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Vad utmärker skickliga lärare? Går det verkligen att objektivt bedöma frågan utan att hamna i subjektiva värderingar och preferenser? Hur ser vägarna till lärarskicklighet ut och vad kan forskningen bidra med för svar? Då lärarskicklighet är den enskilt mest betydelsefulla faktorn för att nå goda elevresultat är frågan om vad som kännetecknar en utmärkt lärare central. Utmärkt lärare bygger på författarnas genomgång av de senaste tjugo årens svenska och internationella forskning om såväl yrkesutveckling som lärarkompetens och visar vilka kvaliteter som kännetecknar lärarskicklighet. Genom olika perspektiv och exempel utreds även forskningens svar på vad som bör göras för att tillgodose behovet av lärare och skapa förutsättningar för en ständigt pågående yrkesutveckling. De sammantagna resultaten ger forskningsgrundade målbilder och stakar ut vägen för att få fler att utvecklas till skickliga lärare genom lärarutbildning, kollegialt lärande, kompetensutveckling och professionsprogram. Fem slutsatser ger riktningen för framtiden. Utmärkt lärare ingår i den så kallade Utmärktserien och vänder sig till blivande och verksamma lärare, men också till rektorer, skolchefer, skolutvecklare, politiker, beslutsfattare och andra med intresse för att utveckla skolans kvalitet och måluppfyllelse. Tidigare utgivna böcker i serien är: Utmärkt undervisning (2020), Utmärkt skolutveckling (2016), samt Utmärkt ledarskap i skolan (2018).

A considerable amount of spending in health care is deemed wasteful. Overdiagnosis, i.e. the labelling of a person with a diagnosis that lacks net benefit, is an entity within the overarching concept of »too much medicine«. Overdiagnosis includes overdetection and overdefinition. Disease mongering is a type of overdefinition with economic drivers. Overtesting and overtreatment are other aspects of »too much medicine«, but are not overdiagnosis per se. Medical research tends to focus on benefits of diagnostics and therapy, whereas overdiagnosis and other harms receive less attention, leading to overestimation of benefits. The international network Choosing Wisely has been successful in changing the diagnostic mindset in several countries and a Swedish campaign is under way, yielding new possibilities to counteract »too much medicine« and the specific problem of overdiagnosis., De flesta förstår att överbehandling med läkemedel är skadligt och kostsamt. Det är inte lika självklart att även utredningar, undersökningar och diagnos sät tning kan ge negativa konsekvenser. För att finna lösningar på de omfattande problemen med överanvändning av medicinska resurser och överdiagnostik, behövs ökad kunskap om vad det är och vad det beror på [1, 2]. Målet med denna artikel är att ge en introduktion till begreppet överdiagnostik och klargöra hur det förhåller sig till andra begrepp inom överanvändning av medicins ka resurser, i syfte att underlätta en konstruktiv diskussion om lämpliga åtgärder.

Inom ramen för det svenska decentraliserade skolsystemet har ansvaret för att bygga upp, utveckla och bedriva ett systematiskt kvalitetsarbete i första hand varit en fråga för huvudmän och skolor att hantera. I ljuset av en ökad re-centralisering av skolan har uppbyggandet av olika kvalitetssystem för uppföljning och kontroll av skolornas resultat också kommit att utgöra ett viktigt sätt för huvudmannen att styra skolan på. I studien benämns detta i termer av kvalitetsstyrning. I och med Samverkan för bästa skola har dessa gränsdragningar mellan det lokala och det nationella kommit att utmanas. Studien bygger på intervjudata inhämtad på fyra skolor som deltar i Samverkan för bästa skola, från skolförvaltningen i samma kommun samt genom intervju med en representant från Skolverket. Utifrån begreppen löst kopplade system och organisatoriska rutiner studeras vad som karaktäriserar den nationella respektive den kommunala kvalitetsstyrningen samt vad som sker i mötet dem emellan på skolor som genomgår insatser inom ramen för Samverkan för bästa skola, samt med vilka konsekvenser. Resultatet av studien visar bland annat på att idéer och metoder om databaserad skolutveckling utgör viktiga legitimitetsgrunder för såväl den kommunala som den nationella kvalitetsstyrningen. Den nationella kvalitetsstyrningen via Samverkan för bästa skola är dock betydligt mer intensifierad och når längre in i skolornas organisation.

General description on research questions, objectives and theoretical framework (600 words) In school systems around the world, there is an increasing focus on pupils’ academic achievements and school results. This has resulted in an intensified control of pupils’ levels of achievement (cf. PISA) and increasing demands for school actors and decision-makers to improve schools. In this respect, Sweden is no exception. Ages of declining student achievement, decreased equality between schools have spurred an intensive critique against the Swedish school system and triggered a more state-regulated governing of the school system in terms of several national reforms, which altogether aim to take control over the schools’ outcome (Wahlström & Sundberg, 2017; Adolfsson, 2018). In light of such a policy movement the Local Education Authorities (LEA) and schools’ responsibility for pupils’ achievement and equality have been highlighted and strengthened in Swedish policy. In addition, to ensure the quality of the teaching and the professionalism of the teachers, a revision of the Swedish Education Act was carried out in 2010. This revision stipulated, among other things, that all schools and local school authorities must conduct a systematic improvement work. This had led to a discussion of how school on a local basis can build capacity to improve themselves. In this context, LEA, in the Swedish municipalities, have become important policy actors (Wahlström & Sundberg, 2017b). To strengthen the schools own capacity for improvement, but also to increase the control over the schools’ processes and outcomes, the construction and implementation of different quality systems has been an important strategy for the local education authorities (Adolfsson & Alvunger, 2017; Håkansson & Sundberg, 2016). In this paper, we will put this ‘meso-level’, i.e. the relationship between LEA and the schools, in focus. We mean that this is an important, but many times overlooked, rela

Objective: The aim of this study was to evaluate the occurrence and consequences of technical complications in implant-supported restorative therapy. Material & Methods: The occurrence and consequences of technical complications in implant-supported restorative therapy over a mean follow-up period of 5.3years were assessed based on documentation in files from 2,666 patients. Risk indicators were identified by the use of survival models, considering repeated events. Results were expressed as hazard ratios (HR) including 95% confidence intervals. Results: Technical complications occurred in 24.8% of the patients. Chipping and loss of retention were the most common, affecting 11.0% and 7.9% of supraconstructions, respectively, while implant-related complications (e.g., implant fracture) were rare. More than 50% of the affected patients experienced technical complications more than once and almost all reported complications led to interventions by a dental professional. The extent of the supraconstruction was the strongest risk indicator for both chipping (HR<0.2) and loss of retention (HR>3). Conclusion: Over a 5-year period, technical complications in implant-supported restorative therapy occurred frequently and their management required professional intervention.

This article contributes to a perspective of school development, where pupils‟ experiences of the teaching they encounter are regarded as a result of improvement work. In a three-year research collaboration with four nine-year compulsory schools in a large Swedish municipality, researchers have continuously conducted group interviews with different actors, collected relevant documentation and reported their preliminary analyses to the schools. In the light of previous research, the results show that the development areas that have been in focus in the schools have in some cases had an impact on the teaching. However, no homogenous change is evident. Rather, the variation between classrooms, teachers and subjects is great, especially if the pupils‟ perspectives are taken into consideration. The pupils‟ experiences and voices on how the improvement work materialises in the classroom contribute to explaining the connections, or lack of them, between the school and classroom levels.

Runt om i världen har ett nytt fjärde generationens paradigmkring skolförbättring gett forskningsresultat medstor potential för ökad måluppfyllelse. Vissa avtryck börjar nu ta form i svenska skolor, men ännu har inga större resultatförbättringar märkts. Så hur väl håller internationellt etablerade modeller som Timperleys för kollegialt lärande, eller andra metoder för utveckling av undervisningen? I boken Utmärkt ledarskap i skolan får vi en sammanfattning av vad den senaste internationella skolförbättringsforskningen säger om attleda utvecklingen av undervisning och lärande. Utifrån inblickar i svenska skolor uppmärksammas såväl möjligheter som fallgropar i utvecklingsarbetets olika faser. Genom att belysa ett hållbart ledarskap i skolan får vi de nycklar vi behöver för systematiska och långsiktiga förbättringar med fokus på elevernas lärande. I Utmärkt ledarskap i skolan får du som skolledare, förstelärare och lärare kompetensutveckling och handledning i ditt dagliga pedagogiska ledarskapsarbete.

Systematic quality work is an important commitment for Swedish preschools. The latest changes to the regulations and curriculum for the Swedish preschool have increased the expectations for follow-up and documentation of each child’ s experiences and proficiencies in the curriculum’ s target areas, as well as how this is linked to quality development work in the preschool in general (cf. Sverige, 2010; The Ministry of Education 2010). Within the preschool manager function lies a special responsibility for the planning, monitoring and development of these activities and for ensuring that the systematic quality work is carried out in conjunction with the staff, guardians and children. Research on principals’ leadership in schools has generated a solid base of knowledge over time, but, in the Swedish context it seems that the research has paid less attention to the preschool manager’ s leadership. This paper focuses on preschool managers’ leadership as it relates to quality development and learning for the staff. It builds upon the results of a previous study where 18 preschool managers, in a questionnarie with open-ended questions, expressed their understanding of their own leadership in the systematic quality work (cf. Håkansson, 2016). The results from the study showed, among other things, a tension between linear and interactive forms of governance in the systematic quality work, but also that knowledge gaps among the staff could lead to uncertainties that the preschool manager has to address. In the study, there were traces of what can be characterised as leadership for learning (ibid.). The research reported in this paper is a qualitative follow-up interview study with ten of the preschool managers mentioned above. The main purpose of the paper is to contribute to a deeper understanding of preschool managers’ leadership of systematic quality work in Swedish preschools. Three research questions are adressed: What strategies and substantial leader actions do the p

AIM: To study the 20-year survival rate and periapical status of root filled teeth in a Swedish population requiring high-cost dental care and to identify factors related to survival and normal periapical status at follow-up.METHODOLOGY: The study population comprised 104 patients selected from four local health insurance districts with treatment plans including radiographs submitted for approval for reimbursement from the Swedish National Dental Insurance in 1977. In 1998, a clinical and radiographic follow-up examination was conducted, to register the status of 449 teeth identified as root filled at baseline. Differences in tooth survival and periapical status at follow-up, with reference to periapical status and quality of root filling at baseline, were analysed by chi-square tests. Multiple regression analysis was used to describe tooth survival and normal periapical status at follow-up, with the explanatory baseline variables: tooth type, type of restoration, type of post, quality of root filling, periapical status, marginal bone loss and caries. Differences were considered significant at a 5% level.RESULTS: Two hundred and ninety (65%) of the root filled teeth survived at follow-up. Baseline variables associated with low odds for tooth survival were mandibular molar, maxillary premolar, prefabricated posts other than screw posts, severe marginal bone loss, caries and apical periodontitis (AP). Normal periapical status at follow-up was registered in 49% of the root filled teeth. Baseline variables associated with low odds for normal periapical status (high risk for AP) at follow-up were mandibular molar, maxillary premolar, AP, severe marginal bone loss and inadequate root filling quality. Of the root filled teeth with AP at baseline, 42% had been left untreated during the observation period, and at follow-up, the AP persisted in 57% of these teeth.CONCLUSIONS: After 20 years, 65% of the root filled teeth had survived and one-third remained with a sound periapi

Vad säger egentligen internationella mätningar omden svenska skolans tillstånd? Stämmer debatten om svenska elevers sjunkande resultat? Behöver svensk skola förändras – och i så fall hur? För den som vill ta sig an skolutveckling på vetenskaplig grund sammanfattar Utmärkt skolutveckling de viktigaste slutsatserna från internationell skolforskning och visar på betydelsefulla framgångsfaktorer. Skolans skyldighet att enligt skollagen bedriva systematiskt kvalitetsarbete är ofta klämt mellan krav på höjda resultat och skolförbättring inom hela läroplanens område. Men det är inte enbart ett svenskt skoldilemma. I dag har det vuxit fram en rik flora av internationella studier som lägger en grund för forskningsbasering av skolors lokala skolutvecklingsarbete. Finns det kanske gemensamma lärdomar att dra från dessa skolors väg mot ökad kvalitet och förbättrad måluppfyllelse? Författarna utforskar och redovisar i denna bok insikter och resultat från internationell forskning och erbjuder en karta över vetenskapligt förankrade vägval och strategier för skolutveckling. Utmärkt skolutveckling vänder sig främst till skolledare, lärare, skolhuvudmän och politiker som vill få vägledning i hur man kan förbättra skolors resultat.

In school systems around the world there is an increasing focus on students' academic achievement and school result. Sweden is no exception in that respect. Parallel to an intensified control of pupils' level of achievement (cf. PISA), there are increasing demands for school decision makers to gradually improve students' academic performance. The question of how schools are changing and improving thus becomes an important issue for all levels, from policy makers to professionals in schools, but also for researchers. Several decades of research on how school’s improvement efforts ultimately affect student learning highlights the importance of paying attention to the balance between "... individual initiative and school/system change, between internal and external resources and ideas, between pressure for accountability and support for change, and between independence and collaboration "(Hopkins et al., 2014). In this context, the coordination of top-down and bottom-up strategies in schools' improvement work seems to be crucial (Fullan, 1994). At the same time, research shows that the building of schools' development capacity is primarily focused on professional learning and development for principals and teachers, which in turn is expected to improve teaching and student learning (cf. Day, 2012; Stoll 2009). From previous studies of local school improvement work, the results show changes in aspects of principals’ and teachers’ learning, which can be connected to certain improvement strategies (Adolfsson & Håkansson, 2014). This paper will investigate these indications further. The focus of this paper is to explore schools' capacity building for improvement in terms of professional learning as strategies over time change character from top-down to bottom-up, a perspective seemingly little illuminated in past research. Within the framework of an ongoing three-year research project in six Swedish compulsory schools, the intention here is to elucidate the way in whic

I denna rapport analyseras det förändrade samspelet mellan utbildningsforskningen och utbildningspolitiken. Genom att särskilt fokusera de s.k. intermediära organisationernas ökade betydelse för att sprida, kommunicera och understödja policyrelevant kunskap för beslutsfattande adresseras frågor om forskning och evidens i utvecklingen och reformeringen av utbildning och skola. Rapporten bidrar med genomgång av forskningen kring forskningsmediering, de centrala begreppen och distinktionerna. I en internationell och nationell litteraturgenomgång identifieras tre ramverk/modeller för forskningsbasering av policy/praktik. Samtliga exemplifieras med intermediärer som verkar internationellt och i norden inom utbildningsområdet genom sin produktion av kunskaps- och forskningsöversikter riktade till beslutsfattare. I resultatdelen ges också en bild av det framväxande svenska intermedieringslandskapet. I det avslutande kapitlet sammanfattas de viktigaste slutsatserna kring resultaten för Skolforskningsinstitutets vidkommande., SKOLFORSK

Learning schools in Sweden – principals understanding of on-going school improvement in an era of accountability Over the last two decades there has been a general transnational policy trend towards major emphasis on learning outcomes. In Sweden – like in many other countries – there is an on-going discussion about pupils’ academic achievement, not to mention due to Swedish pupils’ low results in different international knowledge comparisons (cf. Ball et al., 2012; Grek, 2009). The Education Act of 2010 is part of a top-to-bottom curriculum reform in Sweden, which has put further pressure on municipalities and schools to implement new syllabuses, clearer goals and knowledge demands and a new grading system. At the same time there are still high expectations and demands on performance improvements and school-based development work. So what does it mean working with local school-development under such an external pressure? The starting point for this paper is an on-going three-year research project in six Swedish compulsory schools with the general purpose of exploring and developing theoretical, methodological and practical knowledge for school improvement. The purpose is to explore how local school actors (principals in this case) understand and handle the parallel process of, on the one hand, external pressure to improve students achievement and, on the other hand, the local school-based curriculum development. In the light of such a tension, what are the principals understanding of: - The selection of content areas for curriculum development? - Principals own leadership and learning? - The schools’ capital building, for school improvement? The first theoretical starting point in this paper is a “classical” framework of curriculum theory (i.e. the frame-factor theory with its different levels of analysis – the societal/ideological level, the curriculum level and the teaching and classroom level, cf.