Detta kapitel beskriver Linköpings universitets resa att utveckla en universitetsgemensam modell för pedagogisk meritering, där delägarskap och förankring fått spela en stor roll. I inledningen ligger fokus på den process som genomfördes för att arbeta fram en definition av pedagogisk skicklighet, som kunde rymma lärosätets olika akademiska kulturer och undervisningstraditioner. En kvalitativ tematisk analys genomfördes av muntliga och skriftliga utsagor som samlades in under processen. Fyra huvudteman framkom i analysen. Två teman rörde den övergripande universitetsnivån; Karriärvägar respektive Legitimitet. De andra två temana berörde medarbetarna och deras närmaste verksamhetsnivå; Utveckling av lärarrollen respektive Utveckling av den pedagogiska verksamheten. För att en pedagogisk meriteringsmodell ska bli viktig på riktigt visar analysen att ett individuellt och kollegialt samt ett verksamhetsperspektiv behöver beaktas. Kapitlet avslutas med medskick till andra lärosäten, där faktorer lyfts som vi har sett centrala vid utveckling av en pedagogisk meriteringsmodell.

Tutors in problem-based learning (PBL) need to reflect on their role, to prevent stagnation. We aimed to explore the learning experiences of tutors gained by being and having a critical friend in a PBL group. Eight teachers, from several professional programs at the Faculty of Medicine of a Swedish university, participated in a cross-program activity involving the being and having a critical friend to improve their skills as PBL group tutors. They were individually interviewed, and the transcriptions were subjected to conventional qualitativecontent analysis. The results revealed that a critical friend from another discipline can be useful and that experiences from both roles, to be and to have a critical friend, is necessary for reflection and learning, and thus optimal results. We conclude that support from the organisation, knowledge sharing, and communication are required to enable a systematic use of critical friends to be implemented with credibility.

Hälsoinriktning med interprofessionellt och problembaserat lärande harlång tradition vid den medicinska fakulteten (tidigare Hälsouniversitetet) iLinköpings universitet. Denna ämnesinriktning, pedagogik och förhållningssättgenom syrar också det interprofessionella masterprogram som startade2008. Detta har utgångspunkt i behovet av att utveckla en mer hälsofrämjandehälso- och sjukvård för att möta framtidens behov samt utvecklakvalitet och hälsoresultat. Teori och metod för hälsofrämjande, preventionoch förbättrings kunskap är därför centrala delar i alla professionsinriktningarpå masternivå och inte enbart kunskapsområden för folkhälsovetaren. Dettainnebär att alla studenter får en ämnesspecifi k examen med ett folkhälsovetenskapligtperspektiv, och studenterna med inriktning folkhälsovetenskapen fördjupning av dessa kunskaper. Alumni bekräftar att de fått verktyg föratt utveckla kvalitet och hälsoorientering av hälso- och sjukvården som detidigare saknat.

BACKGROUND: Research has revealed a well-established relationship of depressive symptoms and hopelessness with a variety of physical illnesses that are associated with a dysfunction of the hypothalamic-pituitary-adrenal-axis.

PURPOSE: The purpose of this study was to test if depressive symptoms mediate the relationship between hopelessness and cortisol, a measure of the hypothalamic-pituitary-adrenal-axis.

METHODS: Hopelessness, depressive symptoms, and diurnal cortisol rhythm were measured in 257 adults (128 women and 129 men; age range, 20-74 years) in this cross-sectional study. To test the hypothesis, two linear regression analyses and asymmetrical confidence intervals around the regression weights were conducted. A second set of analyses was calculated to be able to exclude the possibility of hopelessness as a mediator between depressive symptoms and cortisol.

RESULTS: As predicted, after adjusting for age, gender, awakening time, and medication use, more hopelessness predicted more depressive symptoms and more depressive symptoms predicted a flatter diurnal cortisol rhythm. The 95 % confidence intervals revealed that the indirect relationship between hopelessness and diurnal cortisol rhythm was significant. The analyses with hopelessness as a potential mediator revealed that hopelessness does not mediate the association between depressive symptoms and cortisol.

CONCLUSIONS: While the relationship between hopelessness and cortisol was mediated by depressive symptoms in this cross-sectional study, many other risk factors of depression have not been examined. Thus, future longitudinal studies should examine the relationships between those risk factors of depression and the hypothalamic-pituitary-adrenal-axis.

Objective: Previous research has revealed a relationship of depressive symptoms and hopelessness with cardiovascular diseases (CVDs) which are associated with elevated levels of interleukin-6 (IL-6). The objective of this study was to explore whether depressive symptoms and hopelessness are independent predictors of IL-6 levels. Method: Hopelessness, depressive symptoms, and IL-6 were measured in 45 Swedish adults (26 women and 19 men; age range: 31-65 years). Two separated linear regressions were conducted with hopelessness and depressive symptoms serving as individual predictors of IL-6. Another regression analysis examined whether the two predictors predict IL-6 when controlling for each other. The regression coefficients of the models with one predictor and with both predictors were compared. Results: As predicted, after adjusting for age, BMI, illness, smoking, and gender, more depressive symptoms and more hopelessness predicted higher IL-6 levels in independent regressions. When controlling for each other, hopelessness, but not depressive symptoms, predicted IL-6 levels. Finally, when controlling for hopelessness, the regression between depressive symptoms and IL-6 level was significantly reduced; however, there was no significant change in the regression between hopelessness and IL-6 level when controlling for depressive symptoms. Conclusions: Thus, these results suggest that depressive symptoms and hopelessness are not independent predictors of IL-6 levels. Future research should explore the interplay of hopelessness and depressive symptoms on other risk factors of CVDs.

Whereas psychosocial risk factors increase the risk for disease, psychosocial resources reduce this risk. To examine a possible pathway for these effects, the relations between saliva cortisol levels and psychosocial factors were studied in a random sample of 257 men and women aged 30 to 64 years. Saliva samples were collected at home on waking, 30 min after waking, and in the evening. A flatter diurnal rhythm of cortisol, that is, lower deviations between awakening and evening cortisol levels, was related to high levels of psychosocial risk factors (cynicism, depression, and vital exhaustion), whereas a steeper diurnal rhythm was related to psychosocial resources (social support and coping), general health, and well-being (all p < .05). Our results support earlier suggestions that the capacity of the hypothalamic-pituitary- adrenal-axis to dynamically respond to stress is 1 pathway for observed effects of psychosocial factors regarding risk for disease development. Copyright © 2006 by Lawrence Erlbaum Associates, Inc.

Psychosocial factors and interleukin-6 (IL-6) levels are both related to risk of morbidity and mortality. The aim of this study was to investigate how a broad range of psychosocial factors related to levels of IL-6 in different media. Fifty-nine men and women aged 30-65 were recruited from a larger study and selected to cover a broad range of psychosocial status. IL-6 levels were analyzed in serum, in saliva collected at home at three different time points during a day, and in the supernatant of cell cultures stimulated in vitro with lipopolysaccharide. After adjustments for age, gender, self-reported health problems, and lifestyle factors, IL-6-levels in serum were negatively correlated with coping and self-esteem, and positively correlated with cynicism, hostile affect, hopelessness, depression, and vital exhaustion. In saliva samples, at all time points, IL-6 levels were positively correlated to cynicism, and IL-6 levels 30 min after awakening were also positively correlated with hopelessness, depression, and vital exhaustion. After adjustment for age and gender, cynicism, depression, and vital exhaustion were negatively correlated to IL-6 levels in the supernatant of cell cultures stimulated in vitro with lipopolysaccharide, but this effect was lost after control for self-reported health problems and lifestyle factors. In conclusion, we found that IL-6 levels in serum and saliva were negatively related to psychosocial resources and positively related to psychosocial risk factors. These data strengthen the argument that IL-6 is involved in mediating the risk for disease development that has been associated with psychosocial factors. © 2005 Elsevier Inc. All rights reserved.