Non-invasive assessment of cerebral perfusion pressure : Applied towards preoperative planning of aortic arch surgery with selective antegrade cerebral perfusion

Selective antegrade cerebral perfusion (SACP) is a protective procedure to ascertain adequate brain perfusion during aortic arch surgeries requiring moderate hypothermic circulatory arrest. SACP entails catheterization of arteries feeding the brain, which can be done bilaterally (bSACP) or unilaterally (uSACP), but there is no consensus on when to use each approach. bSACP may increase the risk of embolization, while uSACP risks hypoperfusion due to insufficient perfusion pressure in the contralateral hemisphere, since a single catheter must perfuse both hemispheres. We developed and tested the feasibility of a new method for predicting cerebral perfusion pressures (CPP) during SACP, which could potentially aid clinicians in preoperatively identifying which SACP approach to use. Feasibility of the method was evaluated in five patients eligible for aortic arch surgery (65 ± 7 years, 3 men). Patients were investigated preoperatively with computed tomography angiography (CTA) and 4D flow magnetic resonance imaging (MRI) to assess patient-specific arterial anatomy and blood flows. From the imaging, computational fluid dynamics (CFD) simulations estimated the patients' vascular resistances. Applying these resistances and intraoperative SACP pressure/flow settings to the model's boundary conditions allowed for predictions of contralateral CPP during SACP. Predicted pressures were compared to corresponding intraoperative pressure measurements. The method showed promise for predicting contralateral CPP during both uSACP (median error (range): 2.4 (−0.2–18.0) mmHg) and bSACP (0.8 (−3.3–5.4) mmHg). Predictions were most sensitive to collateral artery size. This study showed the feasibility of CPP predictions of SACP, and presents key features needed for accurate modelling

From a national people's community to a European cultural community : an ideological analysis of Per Engdahl 1930–1968

This dissertation presents an ideological analysis based on the writings of the Swedish political thinker Per Engdahl (1909–1994). Engdahl is known for establishing the New-Swedish movement and developing an ideology called New-Swedishness. Previous studies have described Engdahl as a fascist or even a Nazi, but he has seldom been the primary object of study, and his ideology has rarely been subjected to further analysis. Therefore, the aim of this dissertation is to analyze and classify Engdahl's ideology from the early 1930s to 1968. This period encompasses the interwar period, the Second World War, and the post-war era. Thus, the study addresses the reformulation of fascism into neo-fascism in the wake of the Second World War. The analysis of Engdahl's ideology is inspired by Michael Freeden's theoretical model of how ideologies are constructed as configurations of political concepts. The study is based on an analysis of Engdahl's political writings and is divided into two parts. The first part, covering the period 1930–1945, examines the main concepts of Engdahl's ideology and discusses them in relation to theories of interwar fascism. Engdahl created an ideology that was a unique Swedish form of interwar fascism centered on the idea of creating a national people's community. In the second part of the dissertation, which covers the period 1945–1968, there is a significant reformulation of the ideology from fascism to neo-fascism. This development involved a reduction in anti-Semitic rhetoric, and the replacement of the concept of “race” with “culture”. In the post-war era Engdahl shifted his focus from a national perspective to a European perspective and founded the Europäische Soziale Bewegung (European Social Movement), a network for European neo-fascists. During this period, the focus of Engdahl's ideology consequently shifted from a national people's community to a European cultural community

A participatory process in all aspects? : Negotiating agreements within Swedish healthcare

This article deals with agreements within healthcare in Sweden, a unitary state where responsibility for healthcare is decentralized to 21 regions with self-rule. The agreements are concluded by the central government and the Swedish Association of Local Authorities and Regions (SALAR). The literature categorizes agreements as a ‘soft’ policy instrument with participation as a crucial aspect. We investigate the process behind the agreements and focus on the participation of SALAR. Our material consists of interviews with respondents of SALAR and the Ministry of Health and Social Affairs. The findings suggest that the process is participatory, but not in all aspects. Differences are noticed during various phases. A conclusion is that the power relationship between the central government and SALAR is unequal. The results contribute to a more nuanced understanding of central–local relations in the era of multi-level governance, highlighting a power hierarchy

History teaching in a time of migration marked diversity : teachers’ didactical considerations

By exploring the didactical considerations of experienced teachers, the overarching aim of this dissertation is to contribute knowledge about what contemporary migration marked diversity in schools means for history teaching. This is done through two sub-studies and semi-structured interviews with 20 teachers at the lower and upper secondary levels. The methodological foundation of the dissertation is a reflexive thematic analysis, and its primary analytical tool is educational philosopher Gert Biesta’s educational functions: qualification, socialization, and subjectification. In three empirical chapters, different dimensions of teachers’ didactical considerations in classrooms characterized by migration- marked cultural and ethnic diversity are addressed. The focus is on teachers’ teaching intentions, perceived opportunities and challenges, and strategies.This dissertation shows that teachers’ descriptions within the framework of seemingly similar intentions might mean different things. Two clusters of functional intentions emerge within a field of tension. This tension is most evident between socialization and subjectification, and within the domain of qualification. The results show that teachers’ perceptions of the significance of migration marked diversity signal more than value judgments. Opportunities and challenges emerge in both overarching and specific ways, constructed in relation to different (functional) intentions. A central result of the thesis consists of 10 strategies that reflect teachers’ ideas on how to handle challenging circumstances related to teaching history in classrooms characterized by migration marked diversity. The strategies show that teachers exhibit a wide range of ideas on how to overcome specific contextual challenges, with several ideas reminiscent of strategies identified in previous research. However, some of the strategies reflect approaches that have not been prominently featured in previous research. For example, the limitation of content can occur in a covert or open manner in an interaction or confrontation with students, and teachers’ ideas about accommodating diverse and conflicting voices are carried out with different functional intentions. Another result is that there are tensions between history didactical considerations and approaches suitable from a language didactical perspective. According to some teachers, situating teaching close to a history with which students have an emotional relationship can create poorer conditions for students to develop the critical skills that are requested. In other cases, teachers see it as advantageous to situate teaching close to students’ history, as reference knowledge can make it easier to contextualize.While previous research has described a “deficit discourse” – where equivalence is drawn between perceptions of the “immigrant student” and the “problem student” – teacher statements within this study does not entirely support such a discourse. This result has specific connections to history didactics. In relation to specific intentions, such as qualifying students’ understanding of the use of history, the lack of reference knowledge regarding European history among some students can be perceived as a learning opportunity for all students, illustrating how opportunities are constructed in relation to teaching intentions. This dissertation highlights the patchwork of (functional) intentions that teachers collectively attribute to their teaching, often in close contact with what they perceive to be the students’ needs

Challenges and opportunities related to online studies in higher education

Technological and societal developments have increasingly led to higher education programs and courses being offered online as distance education. This can mean an opportunity to study regardless of time and place and thereby combining work, family life, and studies. However, online distance studies also introduce problems at the societal, organisational and individual levels. Due to the rapid transformation of the higher education system towards a larger share of digitalized courses and programs, one can expect that the related problems will also increase. Thus, the present study aimed to investigate experiences and thoughts about challenges and opportunities related to online studies among second-semester master’s students. Data was collected via interviews and analysed using a phenomenographic approach. The analysis revealed increased demands on the student, remote communication and social interaction, and varying conditions for studying from home. The demands on self-leadership, social skills, and digital competence had increased compared to previous campus-based studies at a lower level. These findings pinpoint the importance of taking into consideration student awareness and support regarding self-regulation of study planning, time allocation, and execution of assignments. It also includes teacher awareness of creating a sense of community and avoiding a mere task orientation despite the online context

Kvinnlig konstnär, manlig akt : Manskroppen i konsthistorien och den kvinnliga blicken i samtiden

This study explores representations of the male nude in art history, as well as women artists who, historically, have had the male nude as their main motif. The female nude, unlike its counterpart, has been relentlessly studied and documented throughout art history, ever shaped and presented through the male gaze. The female nude is today regarded as artistic canon in a way that the male nude arguably is not. Thus one of the aims of this study is to explore if and when the male nude has been regarded in a similar way to its female counterpart in different artistic eras and movements, and whether that has any significance on the representations of men we see in art today.   In contemporary art and media a retaliation against the male gaze has been formed; the female gaze. What the female gaze entails has not yet been clearly defined though, as it hasn’t gained traction outside of social media, magazines and popular culture as of yet. However, contemporary women artists who have the male nude or the male body in general as their main motif may give us a clue as to what the female gaze may mean in art. Another aim of this study is thus to explore how the female gaze can be understood in reference to three contemporary women artists who depict the male body in their works.

FOOD INTRODUCTION IN THE FIRST YEAR OF LIFE : Results from dietary questionnaire in the NorthPop study

Bakgrund Under barnets två första levnadsår befinner sig barnet i en sensitiv period där smakinlärning och upprepad exponering kan ligga till grund för hälsosamma matvanor. Livsmedel kan introduceras i pyttesmå smakportioner till intresserade barn som utökas i mängd med den stigande åldern för att tillgodose barnets tillväxt och utveckling. Introduktion av livsmedel med olika smaker, texturer och näringsinnehåll samt allergena livsmedel bör introduceras under barnets första levnadsår. Livsmedelsintroduktion har tidigare studerats i Sverige men introduktion och matvanor förändras i takt med samhällsutvecklingen och bör därav studeras kontinuerligt. Genom den populationsbaserade NorthPop studien kan matintroduktionen undersökas hos små barn.   Syfte Att undersöka vilka livsmedel som introduceras under barns första levnadsår. Metod En kvantitativ metod användes baserat på insamlade webbaserade kostfrågeformulären vid nio och 18 månaders ålder för 4915 barn från NorthPop under åren 2016–2023 i Västerbottens län. Data redovisades deskriptivt och skillnader mellan grupper analyserades med hjälp av Mann-Whitney U-test.   Resultat Introduktion av livsmedel skedde i alla åldersintervall, men som mest i åldersintervallet 4–6 månader. Högst introducerade livsmedel var frukt/bär, färdig-/pulvergröt, potatis och grönsaker/rotsaker i åldersintervallet 0–3 månader (2,3–6,2%) respektive 4–6 månader (86,3–90,3%). I åldersintervallet 7–9 månader var naturell fil/yoghurt, ägg och ris (33,7 - 36,4%) som högst introducerat. Lätt- & mellanmjölk, söta kex, kakor eller bullar och hårt bröd introducerades som högst i åldersintervallet 10–12 månader (14,8–18,3%). Lägst introduktion skedde av paranötter (4,2%), sojadryck (7,7%), sojagurt (8,9%) och godis eller liknande sötsaker (10,5%). Det var ingen skillnad i introduktion av potatis, ris, fisk och grönsaker/rotfrukter mellan flickor och pojkar eller mellan barn med syskon och barn utan syskon.   Slutsats En stor del av de efterfrågade livsmedel introducerades mellan fyra och nio månaders ålder. Potatis, grönsaker/rotfrukter, pasta och frukt/bär var vanligaste att introducera under det första levnadsåret. Introduktion av livsmedel påverkades inte av kön eller syskon vilket ansågs positivt. Större delen av vårt resultat överensstämmer med Livsmedelverkets råd och rekommendationer avseende livsmedelsintroduktion.  

Exploratory space for whom? : children's opportunities for subject-related learning in early childhood education and care

In this article we explore how children's opportunities for subject-related learning in Nordic early childhood education and care (ECEC) depend on intra-actions between the physical environment, gender norms, and the relevant learning content. We apply a socio-material perspective and draw on three Swedish ECEC studies, in which the learning content was related to physics, dance, and environmental sustainability, respectively. The analyses illustrate how socio-material intra-actions encouraged or impeded certain bodily encounters, thereby encouraging or impeding certain kinds of subject-related learning

Inclusive policies and practices in higher education : a systematic literature review

This systematic literature review examines research on inclusive policies and practices in higher education institutions published between 2001 and 2021. Six electronic databases (ERIC, Emerald, Web of Science, Wiley Online, Taylor & Francis Online, and Sage journal) were searched. Forty-three articles met the inclusion criteria and were included in this review. The results suggest that the number of studies on inclusive policies and practices in higher education is gradually increasing. Research on inclusion in higher education primarily focuses on policies, practices and accessibility. Studies reviewed delve into national, regional and university-level policies. Practices mainly related to curriculum, teaching and learning, and accessibility. The curriculum was projected as critical in facilitating inclusive practices in higher education. The curriculum must be learner-centred, promote collaboration, use flexible assessment, and provide individual course guides and flexible and expanded learning opportunities for all students. Teaching must be differentiated, use multi-methods and assessments, and be orchestrated in a conducive atmosphere. Accessibility in terms of physical structures, social environment, attitudinal and digital provision was critical to ensure the inclusion of people who identified as disabled. The findings culminate in the development of an inclusive higher education framework. Implications for research and practice in higher education are highlighted

Beyond forensic psychiatric care : support and risk in the lives of former patients

Rättspsykiatrisk vård representerar ett av samhällets mest extrema ingrepp och innebär ofta långa perioder av frihetsberövande. Trots detta vet vi förvånansvärt lite om vad som händer med de tidigare patienterna efter att deras vård avslutas. Denna avhandling undersöker livet för tidigare rättspsykiatriska patienter, med fokus på deras livssituation. Patienter inom rättspsykiatrin är ofta män med diagnosen schizofreni och har en historia av psykisk ohälsa, kriminalitet och missbruk redan före det brott som ledde till deras vård. Efter utskrivning är de en mycket sårbar grupp som kräver omfattande stöd från olika samhällsinstanser. Det är dock oklart vilken typ av stöd de får och hur effektivt detta stöd är. Sverige har en unik möjlighet att studera dessa frågor, tack vare sina omfattande nationella register med detaljerad information om vård och samhälleliga insatser. Avhandlingen baseras på data från 1 150 personer som skrevs ut från rättspsykiatrisk vård mellan 2009 och 2018. Resultaten visar att hur livet ser ut efter vård skiljer sig mycket åt mellan olika grupper av tidigare patienter. Den största gruppen, som utgör mer än hälften av patienterna, fick omfattande samhällsstöd, inklusive ekonomiskt bistånd, boende bemannat med personal och god man eller förvaltare. Dessa individer uppvisade generellt låga nivåer av återfall i brott och missbruk efter utskrivning. Andra grupper mötte större utmaningar, särskilt de med omfattande behov av psykiatrisk vård. En mindre andel hade mer stabila livssituationer, där vissa var sysselsatta i arbetslivet och andra levde i familjekonstellationer. Dessa grupper hade låga nivåer av återfall och mindre vårdbehov. Resultaten understryker vikten av att anpassa insatser efter individens specifika behov och förutsättningar. En annan central fråga som studerades var avbrott av läkemedelsbehandling. Mer än hälften av de tidigare patienterna avslutade sin medicinering inom två år efter utskrivning. Faktorer som stödde fortsatt medicinering inkluderade att ha en god man eller förvaltare samt att bo i ett boende bemannat med personal. Resultaten belyser vikten av strukturerat stöd även efter att vården avslutats. Avhandlingen visar också att återfall i brott är relativt ovanligt i denna grupp jämfört med personer som avtjänat fängelsestraff, även om vissa faktorer ökar risken. Cirka 14 procent av patienterna dömdes för nya brott under uppföljningsperioden. Endast ett fåtal av dessa nya brott innebar allvarligt våld. Tidigare kriminalitet, missbruk och yngre ålder ökade risken för återfall, medan högre ålder, att ha god man eller förvaltare och boende bemannat med personal var skyddande faktorer. Sammantaget visar resultaten att sociala faktorer, såsom boende bemannat med personal och formaliserat juridiskt stöd, spelar en avgörande roll för att minska återfall och främja stabilitet. Samhällsstöd verkar vara nödvändigt för att kompensera för de utmaningar som denna grupp möter. Samtidigt försvårar historiska riskfaktorer som tidigare kriminalitet och missbruk arbetet med att förebygga återfall. Trots dessa svårigheter är det uppenbart att både rättspsykiatrisk vård och det stöd som ges efter utskrivning är av stor betydelse för många. Det finns dock ett behov av fortsatt forskning för att fördjupa förståelsen för patienternas upplevelser och vilken roll både formellt och informellt stöd har för att förbättra deras livssituation.Forensic psychiatric care represents one of society’s most extreme interventions, often involving extended periods of deprivation of liberty. Despite this, we know surprisingly little about what happens to individuals after their care ends. This dissertation explores the lives of former forensic psychiatric patients, focusing on their life situations. Patients in forensic psychiatric care are often men diagnosed with schizophrenia, with a history of mental illness, criminality, and substance abuse even before the offense that led to their care. After discharge, they are a highly vulnerable group requiring extensive support from various societal institutions. However, it remains unclear what kinds of support they receive and how effective these interventions are. Sweden is uniquely positioned to study these issues, thanks to its extensive national registers containing detailed data on healthcare and societal interventions. This dissertation is based on data from 1,150 individuals discharged from forensic psychiatric care between 2009 and 2018. The findings show that what life looks like after care varies greatly among different subgroups of former patients. The largest group, comprising over half of the patients, received significant societal support, including financial assistance, supported housing with staff, and other formalized help. These individuals generally had low levels of criminal recidivism and post-discharge substance abuse. Other groups faced greater challenges, particularly those with high general psychiatric care needs. A smaller proportion had more stable life situations, with some engaged in employment and others living in family settings. These groups showed low levels of reoffending and care needs. These findings highlight the importance of tailoring interventions to each individual’s needs and circumstances. Another significant area studied was medication discontinuation. Over half of the former patients discontinued their medications within two years of discharge. Factors that supported continued medication use included having a legal guardian or trustee and living in a supported housing arrangement. These results emphasize the importance of structured support even after patients are discharged from care. The dissertation also shows that recidivism is relatively uncommon in this group compared to former prisoners, although certain factors increase the risk. About 14 percent of patients were convicted of new crimes during the follow-up period. Very few new offenses involved serious violence. Prior criminality, substance abuse, and younger age increased the risk of reoffending, while older age, a trustee/limited guardian, and housing supported by staff were protective factors. Overall, the findings demonstrate that social factors, such as supported housing and legal representation, play a critical role in reducing reoffending and promoting stability. Societal support is seemingly essential to compensate for the challenges faced by this group. At the same time, historical risk factors such as previous criminality and substance abuse complicate efforts to prevent reoffending. Despite these challenges, it is evident that both forensic psychiatric care and the support provided after discharge are important for many. However, there remains a need for further research to deepen the understanding of patients’ lived experiences and the role of both formal and informal support in improving their life situations