journal.pone.0176051 (DOI)000399875200064 ()28419149 (PubMedID)2-s2.0-85017624472 (Scopus ID)
    Available from: 2017-05-17 Created: 2017-05-17 Last updated: 2017-05-22Bibliographically approved
    5. Use of Mobile Technologies to Improve Healthcare in Mozambique: Key Failure/Success Factors, Challenges, and Policy Implications
    Open this publication in new window or tab >>Use of Mobile Technologies to Improve Healthcare in Mozambique: Key Failure/Success Factors, Challenges, and Policy Implications
    (English)Manuscript (preprint) (Other academic)
    National Category
    Information Systems, Social aspects
    Identifiers
    urn:nbn:se:oru:diva-57687 (URN)
    Available from: 2017-05-17 Created: 2017-05-17 Last updated: 2017-05-17Bibliographically approved
  • Salmonsson, Lisa
    Örebro University, School of Humanities, Education and Social Sciences, Örebro University, Sweden.
    Mona Lindqvist, Speaking about social suffering? Subjective understandings and lived experiences of migrant women and therapists. Karlstad: Department of Social and Psychological Studies, Karlstad University, 2016: Subjective understandings and lived experiences of migrant women and therapists. Karlstad2017In: Sociologisk forskning, ISSN 0038-0342, Vol. 54, no 1, 147-149 p.Article, book review (Other academic)
  • Dahlstedt, Magnus
    et al.
    Eliassi, Barzoo
    Salmonsson, Lisa
    Örebro University, School of Humanities, Education and Social Sciences, Örebro University, Sweden.
    Medborgarskap och tillhörighet i migrationens tid: inledande reflektioner2017In: Sociologisk forskning, ISSN 0038-0342, Vol. 54, no 1, 5-10 p.Article in journal (Refereed)
  • Adlitzer, Helena
    et al.
    Regionalt cancercentrum Stockholm Gotland.
    Andershed, Birgitta
    Ersta Sköndal Högskola.
    Axelsson, Bertil
    Östersunds sjukhus; Umeå universitet.
    Blomberg, Karin
    Örebro University, School of Health Sciences.
    Fridegren, Inger
    Nacka Närsjukhus.
    Friedrichsen, Maria
    Palliativt kompetenscentrum Östergötland, Vrinnevisjukhuset; Linköpings Universitet .
    Fürst, Carl-Johan
    Palliativt utvecklingscentrum, Lunds universitet och Region Skåne.
    Heedman, Per-Anders
    Palliativt kompetenscentrum i Östergötland.
    Henoch, Ingela
    Sahlgrenska akademin; Göteborgs universitet.
    Kenne Sarenmalm, Elisabeth
    FoU Centrum, Skaraborgs sjukhus, Skövde.
    Löfdahl, Elisabet
    Palliativa sektionen SU/Sahlgrenska universitetssjukhuset.
    Melin-Johansson, Christina
    Mittuniversitetet.
    Molander, Ulla
    Sahlgrenska Universitetssjukhuset, Göteborg.
    Persson, Hans
    Danderyds sjukhus.
    Pessah-Rasmussen, Hélène
    Skånes Universitetssjukhus (SUS).
    Rasmussen, Birgit H
    Lunds universitet och Region Skåne.
    Schaufelberger, Maria
    Sahlgrenska universitetssjukhuset.
    Seiger Cronfalk, Berit
    Ersta Sköndal Högskola; Karolinska Institutet.
    Silk, Gerd
    Kvalitets- och utvecklingsenheten Region Gotland.
    Strang, Peter
    Karolinska Institutet och Stockholms Sjukhem, Stockholm.
    Strömberg, Anna
    Linköpings universitetssjukhus.
    Tavemark, Sofia
    Örebro kommun.
    Ternestedt, Britt-Marie
    Ersta Sköndal Högskola, Stockholm.
    Wennman-Larsen, Agneta
    Sophiahemmet Högskola; Karolinska Institutet.
    Wikström, Gerhard
    Uppsala Universitet.
    Österlind, Jane
    Ersta Sköndal högskola.
    Palliativ vård i livets slutskede: Nationellt vårdprogram2016Report (Other academic)
  • Deutschmann, Mats
    Umeå universitet, Moderna språk.
    Apologising in British English2003Doctoral thesis, monograph (Other academic)
    Abstract [en]

    The thesis explores the form, function and sociolinguistic distribution of explicit apologies in the spoken part of the British National Corpus. The sub-corpus used for the study comprises a spoken text mass of about five million words and represents dialogue produced by more than 1700 speakers, acting in a number of different conversational settings. More than 3000 examples of apologising are included in the analysis.

    Primarily, the form and function of the apologies are examined in relation to the type of offence leading up to the speech act. Aspects such as the sincerity of the apologies and the use of additional remedial strategies other than explicit apologising are also considered. Variations in the distributions of the different types of apologies found are subsequently investigated for the two independent variables speaker social identity (gender, social class and age) and conversational setting (genre, formality and group size). The effect of the speaker-addressee relationship on the apology rate and the types of apologies produced is also examined.

    In this study, the prototypical apology, a speech act used to remedy a real or perceived offence, is only one of a number of uses of the apology form in the corpus. Other common functions of the form include discourse-managing devices such as request cues for repetition and markers of hesitation, as well as disarming devices uttered before expressing disagreement and controversial opinions.

    Among the speaker social variables investigated, age and social class are particularly important in affecting apologetic behaviour. Young and middle-class speakers favour the use of the apology form. No substantial gender differences in apologising are apparent in the corpus. I have also been able to show that large conversational groups result in frequent use of the form. Finally, analysis of the effects of the speaker-addressee relationship on the use of the speech act shows that, contrary to expectations based on Brown & Levinson’s theory of politeness, it is the powerful who tend to apologise to the powerless rather than vice versa.

    The study implies that formulaic politeness is an important linguistic marker of social class and that its use often involves control of the addressee.

  • Olsson, Jan
    et al.
    Örebro University, School of Humanities, Education and Social Sciences, Örebro University, Sweden.
    Petersén, Anna
    Örebro University, School of Law, Psychology and Social Work, Örebro University, Sweden.
    Kvalitetsuppföljning inom äldreomsorgen2017Report (Other academic)
  • Riddell, Nicole
    Örebro University, School of Science and Technology, Örebro University, Sweden.
    Packed Column Supercritical Fluid Chromatography: Applications in Environmental Chemistry2017Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Although gas and liquid chromatography have emerged as dominant separation techniques in environmental analytical chemistry, these methods do not allow for the concurrent analysis of chemically diverse groups of persistent organic pollutants (POPs). There are also a small number of compounds which are not easily amenable to either of these traditional separation techniques. The main objective of this thesis was to address these issues by demonstrating the applicability of packed column supercritical fluid chromatography (pSFC) coupled to mass spectrometry (MS) in various aspects of environmental chemistry.

    First, pSFC/MS analytical methods were developed for legacy POPs (PCDDs, PCDFs, and PCBs) as well as the emerging environmental contaminant Dechlorane Plus (DP), and issues relating to the ionization of target analytes when pSFC was coupled to MS were explored. Novel APPI and APCI reagents (fluorobenzene and triethylamine) were optimized and real samples (water and soil) were analyzed to demonstrate environmental applicability.

    The possibility of chiral and preparative scale pSFC separations was then demonstrated through the isolation and characterization of thermally labile hexabromocyclododecane (HBCDD) stereoisomers. The analytical pSFC separation of the α-, β-, and γ-HBCDD enantiomers as well as the δ and ε meso forms was shown to be superior to results obtained using a published LC method.

    Finally, technical mixtures of phosphorus flame retardants (RBDPP, BPA-BDPP, and DOPO; a group of related compounds which are challenging to analyze concurrently) were examined using multiple analytical techniques and pSFC was found to be the only method which facilitated the accurate determination of the components of all 3 mixtures. This thesis confirms the potential of pSFC/MS as a fast, green, and cost effective means of separating and analyzing environmental contaminants.

    List of papers
    1. Comparative assessment of the chromatographic separation of 2,3,7,8-substituted polychlorinated dibenzo-p-dioxins and polychlorinated dibenzofurans using supercritical fluid chromatography and high resolution gas chromatography
    Open this publication in new window or tab >>Comparative assessment of the chromatographic separation of 2,3,7,8-substituted polychlorinated dibenzo-p-dioxins and polychlorinated dibenzofurans using supercritical fluid chromatography and high resolution gas chromatography
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    2015 (English)In: Analytical Methods, ISSN 1759-9660, E-ISSN 1759-9679, Vol. 7, no 21, 9245-9253 p.Article in journal (Refereed) Published
    Abstract [en]

    The analysis of legacy environmental contaminants, such as polychlorinated dibenzo-p-dioxins (PCDDs) and dibenzofurans (PCDFs), using high resolution gas chromatography (HRGC) is well established and universally accepted. The use of an alternative separation technique, such as packed column supercritical fluid chromatography (pSFC), may be of interest as a fast, green, and cost effective method of analyzing environmental samples. The technique is amenable to a broad range of chemical compounds and could facilitate the simultaneous analysis of multiple compound classes as well as the inclusion of thermally labile compounds in a single targeted analysis. The recent re-emergence of this technology due to the introduction of more robust and efficient instrumentation may result in an increased acceptance of pSFC analytical techniques in this area. Herein, the first reported analytical separation of PCDDs and PCDFs by pSFC is described and its separation capabilities are compared with established HRGC protocols. Elution profiles of 2,3,7,8-substituted PCDDs and PCDFs were examined and the separation of PCDD/PCDF homologue groups was found to be comparable to those accomplished using HRGC. Similarly, the resolution of tetrachlorodibenzo-p-dioxin (TCDD) congeners, as required by current regulatory methods utilizing HRGC, was demonstrated and the separation of possible co-eluting PCDD/PCDF congeners was examined and compared to that achieved using popular HRGC capillary columns. The possibility of concurrent analysis of toxic polychlorinated biphenyls (PCBs) with PCDDs and PCDFs using the developed pSFC method was also investigated. The effective separation of these environmental contaminants obtained using pSFC and subsequent detection utilizing atmospheric pressure photoionization tandem mass spectrometry at environmentally relevant levels demonstrates the promise associated with this technique for the analysis of environmental extracts.

    Place, publisher, year, edition, pages
    Royal Society of Chemistry, 2015
    National Category
    Chemical Sciences Food Science
    Research subject
    Chemistry
    Identifiers
    urn:nbn:se:oru:diva-46699 (URN)10.1039/c5ay01644d (DOI)000363732900034 ()2-s2.0-84945421701 (Scopus ID)
    Available from: 2015-11-23 Created: 2015-11-23 Last updated: 2017-04-21Bibliographically approved
    2. Coupling Supercritical Fluid Chromatography to Positive Ion Atmospheric Pressure Ionization Mass Spectrometry: Ionization Optimization of Halogenated Environmental Contaminants
    Open this publication in new window or tab >>Coupling Supercritical Fluid Chromatography to Positive Ion Atmospheric Pressure Ionization Mass Spectrometry: Ionization Optimization of Halogenated Environmental Contaminants
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    (English)Manuscript (preprint) (Other academic)
    National Category
    Other Chemistry Topics
    Identifiers
    urn:nbn:se:oru:diva-57150 (URN)
    Available from: 2017-04-21 Created: 2017-04-21 Last updated: 2017-04-21Bibliographically approved
    3. Coupling of Supercritical Fluid Chromatography to Mass Spectrometry for the Analysis of Dechlorane Plus: Examination of Relevant Negative Ion Atmospheric Pressure Chemical Ionization Mechanisms
    Open this publication in new window or tab >>Coupling of Supercritical Fluid Chromatography to Mass Spectrometry for the Analysis of Dechlorane Plus: Examination of Relevant Negative Ion Atmospheric Pressure Chemical Ionization Mechanisms
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    (English)Manuscript (preprint) (Other academic)
    National Category
    Other Chemistry Topics
    Identifiers
    urn:nbn:se:oru:diva-57152 (URN)
    Available from: 2017-04-21 Created: 2017-04-21 Last updated: 2017-04-21Bibliographically approved
    4. Enantioselective Analytical- and Preparative-Scale Separation of Hexabromocyclododecane Stereoisomers Using Packed Column Supercritical Fluid Chromatography
    Open this publication in new window or tab >>Enantioselective Analytical- and Preparative-Scale Separation of Hexabromocyclododecane Stereoisomers Using Packed Column Supercritical Fluid Chromatography
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    2016 (English)In: Molecules, ISSN 1420-3049, E-ISSN 1420-3049, Vol. 21, no 11, 1509Article in journal (Refereed) Published
    Abstract [en]

    Hexabromocyclododecane (HBCDD) is an additive brominated flame retardant which has been listed in Annex A of the Stockholm Convention for elimination of production and use. It has been reported to persist in the environment and has the potential for enantiomer-specific degradation, accumulation, or both, making enantioselective analyses increasingly important. The six main stereoisomers of technical HBCDD (i.e., the (+) and (-) enantiomers of α-, β-, and γ-HBCDD) were separated and isolated for the first time using enantioselective packed column supercritical fluid chromatography (pSFC) separation methods on a preparative scale. Characterization was completed using published chiral liquid chromatography (LC) methods and elution profiles, as well as X-ray crystallography, and the isolated fractions were definitively identified. Additionally, the resolution of the enantiomers, along with two minor components of the technical product (δ- and ε-HBCDD), was investigated on an analytical scale using both LC and pSFC separation techniques, and changes in elution order were highlighted. Baseline separation of all HBCDD enantiomers was achieved by pSFC on an analytical scale using a cellulose-based column. The described method emphasizes the potential associated with pSFC as a green method of isolating and analyzing environmental contaminants of concern.

    Place, publisher, year, edition, pages
    Basel, Switzerland: MDPI AG, 2016
    Keyword
    hexabromocyclododecane, enantiomeric separation, supercritical fluid chromatography
    National Category
    Analytical Chemistry
    Identifiers
    urn:nbn:se:oru:diva-53487 (URN)10.3390/molecules21111509 (DOI)000389918200091 ()27834934 (PubMedID)2-s2.0-84997428723 (Scopus ID)
    Available from: 2016-11-15 Created: 2016-11-14 Last updated: 2017-04-21Bibliographically approved
    5. Examination of technical mixtures of halogen-free phosphorus based flame retardants using multiple analytical techniques
    Open this publication in new window or tab >>Examination of technical mixtures of halogen-free phosphorus based flame retardants using multiple analytical techniques
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    2017 (English)In: Chemosphere, ISSN 0045-6535, E-ISSN 1879-1298, Vol. 176, 333-341 p.Article in journal (Refereed) Published
    Abstract [en]

    The application of phosphorus based flame retardants as replacements for commonly used halogenated flame retardants has been gaining interest due to the possibility that these compounds may have a less significant impact on human and environmental health. Unfortunately, little is known about the chemical compositions of many of the technical products (which often are mixtures) and a single separation technique for concurrent analysis of these types of compounds has not been identified. This paper reports the results of an investigation into the constituents of three halogen free organophosphate flame retardants (OPFRs), resorcinol bis(diphenyl phosphate) (RDBPP), bisphenol A bis(diphenyl phosphate) (BPA-BDPP), and 9,10-dihydro-9-oxa-10-phosphaphenanthrene-10-oxide (DOPO). The major components of commercial samples of RDBPP and BPA-BDPP were isolated by preparative TLC and characterized by NMR. A commercial sample of DOPO was found to be essentially pure, but its analysis is complicated by the fact that it can exist in ring-open and ring-closed forms. With the structures of the components confirmed by NMR, multiple analytical separation techniques (gas chromatography (GC), liquid chromatography (LC), and packed column supercritical fluid chromatography (pSFC)) were investigated for the analysis of these three technical products. Packed column supercritical fluid chromatography allows the separation of the components of all three OPFRs, including the two forms of DOPO, in a single run.

    Place, publisher, year, edition, pages
    Elsevier, 2017
    Keyword
    Organophosphate flame retardants (OPFRs); pSFC/MS method; NMR; RDBPP; BPA-BDPP; DOPO
    National Category
    Other Chemistry Topics Environmental Sciences
    Identifiers
    urn:nbn:se:oru:diva-57461 (URN)10.1016/j.chemosphere.2017.02.129 (DOI)000399849300038 ()28282639 (PubMedID)2-s2.0-85015851681 (Scopus ID)
    Available from: 2017-04-25 Created: 2017-04-25 Last updated: 2017-05-23Bibliographically approved
  • Deutschmann, Mats
    et al.
    Örebro University, School of Humanities, Education and Social Sciences, Örebro University, Sweden. Umeå universitet, Institutionen för språkstudier.
    Steinvall, Anders
    Umeå universitet, Institutionen för språkstudier.
    Identifying Identity: Using Second Life in the Teaching of Sociolinguistics for the Raising of Gender Awareness2012In: The EUROCALL Review, ISSN 2192-1032, E-ISSN 1695-2618, Vol. 20, 49-53 p.Article in journal (Refereed)
    Abstract [en]

    This paper presents further innovative use of virtual worlds under the pilot stages of ASSIS (A Second Step in Second Life), a project funded by Umeå University. One of the aims of the project is to make use of the affordances offered by Second Life in order to raise sociolinguistic language awareness among teacher trainees and other students studying courses in sociolinguistics. Several experiments were conducted where creative use of the avatar in combination with so-called “voice morphing” (a tool which allows the voice of the speaker to be distorted so that a male speaker can sound more feminine and vice versa) allowed students to enter the virtual world incognito in order to “experience” a different linguistic identity. Activities were conducted in cross-cultural settings involving students from Sweden and Chile. The paper presents the initial stages of development of a model for how language awareness issues can be internalised through first-hand experience in virtual worlds.

  • Deutschmann, Mats
    et al.
    Örebro University, School of Humanities, Education and Social Sciences, Örebro University, Sweden. Umeå universitet, Institutionen för språkstudier.
    Vu, Mai Trang
    Umeå universitet, Institutionen för språkstudier.
    Computer assisted language learning in language education: an overview of theories, methods, and current practices2015In: Språkdidaktik: researching language teaching and learning / [ed] Eva Lindgren & Janet Enever, Umeå: Department of Language Studies, Umeå University , 2015, 1, 43-60 p.Chapter in book (Refereed)
  • Deutschmann, Mats
    et al.
    Umeå universitet, Institutionen för språkstudier.
    Steinvall, Anders
    Umeå universitet, Institutionen för språkstudier.
    Lagerström, Anna
    Umeå universitet, Institutionen för språkstudier.
    Gender-Bending in Virtual Space: Using Voice-Morphing in Second Life to Raise Sociolinguistic Gender Awareness2011In: Learning a Language in Virtual Worlds: A Review of Innovation and ICT in Language Teaching Methodology, International Conference, Warsaw, 17th November 2011 / [ed] Sławomir Czepielewski, Warsaw: Warsaw Academy of Computer Science, Management and Administration , 2011, 54-61 p.Conference paper (Refereed)
    Abstract [en]

    This paper presents further innovative use of virtual worlds under the pilot stages of ASSIS (A Second Step in Second Life), a project funded by Umeå University. One aim of the project is to make use of the affordances offered by Second Life in order to raise sociolinguistic language awareness among teacher trainees and other students studying sociolinguistics. Several experiments have been conducted where creative use of the avatar in combination with so-called “voice-morphing” allowed students to be exposed to, or experience different linguistic identities. In the following paper, we describe four such experiments.In the First one, we recreated a classic sociolinguistic experimental design, the so-called matched-guise test, in order to test whether our female students were evaluated differently on various personal characteristics when they appeared as male avatars. Contrary to previous match-guise studies, our results showed that all the females were more positively evaluated than all the ‘males’. However, this overall pattern was very likely a result of the poor quality of the female-to-male voice-morph. In the second experiment, students were offered the possibility of experiencing the opposite gender in a cross-cultural course setting in SL, in order to reflect over how this “gender change” affected the way they were treated in conversations. Only one student took this opportunity leaving few conclusions, except awareness of the ethically problematic aspects of such arrangements. In the third experiment, we used voice-morphing in SL to raise students’ awareness of how gender stereotypes can influence their perception of teachers. In addition to the real (male) teacher, we created two voice-morphed teacher assistant avatars in SL, one male and one female. Student evaluations showed that they were partly influenced by stereotypes and partly not. The design of the experiment was criticized by the students, however, as they felt that they had had too little time with the teacher assistants to evaluate them properly and therefore gave average ratings. In the fourth study we used similar characters as in the previous study, but in an online lecture during which the real teacher spoke as himself and also gave talks, one as his female and one as his male 55PhD student. The students listening to the lecture evaluated the female PhD student as more likeable and the male PhD student as more intelligent. After, the design was revealed and the students reflected extensively on the result and how unconscious gender stereotypes influence how we judge people. The models and studies presented here point to the potential of virtual worlds as tools for awareness-raising activities regarding gender as a social construct

  • Ivanov, Sergej
    et al.
    Umeå universitet, Institutionen för språkstudier.
    Deutschmann, Mats
    Örebro University, School of Humanities, Education and Social Sciences, Örebro University, Sweden. Umeå universitet, Institutionen för språkstudier.
    Enever, Janet
    Umeå universitet, Institutionen för språkstudier.
    Researching language-in-education policies: evidence from the Seychelles, Russia and the European Union2015In: Språkdidaktik: researching language teaching and learning / [ed] Eva Lindgren and Janet Enever, Umeå: Department of Language Studies, Umeå University , 2015, 85-101 p.Chapter in book (Refereed)
  • Strid, Åke
    Örebro University, School of Science and Technology, Örebro University, Sweden.
    Knowledge for knowledge’s sake: Personal thoughts on Professor Lars Olof Björn’s impact on plant UV photobiology and on Swedish popular science over the last three decades (at least)2017In: UV4Plants Bulletin, ISSN 2343-323X, Vol. 2016, no 2, 29-31 p.Article in journal (Refereed)
  • Lowry, Stephanie
    et al.
    Örebro University, School of Science and Technology, Örebro University, Sweden.
    Henrik, Andreasson
    Örebro University, School of Science and Technology, Örebro University, Sweden.
    Visual place recognition techniques for pose estimation in changing environments2016In: Visual Place Recognition: What is it Good For? workshop, Robotics: Science and Systems (RSS) 2016, 2016Conference paper (Other academic)
    Abstract [en]

    This paper investigates whether visual place recognition techniques can be used to provide pose estimation information for a visual SLAM system operating long-term in an environment where the appearance may change a great deal. It demonstrates that a combination of a conventional SURF feature detector and a condition-invariant feature descriptor such as HOG or conv3 can provide a method of determining the relative transformation between two images, even when there is both appearance change and rotation or viewpoint change.

  • Johansson, Viktor
    Stockholms universitet, Institutionen för pedagogik och didaktik.
    Dissonant Voices: Philosophy, Children's Literature, and Perfectionist Education2013Doctoral thesis, monograph (Other academic)
    Abstract [en]

    Dissonant Voices has a twofold aspiration. First, it is a philosophical treatment of everyday pedagogical interactions between children and their elders, between teachers and pupils. More specifically it is an exploration of the possibilities to go on with dissonant voices that interrupt established practices – our attunement – in behaviour, practice and thinking. Voices that are incomprehensible or expressions that are unacceptable, morally or otherwise. The text works on a tension between two inclinations: an inclination to wave off, discourage, or change an expression that is unacceptable or unintelligible; and an inclination to be tolerant and accept the dissonant expression as doing something worthwhile, but different.

    The second aspiration is a philosophical engagement with children’s literature. Reading children’s literature becomes a form of philosophising, a way to explore the complexity of a range of philosophical issues. This turn to literature marks a dissatisfaction with what philosophy can accomplish through argumentation and what philosophy can do with a particular and limited set of concepts for a subject, such as ethics. It is a way to go beyond philosophising as the founding of theories that justify particular responses. The philosophy of dissonance and children’s literature becomes a way to destabilise justifications of our established practices and ways of interacting.

    The philosophical investigations of dissonance are meant to make manifest the possibilities and risks of engaging in interactions beyond established agreement or attunements. Thinking of the dissonant voice as an expression beyond established practices calls for improvisation. Such improvisations become a perfectionist education where both the child and the elder, the teacher and the student, search for as yet unattained forms of interaction and take responsibility for every word and action of the interaction.

    The investigation goes through a number of picture books and novels for children such as Harry Potter, Garmann’s Summer, and books by Shaun Tan, Astrid Lindgren and Dr. Seuss as well narratives by J.R.R. Tolkien, Henrik Ibsen, Jane Austen and Henry David Thoreau. These works of fiction are read in conversation with philosophical works of, and inspired by, Ludwig Wittgenstein and Stanley Cavell, their moral perfectionism and ordinary language philosophy.

  • Larsson, Madelene
    Örebro University, School of Health Sciences.
    Formal Female Mentoring Relationship as Health Promotion2016Licentiate thesis, comprehensive summary (Other academic)
    Abstract [en]

    The transition from adolescence to adulthood can bring with it mental health problems, resulting in reduced mental well-being among young women and an increasing public health issue. Perceived mental health problems can be a major obstacle to personal development and opportunities for becoming established in society. Thus, promotive interventions are needed.

    The overall aim of this thesis was to explore women’s experience of mentoring relationships as health promotion from the perspectives of both parties in the dyad: the young woman transitioning from adolescence to adulthood (the protégé), and her ten-year-older female mentor.

    This thesis used a practice-based approach to investigate a group of participants involved in a Swedish non-governmental organization, the Girls Zone. Data collection was conducted including interviews (n = 5) and surveys (n = 52) with female protégés, and interviews with female mentors (n = 12). Study I explored the characteristics of the female protégés and the development of the mentoring relationship, and used mixed methods. Study II, which investigated mentors’ initial motives and the organizational context which enabled the mentors’ engagement, used an explorative qualitative method.

    This thesis showed that female mentoring relationships seem to have potential to be a health-promoting intervention. A variety of young women were attracted to the mentoring program, and mentorships in line with the perspectives of relational-cultural theory could meet the relationship needs expressed by the female protégés. Further, mentors’ motivations for engaging as mentors were linked to the fulfillment of basic psychological needs for autonomy, competence, and relatedness, in accordance with the perspective of self-determination theory.

    List of papers
    1. Enabling relationship formation, development, and closure in a one-year female mentoring program at a non-governmental organization: a mixed-method study
    Open this publication in new window or tab >>Enabling relationship formation, development, and closure in a one-year female mentoring program at a non-governmental organization: a mixed-method study
    2016 (English)In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 16, no 1, 179Article in journal (Refereed) Published
    Abstract [en]

    Background: Mental health problems among young women aged 16-24 have increased significantly in recent decades, and interventions are called for. Mentoring is a well-established preventative/promotive intervention for developing adolescents, but we have yet to fully understand how the relationship between the mentor and the protégé forms, develops, and closes. In this study, we focused on a female mentoring program implemented by a Swedish non-governmental organization, The Girls Zone. First, we examined the psychological and social characteristics of the young women who chose to take part in the program as protégés. Second, we investigated adolescent female protégés’ own experiences of the relationship process based on a relational-cultural theory perspective.

    Methods: The mixed-method study included 52 questionnaires and five semi-structured interviews with young women aged 15–26 who had contacted The Girls Zone between 2010 and 2012 in order to find a mentor. Their experience of the mentoring relationships varied in duration. Data were analysed statistically and with inductive qualitative content analysis.

    Results: The group of protégés was heterogeneous in that some had poor mental health and some had good mental health. On the other hand, the group was homogenous in that all its members had shown pro-active self-care by actively seeking out the program due to experiences of loneliness and a need to meet and talk with a person who could listen to them. The relationships were initially characterized by feelings of nervousness and ambivalence. However, after some time, these developed into authentic, undemanding, non-hierarchical relationships on the protégés’ terms. The closure of relationships aroused feelings of both abandonment and developing strength.

    Conclusions: Mentorships that are in line with perspectives of the relational-cultural theory meet the relationship needs expressed by the female protégés. Mentor training should focus on promoting skills such as active listening and respect for the protégé based on an engaged, empathic, and authentic approach in a non-hierarchical relationship. These insights have the potential to inform interventions in several arenas where young women create authentic relationships with older persons, such as in school, in traditional health care contexts, and in youth recreation centres. 

    Place, publisher, year, edition, pages
    London, United Kingdom: BioMed Central, 2016
    Keyword
    Mixed methods, Mentoring, Gender, Intervention, Emerging adulthood, Young women, Prevention, NGO, Relationship process, Sweden
    National Category
    Public Health, Global Health, Social Medicine and Epidemiology
    Research subject
    Public health
    Identifiers
    urn:nbn:se:oru:diva-48134 (URN)10.1186/s12889-016-2850-2 (DOI)000370666500001 ()26905222 (PubMedID)2-s2.0-84958967859 (Scopus ID)
    Projects
    Genusinriktad ANDT prevention - Förebyggande och främjande verksamhet för unga tjejer
    Funder
    Public Health Agency of Sweden
    Available from: 2016-02-09 Created: 2016-02-09 Last updated: 2017-03-10Bibliographically approved
    2. Initial motives and organizational context enabling female mentors' engagement in formal mentoring: a qualitative study from the mentors' perspective
    Open this publication in new window or tab >>Initial motives and organizational context enabling female mentors' engagement in formal mentoring: a qualitative study from the mentors' perspective
    2016 (English)In: Children and youth services review, ISSN 0190-7409, E-ISSN 1873-7765, Vol. 71, 17-26 p.Article in journal (Refereed) Published
    Abstract [en]

    Mentoring aimed at supporting young people and their development shows promising results, but its delivery is threatened by the difficulty of recruiting sufficient numbers of mentors and keeping them engaged over time. The aim of this study was to help overcome this problem by examining female mentors’ motives for engaging in formal voluntary mentoring of young women, and exploring how organizations can facilitate these mentors’ satisfaction in staying engaged over time. Based on qualitative interviews with 12 mentors in a Swedish non-governmental organization, the Girls Zone, we show six categories of mentor motives related to initial motivation for engagement: self-interested reasons, empowering women, being a responsible citizen, sense of compassion, self-awareness, and longing for meaningfulness. In addition, we show five categories related to the organizational work of satisfying mentors: a win-win relationship, a feeling of ambivalence despite clear responsibilities and contributions, customized support and guidance, a caring organizational identity, and a commitment to pursue with feelings of duty and emotional connection. Using Self-Determination Theory as the framework to guide our understanding of the findings, we conclude that mentors’ motivations for engaging as mentors are linked to the fulfillment of basic psychological needs for autonomy, competence, and relatedness. Practical recommendations are offered in light of the findings.

    Place, publisher, year, edition, pages
    Oxford, United Kingdom: Elsevier, 2016
    Keyword
    Motives, organizational context, self-determination theory, female mentors, community-based mentoring
    National Category
    Public Health, Global Health, Social Medicine and Epidemiology Social Work
    Research subject
    Public health
    Identifiers
    urn:nbn:se:oru:diva-53053 (URN)10.1016/j.childyouth.2016.10.026 (DOI)000390642400004 ()2-s2.0-84992409200 (Scopus ID)
    Funder
    Public Health Agency of Sweden
    Available from: 2016-10-20 Created: 2016-10-20 Last updated: 2017-02-02Bibliographically approved
  • Lindahl, Robert
    et al.
    Örebro University, School of Law, Psychology and Social Work, Örebro University, Sweden.
    Bruhn, Anders
    Örebro University, School of Law, Psychology and Social Work, Örebro University, Sweden.
    Foster children's experiences and expectations concerning the child-welfare officer role: Prerequisites and obstacles for close and trustful relationships2017In: Child & Family Social Work, ISSN 1356-7500, E-ISSN 1365-2206Article in journal (Refereed)
  • Johansson, Viktor
    Department of Education, Stockholms universitet, Stockholm, sweden.
    The Philosophy of Dissonant Children: Stanley Cavell's Wittgensteinian Philosophical Therapies as an Educational Conversation2010In: Educational Theory, ISSN 0013-2004, E-ISSN 1741-5446, Vol. 60, no 4, 469-486 p.Article in journal (Refereed)
    Abstract [en]

    Education is often understood as a process whereby children come to conform to the norms teachers believe should govern our practices. This picture problematically presumes that educators know in advance what it means for children to go on the way that is expected of them. In this essay Viktor Johansson suggests a revision of education, through the philosophy of Stanley Cavell, that can account for both the attunement in our practices and the possible dissonance that follows when the teacher and child do not go on together. There is an anxiety generated by the threat of disharmony in our educational undertakings that may drive teachers toward philosophy in educational contexts. Here Johansson offers a philosophical treatment of this intellectual anxiety that teachers may experience when they, upon meeting dissonant children, search for epistemic justifications of their practices—a treatment whereby dissonant children can support teachers in dissolving their intellectual frustrations.

  • Bennich, Maria
    Linköpings universitet, Pedagogik och sociologi.
    Kompetens och kompetensutveckling i omsorgsarbete: Synen på kompetens och lärande – i spänningsfältet mellan samhälleliga förutsättningar och organisatoriska villkor2012Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The dissertation is a compilation article thesis and the main purpose is to study how perceptions about competence are related to learning environments and competence development strategies. Parallel to this purpose, I have analysed and discuss competence development from a societal and inter-organisational perspective. Here the focus is on governing principles, user-influence and national development programmes.

    The dissertation consists of a local study based on 22 interviews and 74 questionnaires, a research review and a study based on evaluations of the national Steps for Skill Programme (Kompetensstegen).

    The results of the local study – two care homes and two home-help units – showed that prerequisites for learning environments differ depending on the type of activity being conducted. In the home-help context, the support and involvement of the management was more central for competence development than in the care homes. At the same time, the results showed that in those activities where there was a more developed learning environment and an integrated strategy for competence development, i.e. a combination of informal and formal learning activities, perceptions about the competence of care staff were more advanced. Here the focus was on developing competence and the work itself. What was common to all the activities was the perception that staff needed to be able to develop relations with users.

    The analysis of the Steps for Skill Programme – a major national initiative – revealed deficiencies in the interplay and equal relations between workplaces and educational institutions. This had implications for the success of the competence development programme. In those areas where the workplace- and educational system cooperated, the workplace learning was more flexible, efficient and serviceable for the participants. This example indicated that competence issues need to be analysed from a societal perspective.

    The societal analysis showed that competence issues are easily neglected if they are not integrated into governing principles, such as exposure to competition, procurement procedures and customer choice. Competence development in elder care is a complex, difficult to define and demanding process that needs to be synchronised at different levels. National ventures, where formal education dominates, have had very little impact. The perspective has often been shortsighted and individual-oriented. Also, one-off projects and occasional resource allocations do not lead to competence development being prioritised or to essential resources being allocated locally. Keywords: Care-staff, competence, competence development, elder care,  interactive research, inter-organisational cooperation.

    List of papers
    1. Lärmiljöer, lärstrategier och synen på kompetens i omsorgsarbete
    Open this publication in new window or tab >>Lärmiljöer, lärstrategier och synen på kompetens i omsorgsarbete
    2015 (Swedish)In: Tidsskrift for Arbejdsliv, ISSN 1399-1442, Vol. 17, no 1, 61-77 p.Article in journal (Other academic) Published
    Abstract [sv]

    Omsorgsarbetet är ett komplext arbete och från nationell myndighetsnivå beskrivs att omsorgspersonalen behöver en särskild kompetens (Socialstyrelsen 2002; Ahnlund & Johansson 2006; SOU 2008:126). I en utredning fastslås till exempel att omsorgspersonal bör ha kunskaper inom medicin, pedagogik samt det sociala fältet (Socialstyrelsen 2004). Enligt Socialstyrelsen (2007) är just kompetensförsörjning den viktigaste frågan för att säkra god kvalitet i omsorgen om äldre. Samtidigt betonas att det måste finnas utvecklingsmöjligheter i arbetet för omsorgspersonalen. Frågor om kompetens och lärande diskuteras ofta på en strategisk nivå, men lokala studier där omsorgspersonalens uppfattningar lyfts fram är sällsynta (se t.ex.Törnquist 2004). Det är få studier som kopplar samman organisatoriska förutsättningar för lärande med synen på kompetens bland de anställda. Syftet med denna studie är att a) undersöka hur lärmiljön och strategier för kompetensutveckling ser ut i ett antal verksamheter i äldreomsorgen och b) att analysera om dessa faktorer är relaterade till omsorgspersonalens uppfattningar om kompetens. Jag inleder med att redogöra för några centrala begrepp om kompetens och hur den kan utvecklas genom olika lärprocesser.

    Place, publisher, year, edition, pages
    Center for studier i arbejdsliv (CSA), 2015
    National Category
    Pedagogy Sociology
    Identifiers
    urn:nbn:se:oru:diva-55892 (URN)
    Available from: 2012-10-17 Created: 2017-02-21 Last updated: 2017-03-09Bibliographically approved
    2. Kompetensutveckling ur ett styrningsperspektiv: exemplet omsorgen
    Open this publication in new window or tab >>Kompetensutveckling ur ett styrningsperspektiv: exemplet omsorgen
    2009 (Swedish)In: Tidsskrift for Arbejdsliv, ISSN 1399-1442, Vol. 11, no 3, 62-77 p.Article in journal (Refereed) Published
    Abstract [sv]

    Styrningen av en verksamhet kan vara avgörande för om och hur en framtida satsning på kompetensutveckling inom äldreomsorgen kommer att se ut. Parallellt med och som en kritik mot den offentliga och uppifråndrivna strategin för kvalitetsutveckling har nya styrprinciper vuxit fram i äldreomsorgen, nämligen brukarstyrning och eget val. Dessa nya styrprinciper kan leda till att kompetensinsatser inte prioriteras. I stället kan det mer handla om att välja rätt personal som är anpasslig och som har de kunskaper som krävs i ett kortsiktigt perspektiv. Artikeln, som är tentativ, vill alltså diskutera betydelsen av olika styrprinciper inom omsorgen och vad de kan betyda för personalens kompetens i framtiden. Underlaget bygger på en litteraturgenomgång av forskning i de nordiska länderna och en sammanfattning av erfarenheterna från ett omfattande nationellt program, där avsikten var att kompetensutveckling ska leda till en ökad kvalitet.

    Place, publisher, year, edition, pages
    Center for studier i arbejdsliv (CSA), 2009
    National Category
    Social Work
    Identifiers
    urn:nbn:se:oru:diva-55891 (URN)
    Available from: 2009-10-20 Created: 2017-02-21 Last updated: 2017-03-09Bibliographically approved
    3. Organising workplace learning: an inter-organisational perspective
    Open this publication in new window or tab >>Organising workplace learning: an inter-organisational perspective
    2009 (English)In: Journal of European Industrial Training, ISSN 0309-0590, E-ISSN 1758-7425, Vol. 33, no 8/9, 771-786 p.Article in journal (Refereed) Published
    Abstract [en]

    Purpose: The purpose of this paper is to argue that both the supply-based model and the demand-based form of vocational education and training (VET) have their limitations and propose a "third way" in which reflective learning in the workplace is a central ingredient.

    Design/methodology/approach: The data was collected from several studies of VET programmes in Sweden based on individual and group interviews, a survey and continuous participation in developmental work. The paper uses an interactive research approach in the research design.

    Findings: The paper proposes a "third way" that tries to overcome the deficiencies of both the supply- and demand-based strategies for VET by developing a more equal balance in the relationship between the education and workplace systems. Collaboration and partnership between education providers and progressive workplaces are core elements.

    Research limitations/implications: The paper tries to connect activities and changes at the organisational, inter-organisational and institutional levels of the VET system. It is argued that changes at different levels are strongly interconnected and necessary to an understanding of the prerequisites for workplace learning. These vertical relationships form the main focus of future research.

    Practical implications: It is argued that changes in the VET system should be initiated using a "bottom up" approach, start at the local level, and include change at all levels. The "bottom up" approach should include a combined employer, employee and service-user perspective. It requires that learning issues are solved in a partnership that represents both the supply side of education and the demand side of working life.

    Originality/value: Inter-organisational relations need to be based on equal, mutual and trustful relationships between the education and workplace systems in order to support a sustainable change process.

    Place, publisher, year, edition, pages
    Bingley, United Kingdom: Emerald Group Publishing Limited, 2009
    Keyword
    Workplace learning, Vocational training, Learning, Supply and demand
    National Category
    Work Sciences
    Research subject
    Working Life Science
    Identifiers
    urn:nbn:se:oru:diva-55899 (URN)10.1108/03090590910993625 (DOI)2-s2.0-72149094066 (Scopus ID)
    Available from: 2012-02-08 Created: 2017-02-21 Last updated: 2017-03-09Bibliographically approved
  • Beland Lindahl, Karin
    et al.
    Unit of Political Science, Luleå University of Technology, Luleå, Sweden.
    Sténs, Anna
    Dept. of Historical, Philosophical and Religious studies, Umeå University, Umeå, Sweden.
    Sandström, Camilla
    Dept. of Political Science, Umeå, Umeå University, Sweden.
    Johansson, Johanna
    Dept. of Political Science, Umeå, Umeå University, Sweden.
    Lidskog, Rolf
    Örebro University, School of Humanities, Education and Social Sciences, Örebro University, Sweden.
    Ranius, Thomas
    Dept. of Ecology, Swedish University of Agricultural Sciences (SLU), Uppsala, Sweden.
    Roberge, Jean-Michel
    Dept. of Wildlife, Fish, and Environmental Studies, Swedish University of Agricultural Sciences (SLU), Umeå, Sweden.
    The Swedish forestry model: More of everything?2017In: Forest Policy and Economics, ISSN 1389-9341, E-ISSN 1872-7050, Vol. 77, 44-55 p.Article in journal (Refereed)
    Abstract [en]

    “The Swedish forestry model” refers to the forest regime that evolved following the 1993 revision of the Swedish Forestry Act. It is key to Swedish forest politics and used to capture the essence of a sustainable way of managing forests. However, the ideas, institutions and practices comprising the model have not been comprehensively analyzed previously. Addressing this knowledge gap,we use frame analysis and a Pathways approach to investigate the underlying governance model, focusing on the way policy problems are addressed, goals, implementation procedures, outcomes and the resulting pathways to sustainability.Wesuggest that the institutionally embedded response to pressing sustainability challenges and increasing demands is expansion, inclusion and integration: more of everything. The more-of-everything pathway is influenced by ideas of ecological modernization and the optimistic view that existing resources can be increased. Our findings suggest that in effect it prioritizes the economic dimension of sustainability. While broadening out policy formulation it closes down the range of alternative outputs, a shortcoming that hampers its capacity to respond to current sustainability challenges. Consequently, there is a need for a broad public debate regarding not only the role of forests in future society, but also the operationalization of sustainable development.

  • Petersén, Anna
    Örebro University, School of Law, Psychology and Social Work, Örebro University, Sweden.
    Evaluations that matter in social work2017Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    A great deal of evaluations are commissioned and conducted every year in social work, but research reports a lack of use of the evaluation results. This may depend on how the evaluations are conducted, but it may also depend on how social workers use evaluation results. The aim of this thesis is to explore and analyse evaluation practice in social work from an empirical, normative, and constructive perspective. The objectives are partly to increase the understanding of how we can produce relevant and useful knowledge for social work using evaluation results and partly, to give concrete suggestions on improvements on how to conduct evaluations. The empirical data has been organised as four cases, which are evaluations of temporary programmes in social work. The source materials are documents and interviews. The results show that findings from evaluations of temporary programmes are sparingly used in social work. Evaluations seem to have unclear intentions with less relevance for learning and improvement. In contrast, the evaluators themselves are using the data for new purposes. These empirical findings are elaborated further by using the knowledge form phronesis, which can be translated into practical wisdom. The overall conclusion is that social work is in need of knowledge that social workers find relevant and useful in practice. In order to meet these needs, researchers and evaluators must broaden their knowledge view and begin to include practical knowledge instead of solely relying on scientific knowledge when conducting evaluations. Finally, a new evaluation model is suggested. It is called phronesis-based evaluation and is argued to have great potential to address and include professionals’ praxis-based knowledge. It advocates a view that takes social work’s dynamic context into serious consideration and acknowledges values and power as important components of the evaluation process.

    List of papers
    1. An evaluation paradox in social work?: an empirical study of evaluation use in connection with temporary programmes in Swedish social work
    Open this publication in new window or tab >>An evaluation paradox in social work?: an empirical study of evaluation use in connection with temporary programmes in Swedish social work
    2014 (English)In: European Journal of Social Work, ISSN 1369-1457, E-ISSN 1468-2664, Vol. 17, no 2, 175-191 p.Article in journal (Refereed) Published
    Abstract [en]

    This article contributes to the debate on evaluation use by analysing temporary national programmes in Swedish social work. Previous empirical research shows a gloomy picture of evaluation use, thus supporting an evaluation paradox: evaluations are not used for learning and development, but are continually prioritised. The aim of this article is to study, through interviews and document analysis, how evaluations of temporary programmes in social work are designed and used. The results support the paradox and we found that it has two dimensions. First, evaluations are prioritised, but they function as a ritual, characterised by routine and unclear intentions, with limited relevance for professional learning and improvement. The second dimension is about limited use by those commissioning the evaluations, but the evaluators are using data for new purposes and in new contexts. This is, at best, a form of conceptual use, hopefully contributing indirectly to social work practice. The article ends in a discussion on how evaluations could be designed for learning and improvement by focusing on three normative models: utilisation-focused evaluation, responsive evaluation and evidence-based practice approach (EBP).

    Abstract [sv]

    Föreliggande artikel bidrar till debatten om utvärderingsanvändning genom en analys av tidsbegränsade nationella projekt med relevans för socialt arbete i Sverige. Tidigare empirisk forskning ger en mörk bild av utvärderingsanvändning och stödjer därmed en utvärderingsparadox: utvärderingar används inte för lärande och utveckling, men prioriteras ändå kontinuerligt. Artikelns syfte är att genom intervjuer och dokumentanalys undersöka hur utvärderingar av tidsbegränsade projekt i socialt arbete utformas och används. Resultatet stödjer paradoxen och vi har funnit att den har två dimensioner. För det första, utvärderingar prioriteras men de fungerar som en ritual, karaktäriserade av rutin och oklara intentioner med begränsad relevans för professionellt lärande och utveckling. Den andra dimensionen handlar om begränsad användning av dem som beställer utvärderingen, medan utvärderarna själva använder materialet för nya syften och i nya sammanhang. Det här kan som bäst betraktas som en form av konceptuell användning, vilken förhoppningsvis bidrar indirekt till det sociala arbetets praktik. Artikeln avslutas med en diskussion om hur utvärderingar skulle kunna utformas för lärande och utveckling genom att fokusera på tre normativa modeller: Pattons modell för ‘utilisation-focused evaluation’, Guba och Lincolns modell för responsiv utvärdering samt EBP.

    Keyword
    Social work; Evaluation design; Evaluation use; Evaluation paradox; Ritualised use, Socialt arbete; Utvärderingsdesign; Utvärderingsanvändning; Utvärderingsparadox; Ritualiserad användning
    National Category
    Social Work Political Science
    Research subject
    Social Work; Political Science
    Identifiers
    urn:nbn:se:oru:diva-33482 (URN)10.1080/13691457.2013.802226 (DOI)000334059600003 ()2-s2.0-84940336681 (Scopus ID)
    Available from: 2014-01-31 Created: 2014-01-31 Last updated: 2017-04-06Bibliographically approved
    2. Calling evidence-based practice into question: acknowledging phronetic knowledge in social work
    Open this publication in new window or tab >>Calling evidence-based practice into question: acknowledging phronetic knowledge in social work
    2015 (English)In: British Journal of Social Work, ISSN 0045-3102, E-ISSN 1468-263X, Vol. 45, no 5, 1581-1597 p.Article in journal (Refereed) Published
    Abstract [en]

    In this article, we call into question evidence-based practice as a working strategy for relevant applied knowledge in social work. We argue that evidence-based practice suffers from a dilemma whereby a narrow view of evidence is prioritised at the cost of relevance to social work. Instead, we suggest that praxis-based knowledge informed by different forms of knowledge is a better option with a greater potential to enhance the use of knowledge in social work practice. The article takes its starting point from Aristotle’s knowledge triad of episteme, techne and phronesis, and further incorporates Flyvbjerg’s perspective on a phronetic knowledge, which is value-based, context-dependent, sensitive to power relations and grounded in practical experience. We argue that phronesis is important for making social science matter in practice, and that this holds in particular for socialwork.Thepraxis-basedknowledgeapproachcan offerawiser solution to the evidence – relevance dilemma by using a broader knowledge view and thereby taking practical relevance more seriously. This article pays particular attention to ways of making the extensive evaluation activity in social work more relevant and useful from a phronetic evaluation perspective.

    Keyword
    phronesis, episteme, evidence-based practice, praxis-based knowledge
    National Category
    Social Work
    Research subject
    Social Work
    Identifiers
    urn:nbn:se:oru:diva-42259 (URN)10.1093/bjsw/bcu020 (DOI)000359085500013 ()2-s2.0-84938313976 (Scopus ID)
    Available from: 2015-01-29 Created: 2015-01-29 Last updated: 2017-04-06Bibliographically approved
    3. Phronesis-Based Evaluation
    Open this publication in new window or tab >>Phronesis-Based Evaluation
    (English)Manuscript (preprint) (Other academic)
    National Category
    Social Work
    Identifiers
    urn:nbn:se:oru:diva-56964 (URN)
    Available from: 2017-04-06 Created: 2017-04-06 Last updated: 2017-04-06Bibliographically approved
  • Cajander, Sara
    Örebro University, School of Medical Sciences.
    Dynamics of Human Leukocyte Antigen-D Related expression in bacteremic sepsis2017Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Monocytic human leukocyte antigen-D related (mHLA-DR) expression determined by flow cytometry has been suggested as a biomarker of sepsisinduced immunosuppression.

    In order to facilitate use of HLA-DR in clinical practice, a quantitative real-time PCR technique measuring HLA-DR at the transcription level was developed and evalutated. Levels of HLA-DR mRNA correlated to mHLADR expression and were robustly measured, with high reproducibility, during the course of infection. Dynamics of mHLA-DR expression was studied during the first weeks of bloodstream infection (BSI) and was found to be dependent on the bacterial etiology of BSI. Moreover, mHLA-DR was shown to be inversely related to markers of inflammation. In patients with unfavourable outcome, sustained high C-reactive protein level and high neutrophil count were demonstrated along with low mHLA-DR expression and low lymphocyte count. This supports the theory of sustained inflammation in sepsis-induced immunosuppression. The association between mHLA-DR and bacterial etiology may be linked to the clinical trajectory via differences in ability to cause intractable infection. Staphylococcus aureus was the dominating etiology among cases with unfavourable outcome. With focus on patients with S. aureus BSI, those with complicated S. aureus BSI were found to have lower HLA-DR mRNA expression during the first week than those with uncomplicated S. aureus BSI. If these results can be confirmed in a larger cohort, HLA-DR measurement could possibly become an additional tool for early identification of patients who require further investigation to clear infectious foci and achieve source control.

    In conclusion, PCR-based measurement of HLA-DR is a promising method for measurements of the immune state in BSI, but needs further evaluation in the intensive care unit setting to define the predictive and prognostic value for deleterious immunosuppression. The etiology of infection should be taken into consideration in future studies of translational immunology in sepsis.

    List of papers
    1. Preliminary results in quantitation of HLA-DRA by real-time PCR: a promising approach to identify immunosuppression in sepsis
    Open this publication in new window or tab >>Preliminary results in quantitation of HLA-DRA by real-time PCR: a promising approach to identify immunosuppression in sepsis
    Show others...
    2013 (English)In: Critical Care, ISSN 1364-8535, E-ISSN 1466-609X, Vol. 17, no 5, R223Article in journal (Refereed) Published
    Abstract [en]

    Introduction: Reduced monocyte human leukocyte antigen (mHLA)-DR surface expression in the late phase of sepsis is postulated as a general biomarker of sepsis-induced immunosuppression and an independent predictor of nosocomial infections. However, traditional monitoring of mHLA-DR by flow cytometry has disadvantages due to specific laboratory requirements. An mRNA-based HLA-DR monitoring by polymerase chain reaction (PCR) would improve the clinical usage and facilitate conduction of large multicenter studies. In this study, we evaluated an mRNA-based HLA-DR monitoring by quantitative real-time PCR (qRT-PCR) as an alternative method to traditional flow cytometry.

    Methods: Fifty-nine patients with sepsis and blood culture growing pathogenic bacteria were studied. Blood samples were collected at day 1 or 2 after admission, for measurement of mHLA-DR by flow cytometry and mRNA expression of HLA-DRA and class II transactivator (CIITA) by qRT-PCR. Blood samples from blood donors were used as controls (n = 30).

    Results: A significant reduced expression of mHLA-DR, HLA-DRA, and CIITA was seen in septic patients compared with controls. HLA-DRA mRNA level in whole blood was highly correlated with surface expression of mHLA-DR.

    Conclusions: Patients with sepsis display a diminished expression of HLA-DR at the monocyte surface as well as in the gene expression at the mRNA level. The mRNA expression level of HLA-DRA monitored by qRT-PCR correlates highly with surface expression of HLA-DR and appears to be a possible future biomarker for evaluation of immunosuppression in sepsis.

    Place, publisher, year, edition, pages
    London, United Kingdom: BioMed Central, 2013
    National Category
    Medical and Health Sciences Clinical Laboratory Medicine
    Research subject
    Medicine
    Identifiers
    urn:nbn:se:oru:diva-34293 (URN)10.1186/cc13046 (DOI)000331540900039 ()24093602 (PubMedID)2-s2.0-84884967732 (Scopus ID)
    Note

    Funding Agencies:

    Nyckelfonden (Örebro, Sweden)

    Research committee of Örebro County Council

    Available from: 2014-03-13 Created: 2014-03-13 Last updated: 2017-04-25Bibliographically approved
    2. Quantitative Real-Time Polymerase Chain Reaction Measurement of HLA-DRA Gene Expression in Whole Blood Is Highly Reproducible and Shows Changes That Reflect Dynamic Shifts in Monocyte Surface HLA-DR Expression during the Course of Sepsis
    Open this publication in new window or tab >>Quantitative Real-Time Polymerase Chain Reaction Measurement of HLA-DRA Gene Expression in Whole Blood Is Highly Reproducible and Shows Changes That Reflect Dynamic Shifts in Monocyte Surface HLA-DR Expression during the Course of Sepsis
    Show others...
    2016 (English)In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 11, no 5, e0154690Article in journal (Refereed) Published
    Abstract [en]

    Introduction: A decrease in the expression of monocyte surface protein HLA-DR (mHLA-DR), measured by flow cytometry (FCM), has been suggested as a marker of immunosuppression and negative outcome in severe sepsis. However, FCM is not always available due to sample preparation that limits its use to laboratory operational hours. In this prospective study we evaluated dynamic changes in mHLA-DR expression during sepsis in relation to changes in HLA-DRA gene expression and Class II transactivator (CIITA), measured by quantitative Real-Time Polymerase Chain Reaction (qRT-PCR).

    Aims: The aims of this study were: 1. to validate the robustness of qRT-PCR measurement of HLA-DRA- and CIITA-mRNA expression, in terms of reproducibility; and 2. to see if changes in expression of these genes reflect changes in mHLA-DR expression during the course of severe and non-severe bacteraemic sepsis.

    Methods and Findings: Blood samples were collected from 60 patients with bacteraemic sepsis on up to five occasions during Days 1-28 after hospital admission. We found the reproducibility of the qRT-PCR method to be high by demonstrating low threshold variations (<0.11 standard deviation (SD)) of the qRT-PCR system, low intra-assay variation of Ct-values within triplicates (≤0.15 SD) and low inter-assay variations (12%) of the calculated target gene ratios. Our results also revealed dynamic HLA-DRA expression patterns during the course of sepsis that reflected those of mHLA-DR measured by FCM. Furthermore, HLA-DRA and mHLA-DR recovery slopes in patients with non-severe sepsis differed from those in patients with severe sepsis, shown by mixed model for repeated measurements (p<0.05). However, during the first seven days of sepsis, PCR-measurements showed a higher magnitude of difference between the two sepsis groups. Mean differences (95% CI) between severe sepsis (n = 20) and non-severe sepsis (n = 40) were; on day 1-2, HLA-DRA 0.40 (0.28-0.59) p<0.001, CIITA 0.48 (0.32-0.72) p = 0.005, mHLA-DR 0.63 (0.45-1.00) p = 0.04, day 7 HLA-DRA 0.59 (0.46-0.77) p<0.001, CIITA 0.56 (0.41-0.76) p<0.001, mHLA-DR 0.81 (0.66-1.00) p = 0.28.

    Conclusion: We conclude that qRT-PCR measurement of HLA-DRA expression is robust, and that this method appears to be preferable to FCM in identifying patients with severe sepsis that may benefit from immunostimulation.

    Place, publisher, year, edition, pages
    San Francisco, USA: Public Library of Science, 2016
    National Category
    Infectious Medicine
    Identifiers
    urn:nbn:se:oru:diva-50323 (URN)10.1371/journal.pone.0154690 (DOI)000375676400061 ()27144640 (PubMedID)
    Note

    Funding Agencies:

    Nyckelfonden (Örebro, Sweden)

    Research committee of Örebro County Council

    Available from: 2016-05-27 Created: 2016-05-16 Last updated: 2017-04-25Bibliographically approved
    3. Monocytic HLA-DR expression differs between bacterial etiologies and is inversely related to C-reactive protein and neutrophil count during the course of bloodstream infection
    Open this publication in new window or tab >>Monocytic HLA-DR expression differs between bacterial etiologies and is inversely related to C-reactive protein and neutrophil count during the course of bloodstream infection
    Show others...
    (English)Manuscript (preprint) (Other academic)
    National Category
    Family Medicine
    Identifiers
    urn:nbn:se:oru:diva-57488 (URN)
    Available from: 2017-04-25 Created: 2017-04-25 Last updated: 2017-04-25Bibliographically approved
    4. Expression of HLA-DRA and CD74 mRNA in whole blood during the course of complicated and uncomplicated Staphylococcus aureus bacteraemia
    Open this publication in new window or tab >>Expression of HLA-DRA and CD74 mRNA in whole blood during the course of complicated and uncomplicated Staphylococcus aureus bacteraemia
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    (English)Manuscript (preprint) (Other academic)
    National Category
    Family Medicine
    Identifiers
    urn:nbn:se:oru:diva-56198 (URN)
    Available from: 2017-03-08 Created: 2017-03-08 Last updated: 2017-04-25Bibliographically approved
  • Tolgfors, Björn
    Örebro University, School of Health Sciences.
    Bedömning för vilket lärande?: En studie av vad bedömning för lärande blir och gör i ämnet idrott och hälsa2017Doctoral thesis, monograph (Other academic)
    Abstract [en]

    This dissertation deals with the didactic consequences of assessment for learning (AfL) in the subject of physical education and health (PEH) at three upper secondary schools in Sweden. The purpose of the study is to investigate how assessment for learning is realised in PEH and what triadic relations between the teacher, student and subject content are established in the formative assessment practice. The empirical material consists of group reflections within a Teacher Learning Community (TLC) as well as field studies, including lesson observations and semi structured interviews with both students and teachers. In the first step of the analysis the material is categorized by means of the five key strategies (Wiliam, 2010a), in order to identify different ways of working with AfL in upper secondary PEH. The second step is a combination of a governmentality (Foucault, 1978/1991b), a performativity (Ball, 2003) and a didactic (Hudson, 2002) analysis, which illuminates what triadic relations are established under different conditions of governance.

    The findings highlight five fabrications of AfL in PEH, named after their most prominent features or functions, AfL as: i) Empowerment, ii) Physical Activation, iii) Grade Generation, iv) Constructive Alignment, v) Negotiation. ”Among the products of discursive practices are the very persons who engage in them” (Davies & Harré, 2001, p. 263). Accordingly, different teacher and student subjects as well as characteristics of the subject content are constituted in each of these fabrications.

    Moreover, the so called ‘backwash effect’ (Torrance, 2012) implies that the contrasting versions of AfL promote different kinds of learning, such as: i) increased autonomy, ii) participation in a community of practice, iii) criteria compliance, iv) acquisition of prescribed abilities, v) group development. However, the big idea of AfL is to adapt the teaching to the students and not the students to the knowledge requirements. Hence, this dissertation could serve as a basis for discussion on possible didactic implications of AfL in PEH.

  • Edberg, Karin
    et al.
    Södertörn University.
    Fransson, Anna-Lisa
    Örebro University, School of Humanities, Education and Social Sciences, Örebro University, Sweden.
    Elander, Ingemar
    Örebro University, School of Humanities, Education and Social Sciences, Örebro University, Sweden.
    Island and the Pipeline: Gotland Facing the Geopolitical Power of Nord Stream2017Report (Other academic)
    Abstract [en]

    In 2005, the Nord Stream Consortium launched a pipeline project with the intention to bring Russian natural gas to Germany across the Baltic Sea. Although this raised crucial issues of Russia-EU-Sweden relations on security, energy and the environment the focus of this report is on the Gotland local government response to the Nord Stream approach, thus illustrating the need for a transversal human geography-political studies perspective. Situated in the heart of the Baltic Sea, and in line with the established Swedish governmental "remiss" procedure of commission and referral for consideration the Gotland authority was requested by the Swedish Government to make a statement about the pipeline. How-ever, before the government was even asked for permission the Nord Stream Consortium with Russian Gazprom as the major shareholder turned to the Gotland authority with an offer they after some conflict-ridden twists and turns, manifested in three policy lines as described in the report, decided not to refuse. A narrative inspired analytical ap-proach is applied to dissect the more or less contradictory standpoints and legitimating arguments posed by the actors in the political process preceding the local authority decision to accept the Nord Stream offer, i.e. the local scale actors were provoked to take a stand on a big issue raised by a huge multinational company. By in detail examining the local political repercussions of the energy project the case study contributes to a trans-disciplinary understanding of multi-scalar/multi-level govern-ance. In an epilogue the report also highlights the sudden turnaround of the local narrative in autumn 2016 when Gotland Regional Authority was on the brink of making a deal with Nord Stream II. The turnaround flashlights the geopolitical position of the island in the crossfire of inter-ests concerning the Baltic Sea Region.

  • Sundqvist, Ann-Sofie
    Örebro University, School of Health Sciences.
    Perioperative patient advocacy: having the patient's best interests at heart2017Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Patient advocacy implies taking action on someone else’s behalf, and has been described as a key element of nurses’ professional care. In the perioperative setting, it involves not only critical decision making, but also all the small things that the nurses do for the sake of the patients during their working day. Since previous research on the advocacy role of a registered nurse anesthetist (RNA) is sparse, and has not been conducted in a Swedish context, this thesis was intended to contribute to a greater understanding of advocacy in the perioperative context. The overall aim was therefore to explore the characteristics and consequences of perioperative patient advocacy (Study I), and to describe RNAs’ views of advocacy in anesthetic nursing through interviews (Study II), a questionnaire (Study III), and observations (Study IV).

    The synthesis of the characteristics and consequences of perioperative patient advocacy was interpreted in this thesis as the RNAs having the patient’s best interests at heart, in that they (1) had control of the situation, (2) preserved human values, and finally (3) were emotionally affected, as the results from the four studies suggested this as the core of perioperative patient advocacy.

    Perioperative patient advocacy is not always perceived as easy. In praxis, it is linked to the code of ethics outlined by the International Council of Nurses, which states that all registered nurses, regardless of their working context, shall respect human rights, promote health, prevent illness, and ensure that the individual receives accurate and sufficient information. This thesis elaborates on how this is done by describing how RNAs exert perioperative patient advocacy and how they interact in order to facilitate the best possible care for the patient. The results deepen the understanding of perioperative patient advocacy from the RNA’s perspective and contribute to a new insight in the RNA’s professional role.

    List of papers
    1. Perioperative Patient Advocacy: An Integrative Review
    Open this publication in new window or tab >>Perioperative Patient Advocacy: An Integrative Review
    2016 (English)In: Journal of Perianesthesia Nursing, ISSN 1089-9472, E-ISSN 1532-8473, Vol. 31, no 5, 422-433 p.Article in journal (Refereed) Published
    Abstract [en]

    Purpose: The purpose of this review was to identify the characteristics and consequences of perioperative patient advocacy.

    Design: An integrative review method was employed.

    Methods: A database search to identify peer-reviewed articles that focused on perioperative patient advocacy was conducted in PubMed and CINAHL, followed by a manual search for additional articles. Studies were selected if they reported original empirical research findings with regard to perioperative patient advocacy. The data abstraction and synthesis were achieved with an inductive qualitative content analysis.

    Finding: The analysis resulted in seven categories, two subthemes, and one main theme. The main theme, “Doing good for another human being—a balancing act between philanthropy and personal gratification,” was the core of perioperative patient advocacy.

    Conclusion: Perioperative patient advocacy is part of the professional role of the perioperative nurse, and it affects the perioperative nurse emotionally. This advocacy shares similarities with descriptions of patient advocacy in general nursing.

    Place, publisher, year, edition, pages
    New York, USA: Elsevier, 2016
    Keyword
    Advocacy, integrative review, perioperative nursing
    National Category
    Nursing
    Research subject
    Caring sciences
    Identifiers
    urn:nbn:se:oru:diva-49820 (URN)10.1016/j.jopan.2014.12.001 (DOI)000385340100010 ()27667349 (PubMedID)2-s2.0-84962502652 (Scopus ID)
    Projects
    Anestesisjuksköterskan, patientens advokat
    Note

    Funding Agencies:

    Örebro University

    Research Committee at Örebro County Council, Örebro, Sweden OLL-426621

    Available from: 2016-04-14 Created: 2016-04-14 Last updated: 2017-04-24Bibliographically approved
    2. Holding the patient's life in my hands: Swedish registered nurse anaesthetists' perspective of advocacy
    Open this publication in new window or tab >>Holding the patient's life in my hands: Swedish registered nurse anaesthetists' perspective of advocacy
    2014 (English)In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 28, no 2, 281-288 p.Article in journal (Refereed) Published
    Abstract [en]

    Background: Anaesthesia often induces a state of unconsciousness that includes inability to communicate and influence the situation. The patient has to rely on the nurse anaesthetist to speak up for her/him as well as maintain her/his dignity and safety. Consequently, the nurse anaesthetist can be likened to the patient's advocate.

    Aim: The aim of the study was to describe advocacy in anaesthesia care during the perioperative phase from the perspective of the registered nurse anaesthetist.

    Method: Data for this qualitative descriptive study were collected during March and April, 2011. Individual interviews were conducted with a purposive sample of 20 nurse anaesthetists from two hospitals in Sweden. The audio-taped interviews were transcribed verbatim and analysed by means of qualitative content analysis.

    Findings: The main theme, Holding the patient's life in my hands, described the nurse anaesthetists' perception of advocacy and comprised three subthemes: providing dignified care, providing safe care and a moral commitment.

    Conclusion: Acting as the patient's advocate includes important health and well-being issues and could be stressful for the nurse anaesthetists'. A work environment where the nurse anaesthetists' can make their voices heard and feel that their opinion regarding the patient's best interests is taken seriously would be desirable, as all health professionals should ideally focus on those in their care.

    Place, publisher, year, edition, pages
    Hoboken: Wiley-Blackwell, 2014
    Keyword
    advanced practice nursing, nurse anaesthetist, advocacy, content analysis, nursing
    National Category
    Nursing
    Research subject
    Caring sciences
    Identifiers
    urn:nbn:se:oru:diva-34993 (URN)10.1111/scs.12057 (DOI)000334503400009 ()23713584 (PubMedID)2-s2.0-84898893862 (Scopus ID)
    Available from: 2014-05-09 Created: 2014-05-09 Last updated: 2017-04-24Bibliographically approved
    3. Protective Nursing Advocacy: Translation and Psychometric Evaluation of an Instrument and a Descriptive Study of Swedish Registered Nurse Anesthetists' Beliefs and Actions
    Open this publication in new window or tab >>Protective Nursing Advocacy: Translation and Psychometric Evaluation of an Instrument and a Descriptive Study of Swedish Registered Nurse Anesthetists' Beliefs and Actions
    2017 (English)In: Journal of Perianesthesia Nursing, ISSN 1089-9472, E-ISSN 1532-8473Article in journal (Refereed) Epub ahead of print
    Abstract [en]

    Purpose: To translate and adapt the Protective Nursing Advocacy Scale (PNAS) into a Swedish version (PNAS-Swe), evaluate its psychometric properties, and describe registered nurse anesthetists' (RNAs) advocacy beliefs and actions from a protective perspective.

    Design: A cross-sectional design was used.

    Methods: First, the PNAS was translated into Swedish. Next, the content and construct validity of the PNAS four subscales was evaluated. Finally, the PNAS-Swe was used to describe Swedish RNA beliefs and actions regarding protective nursing advocacy.

    Finding: The final PNAS-Swe has 29 items in four subscales. The RNAs reported that they feel that they should provide protective nursing advocacy for their patients. There were no differences in gender, or associations with age, or work experience regarding their advocacy beliefs or actions.

    Conclusions: The PNAS-Swe is valid for use in a Swedish context. Protective nursing advocacy is important to the RNAs, which is in congruence with earlier qualitative studies.

    Place, publisher, year, edition, pages
    WB Saunders, 2017
    Keyword
    nursing advocacy, Protective Nursing Advocacy Scale, psychometrics, Rasch analysis
    National Category
    Nursing
    Research subject
    Caring Sciences w. Medical Focus
    Identifiers
    urn:nbn:se:oru:diva-57127 (URN)10.1016/j.jopan.2016.10.002 (DOI)
    Available from: 2017-04-20 Created: 2017-04-20 Last updated: 2017-04-24Bibliographically approved
    4. Registered nurse anaesthetists practicing of perioperative patient advocacy: an observational study
    Open this publication in new window or tab >>Registered nurse anaesthetists practicing of perioperative patient advocacy: an observational study
    (English)Manuscript (preprint) (Other academic)
    National Category
    Other Health Sciences
    Identifiers
    urn:nbn:se:oru:diva-57177 (URN)
    Available from: 2017-04-24 Created: 2017-04-24 Last updated: 2017-04-24Bibliographically approved