10 research outputs found

    The view of collaboration : A qualitative study on interorganizational collaboration of mental ill-health between social services, child and adolescent psychiatries and school

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    Denna studie undersöker hur samverkan upplevs fungera mellan skola, socialtjĂ€nst och Barn-och ungdomspsykiatri (BUP) som möter barn med psykisk ohĂ€lsa i samverkansmöten. Studien bygger pĂ„ sex semistrukturerade intervjuer med tvĂ„ skolkuratorer, tvĂ„ socialsekreterare samt tvĂ„ kuratorer frĂ„n BUP. Empirin har analyserats med innehĂ„llsanalys och har dĂ€refter tolkats genom Sociala representationer och Institutionell teori. Resultatet bestĂ„r av kategorierna Möjligheter med samverkan, SvĂ„righeter med samverkan, Ansvarsfördelning, SĂ€tt att frĂ€mja samverkan och sist Sociala representationer. Resultatet visade att det som fungerade bra med samverkan var att det fanns tydliga rutiner och ansvarsomrĂ„den samt att aktörerna lĂ€rde sig om varandras professioners sĂ€tt att tĂ€nka utifrĂ„n deras olika kompetenser. Resultatet visade att det inte existerade nĂ„gon maktobalans mellan professionerna men att det kunde förekomma i deras handlingsförmĂ„ga. Det som kunde pĂ„verka samverkan negativt var resurshinder inom de olika organisationerna. Intervjupersonernas synsĂ€tt om varandra var positivt i övergripande bemĂ€rkelse och det framkom att det fanns Ă„sikter om varandra som pĂ„verkade samverkan positivt. Slutsatsen Ă€r att samverkan genom samordnad individuell plan (SIP) haft en positiv utveckling för samverkan, dĂ„ den gett möjlighet att trĂ€ffas och fĂ„ kĂ€nnedom om varandras organisationer, kompetenser och ansvarsomrĂ„den. Aktörernas olika organisatoriska förutsĂ€ttningar ledde ofta till att det uppstod olika tolkningar om hur ett socialt problem skulle tolkas och lösas, vilket bidrog positivt till en helhetsbild av en klients situation.This study aims to investigate how the collaboration between Social services, Child and adolescent psychiatry (BUP) and School are being perceived regarding children with mental ill-health. The study is based upon six semi-structured interviews with two school social workers, two social service workers and two counselors from BUP. The results has been analysed with content analysis and thereafter interpreted through Social representations and Institutional theory. The emerging categories were: Possibilities with collaboration, Difficulties with collaboration, Responsibility distribution, Ways to improve collaboration and Social representations. The results showed that what was perceived as a positive collaboration was distinctive routines, clear areas of responsibility and to learn about each of the professions way of thinking, as they have different expertise. The results also showed that it did not exist a balance of power, but that it could affect their professional ability to act. What could affect the collaboration negatively was the difficulty of resource management within the organizations. The view the participants had of each other was generally positive, and it did exist thoughts of each other in some way affecting the collaboration. The conclusion is that collaboration through Specialized individual plan (SIP) has had a positive effect, as it has given the opportunity for professionals to meet and get knowledge about each other’s organizations, competences and areas of responsibility. The participants different organizational conditions often led to different interpretations on how a social problem should be interpreted and solved, which contributed positively to an overall picture regarding a client’s situation

    Registered nurses experience of working with oral health and oral care in municipality care : a qualitative interview studya qualitative interview study

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    Bakgrund: Fysiska och kognitiva handikapp kan leda till minskad förmĂ„ga att klara sin munvĂ„rd och risken att drabbas av ohĂ€lsa i munnen ökar. Omsorgspersonal har bristande kunskaper inom munhĂ€lsa och munvĂ„rden prioriteras lĂ€gre Ă€n andra omvĂ„rdnadsĂ„tgĂ€rder. Sjuksköterskan Ă€r ytterst ansvarig för omvĂ„rdnaden men det saknas studier om hur sjuksköterskor arbetar med munhĂ€lsa inom kommunal hĂ€lso- och sjukvĂ„rd. Syftet med studien var att undersöka sjuksköterskors erfarenhet av att arbeta med munhĂ€lsa och munvĂ„rd i kommunal hĂ€lso- och sjukvĂ„rd. Metoden som anvĂ€ndes var en kvalitativ innehĂ„llsanalys med induktiv ansats med en fokusgruppsintervju samt sju enskilda intervjuer. Resultat: Tre kategorier identifierades: MunhĂ€lsa Ă€r att frĂ€mja hĂ€lsa, Arbetar med munhĂ€lsa vid egenvĂ„rdsbrist och Aktörer i omvĂ„rdnadssystemet. Slutsats: De intervjuade sjuksköterskorna ansĂ„g att munhĂ€lsa Ă€r nĂ„got sjĂ€lvklart och att det Ă€r viktigt att vĂ€rna om patientens egenvĂ„rd och integritet. I arbetet med kvalitetsregister ökade sjuksköterskornas delaktighet i munhĂ€lsoarbetet men de arbetade frĂ€mst med munhĂ€lsa först nĂ€r ett problem uppstĂ„tt. Stort fokus lades pĂ„ munhĂ€lsa och munvĂ„rd hos palliativa patienter medan arbetet med munhĂ€lsa kunde bli lidande hos patienter som till viss del sköter sig sjĂ€lva. För att förbĂ€ttra munhĂ€lsan, hos patienter i den kommunala hemsjukvĂ„rden, finns ett behov av ökad kunskap hos bĂ„de omsorgspersonal och sjuksköterskor, bĂ€ttre rutiner och ökat samarbete med tandvĂ„rden.Background: Physical and cognitive disabilities may affect patients’ ability to cope with oral health and increase the risk of suffering from illness in the mouth. Studies show that staff in municipality provided care have poor knowledge in oral health and that oral health is less prioritized than other nursing interventions. Registered Nurses (RN) have the ultimate responsibility for providing care but there are few studies that describe how nurses experience working with oral health. Aim: To examine the experience of RN’s with regards to oral health and oral care in municipal health care. Method: A qualitative content analysis with an inductive approach including one focus group discussion, with five RN’s participating, and seven patientual interviews. Results: Three categories were identified: Oral health promotes general health, Works with oral health when self-care deficit and Agents in the nursing system. Conclusion: The RN’s believed that oral health is self-evident and that it is important to safeguard the patient's self-care and integrity. When working in quality registers, the RN participation in oral health work increase, but they primarily work with oral health when a problem arises. Great focus was placed on oral health and oral care in palliative patients, but the work with oral health could be suffering in patients who to some extent manage themselves. To improve oral health, the study showed that there is a need for more education for health care workers providing municipality care and RN’s, there is also a need for better routines and better collaboration with the dental care

    LĂ€sutveckling : En studie av elever i Ă„r 4

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    Syftet med vĂ„r studie var att undersöka, analysera och diskutera lĂ€rarens, elevers och förĂ€ldrars medvetenhet och engagemang om elevernas progression inom lĂ€sinlĂ€rningen. Analys och slutsatser byggde vi pĂ„ vĂ„ra resultat och modern forskning om barns sprĂ„kinlĂ€rning. Detta gjorde vi med hjĂ€lp av en klass bestĂ„ende av 1 lĂ€rare, 19 elever och deras förĂ€ldrar. Vi anvĂ€nde oss av kartlĂ€ggningsmetoderna God LĂ€sutveckling och Ordkedjor, enkĂ€ter och intervju. Resultatet av vĂ„r studie visade att kartlĂ€ggningsmetoden var betydelsefull, men metodvalet inte var det avgörande för lĂ€sutvecklingen hos eleverna. Av stor vikt var lĂ€rarens medvetenhet och engagemang runt eleven och uppmuntran frĂ„n förĂ€ldrar. Detta genererade elever som fann lust och meningsfullhet till lĂ€randet och pĂ„ sĂ„ sĂ€tt ökade sin progression. The purpose of our study was to investigate, analysis and discuss the teacher’s, the pupils’ and the parents’ awareness and involvement in pupils’ progression in reading development. The analysis and the conclusion were built on our results and modern research about children’s reading development. We did this with help from a school class, consisting of 1 teacher, 19 pupils’ and their parents’. In this study we used God LĂ€sutveckling and Ordkedjor (method of assessment), questionnaires and one interview. The result of our study shows that a method of assessment is a very important tool, but the selection of what method was not the important issue for pupils reading development. The important issue was the teachers’ awareness and the involvement around the pupils’ and encouraging parents’. All this together generated pupils with confidence, this lead to meaningful learning and increased progression

    Registered nurses experience of working with oral health and oral care in municipality care : a qualitative interview studya qualitative interview study

    No full text
    Bakgrund: Fysiska och kognitiva handikapp kan leda till minskad förmĂ„ga att klara sin munvĂ„rd och risken att drabbas av ohĂ€lsa i munnen ökar. Omsorgspersonal har bristande kunskaper inom munhĂ€lsa och munvĂ„rden prioriteras lĂ€gre Ă€n andra omvĂ„rdnadsĂ„tgĂ€rder. Sjuksköterskan Ă€r ytterst ansvarig för omvĂ„rdnaden men det saknas studier om hur sjuksköterskor arbetar med munhĂ€lsa inom kommunal hĂ€lso- och sjukvĂ„rd. Syftet med studien var att undersöka sjuksköterskors erfarenhet av att arbeta med munhĂ€lsa och munvĂ„rd i kommunal hĂ€lso- och sjukvĂ„rd. Metoden som anvĂ€ndes var en kvalitativ innehĂ„llsanalys med induktiv ansats med en fokusgruppsintervju samt sju enskilda intervjuer. Resultat: Tre kategorier identifierades: MunhĂ€lsa Ă€r att frĂ€mja hĂ€lsa, Arbetar med munhĂ€lsa vid egenvĂ„rdsbrist och Aktörer i omvĂ„rdnadssystemet. Slutsats: De intervjuade sjuksköterskorna ansĂ„g att munhĂ€lsa Ă€r nĂ„got sjĂ€lvklart och att det Ă€r viktigt att vĂ€rna om patientens egenvĂ„rd och integritet. I arbetet med kvalitetsregister ökade sjuksköterskornas delaktighet i munhĂ€lsoarbetet men de arbetade frĂ€mst med munhĂ€lsa först nĂ€r ett problem uppstĂ„tt. Stort fokus lades pĂ„ munhĂ€lsa och munvĂ„rd hos palliativa patienter medan arbetet med munhĂ€lsa kunde bli lidande hos patienter som till viss del sköter sig sjĂ€lva. För att förbĂ€ttra munhĂ€lsan, hos patienter i den kommunala hemsjukvĂ„rden, finns ett behov av ökad kunskap hos bĂ„de omsorgspersonal och sjuksköterskor, bĂ€ttre rutiner och ökat samarbete med tandvĂ„rden.Background: Physical and cognitive disabilities may affect patients’ ability to cope with oral health and increase the risk of suffering from illness in the mouth. Studies show that staff in municipality provided care have poor knowledge in oral health and that oral health is less prioritized than other nursing interventions. Registered Nurses (RN) have the ultimate responsibility for providing care but there are few studies that describe how nurses experience working with oral health. Aim: To examine the experience of RN’s with regards to oral health and oral care in municipal health care. Method: A qualitative content analysis with an inductive approach including one focus group discussion, with five RN’s participating, and seven patientual interviews. Results: Three categories were identified: Oral health promotes general health, Works with oral health when self-care deficit and Agents in the nursing system. Conclusion: The RN’s believed that oral health is self-evident and that it is important to safeguard the patient's self-care and integrity. When working in quality registers, the RN participation in oral health work increase, but they primarily work with oral health when a problem arises. Great focus was placed on oral health and oral care in palliative patients, but the work with oral health could be suffering in patients who to some extent manage themselves. To improve oral health, the study showed that there is a need for more education for health care workers providing municipality care and RN’s, there is also a need for better routines and better collaboration with the dental care

    ”Everyone who sings knows that it’s important” : A study of students thoughts regarding the concept of breath support in singing education

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    Syftet med föreliggande studie Àr att undersöka hur sÄngelever talar om sina uppfattningar om, och sitt arbete med, stöd. För att ta reda pÄ detta anvÀnde vi oss av kvalitativa intervjuer med sex stycken sÄngelever pÄ gymnasiets estetiska program med inriktning musik. Huvuddragen i de uppfattningar som vi mötte var att stöd Àr nödvÀndigt för att sjunga hÀlsosamt, speciellt vid starka och höga toner. De flesta av vÄra informanter hade svÄrt att uttrycka sig verbalt om vad som sker i kroppen vid stödanvÀndning, trots att flera uppgav att de har lÀtt för att anvÀnda sig av stöd rent praktiskt. Informanterna kopplar frÀmst stöd till bukmuskulaturen och andningen. Andra omrÄden sÄ som rygg, bröstkorg och solarplexus anses ocksÄ vara kopplade till stöd. Informanternas stödövningar gÄr oftast ut pÄ att kÀnna muskelaktivitet nÄgonstans i kroppen. Genom en fenomenografisk ansats har vi Àven kunnat ta reda pÄ hur och pÄ vilket sÀtt informanterna talade om sina uppfattningar. De flesta uppfattningarna beskrivs utifrÄn kroppsliga erfarenheter, i motsats till anatomiska förklaringar. Informanterna hade relativt goda uppfattningar om stöd samtidigt som de hade svÄrt att verbalisera sin kunskap

    International maintenance of competence : Three companies experiences of expatriation and tax relief for foreign key personnel

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    FrÄgestÀllningar: Hur anvÀnder svenska multinationella företag expatriering? Hur fungerar expertskatten i förhÄllande till dess syfte? Vilka konsekvenser medför anvÀndandet eller icke-anvÀndandet av expertskatten för företagen? Syfte: Syftet Àr att undersöka hur svenska multinationella företag anvÀnder sig av expatriering som kompetensförsörjning och i det perspektivet utreda huruvida expertskatten fungerar i förhÄllande till dess syfte. Metod: En tvÀrsnittsundersökning genomfördes vid insamling av det empiriska materialet. PrimÀrdata samlades in med hjÀlp av intervjuer frÄn tre undersökningsföretag. Viss kompletterande sekundÀrdata har Àven bidragit till undersökningen. Slutsatser: Vid de tillfÀllen dÄ företagen inte kan tillgodose sitt kÀrnkompetensbehov pÄ en lokal marknad Àr expatriering en metod att tillgÄ. Expatriering leder dÄ till en kunskapsförflyttning över de nationella grÀnserna. Samtliga undersökningsobjekt stÀller sig positiva till anvÀndandet av expatriering och anvÀnder det frÀmst vid behovsdrivna uppdrag. Företagen anvÀnder sig av expatriering vid bÄde korta och lÄnga uppdrag. Expatriering Àr en anstÀllningsform som Àr förknippad med mycket höga kostnader för företagen och för att kunna behÄlla konkurrenskraften pÄ de internationella marknaderna finner företagen det absolut nödvÀndigt med politiska incitament i form av skattelÀttnader för att kompetensförsörjningen fortsÀttningsvis ska kunna fortsÀtta. Det politiska incitament som idag förekommer i form av expertskatten har visat sig inte nyttjas i sÀrskilt stor utstrÀckning av olika anledningar och med anledning av detta stÀller vi oss kritiska till om expertskatten verkligen fungerar i förhÄllande till dess syfte.Problem: How do Swedish multinational companies use expatriation? How does the tax relief for foreign key personnel function in relation to its purpose according to the companies? What consequences does the use or non-use of tax relief for foreign key personnel according to the companies? Purpose: The purpose is to examine how Swedish multinational companies use expatriation as maintenance of competence and in that perspective, analyze whether the tax relief for foreign key personnel function in relation to its purpose.   Method: A cross-sectional survey was conducted for collection of the empirical material. Primary data were collected through interviews from three companies. Some additional secondary data have also contributed to the study.   Conclusion: At times when companies are not being able to meet their core competencies necessary for a local market, expatriation is a method available to use. Expatriation leads to a knowledge transfer across national borders. All survey items are in favor of using expatriation and use it primarily when they have a need-driven mission. The companies use expatriation at both short and long-term missions. Expatriation is associated with very high costs and to maintain competitiveness on international markets, the companies find it absolutely necessary to be able to use political incentives in the form of tax relief for foreign key personnel. The political incentives that currently exist in the form of tax relief for foreign key personnel have been identified as not used to any great extent for various reasons. Because of the results in this thesis we are critical about whether the tax relief for foreign key personnel actually works in relation to its purpose

    A Detailed Flow Cytometric Analysis of Immune Activity Profiles in Molecular Subtypes of Colorectal Cancer

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    The local anti-tumour immune response has important prognostic value in colorectal cancer (CRC). In the era of immunotherapy, a better understanding of the immune response in molecular subgroups of CRC may lead to significant advances in personalised medicine. On this note, microsatellite instable (MSI) tumours have been characterised by increased immune infiltration, suggesting MSI as a marker for immune inhibitor checkpoint therapy. Here, we used flow cytometry to perform a comprehensive analysis of immune activity profiles in tumour tissues, adjacent non-malignant tissues and blood, from a cohort of 69 CRC patients. We found several signs of immune suppression in tumours compared to adjacent non-malignant tissues, including T cells more often expressing the immune checkpoint molecules programmed cell death protein (PD-1) and cytotoxic T lymphocyte-associated protein 4 (CTLA-4). We further analysed immune cell infiltration in molecular subgroups of CRC. MSI tumours were indeed found to be associated with increased immune infiltration, including increased fractions of PD-1+ T cells. No correlation was, however, found between MSI and the fraction of CTLA-4+ T cells. Interestingly, within the group of patients with microsatellite stable (MSS) tumours, some also presented with increased immune infiltration, including comparably high portions of PD-1+ T cells, but also CTLA-4+ T cells. Furthermore, no correlation was found between PD-1+ and CTLA-4+ T cells, suggesting that different tumours may, to some extent, be regulated by different immune checkpoints. We further evaluated the distribution of immune activity profiles in the consensus molecular subtypes of CRC. In conclusion, our findings suggest that different immune checkpoint inhibitors may be beneficial for selected CRC patients irrespective of MSI status. Improved predictive tools are required to identify these patients

    Parvimonas micra is associated with tumour immune profiles in molecular subtypes of colorectal cancer

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    The importance of the tumour microbiome in different aspects of colorectal cancer (CRC) has been increasingly recognised, but many questions remain. The aim of this study was to explore the effect of specific CRC associated microbes on the tumour immune response, which has a considerable prognostic value in CRC. We applied specific qPCR to detect Parvimonas micra and Fusobacterium nucleatum in tumour tissues from an immunologically well-characterised cohort of 69 CRC patients. This cohort included detailed analyses of immune profiles based on flow cytometry and transcriptomics in tumour tissue and blood, along with comprehensive analyses of molecular subtypes. P. micra and F. nucleatum were detected in 24% and 64% of tumour tissues, respectively. We found a significant association of P. micra with high-grade tumours and tumours of CMS1 subtype. F. nucleatum was significantly associated with right-sided tumours, microsatellite instability, and CMS1 tumours. The immunological analyses revealed significant associations of P. micra with activated CD69+ T lymphocytes and increased antigen-presenting HLA-DR+ B lymphocytes. P. micra was also positively associated with M1 and M2 macrophage traits. The impact of P. micra tumour colonisation on the immune response was further assessed using transcriptomics in validation of our findings. No associations were found between F. nucleatum and immune profiles in this study. Our findings support novel associations between P. micra and the immune response in CRC. A better understanding of these interactions might help to identify important predictive and prognostic tools as well as new targets for therapy
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