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1.
  • Karlsson-Tuula, Marie, 1961- (author)
  • Rekonstruktion av företag inom insolvenslagstiftningens ramar : en jämförande studie av svensk och amerikansk insolvensrätt
  • 2001
  • Doctoral thesis (other academic/artistic)abstract
    • Insolvency law is the rooth of commercial and financial law because it obliges the legislator to chose. There is not enough money to go round so the law must chose who to pay. The law must always decide who is to bear the risk so there is always a winner and a loser. The insolvency law has been at the policy agenda in many countries in the last years. In France, Germany, Italy, Japan and other countries have the legal frameworks changed from liquidation procedures to reorganization business. The legal situation in Sweden has also changed from compositions to reorganization business, lagen om företagsrekonstruktion. The key issues are to encourage the formal proceeding by enlarging the debtors control of the business and by inroads creditors rights, in which case the proceeding is pro-debtor.This dissertation compares Swedish and American Bankruptcy Codes with respect to similarities and differences at macro- and micro perspectives. Chapter 11 Reorganization Business in America provides a corporate rehabilitation model, which has been used in other countries. The dissertation also compares the use of the concepts of - the purpose, - the function and - the direction of Swedish and American Bankruptcy Laws in order to establish whether the law is pro-debtor or pro-creditor. The key indicators of whether the rescue proceeding is pro-debtor or pro-creditor include; - How easy it is to enter the rescue proceeding. Debtor's incentives to commence proceeding, freeze on executions and liquidation petitions, impact on security, impact on title of finance, impact on set-off and netting, impact on contract rescissions and lease forfeitures. Disclaimer and abandonment, ability to replace the management, financing of the rescue, scope of the rehabilitation plan. It is argued that the optimal bankruptcy law can be achieved if the law purpose, the function and the law direction relate to each other in Sweden, in both reorganization business and in the liquidation code and it also compared with the American Bankruptcy Code. According to my opinion this is important both in a national and international context.The dissertation also deals with debtor's contract in an insolvency situation in reorganization business and in liquidation. Swedish Laws are compared to the American Bankruptcy Code and point out similarities and differences. In the American Bankruptcy Code there is a special section 365 § BC dealing with executory contract, this section is nearly the same for both the reorganization- and liquidationproceedings. The contracts must be unperformed which means the obligation of both the bankrupt and the other party in the contract are so far unperformed that the failure of either to complete performance would constitute a material breach excusing the performance of the other. If the contract is unperformed the debtor has the possibility to chose if the contracts shall be assumed, assumed and assigned or rejected. Section 365 § BC requires the court to consider whether assumption of the contract in question will further be needed in either rehabilitation or liquidation of the bankruptcy estate. The court reviews the financial impact of the estate and if it is benefiting becoming administratively obligated to perform. The court also review if is best to breach the contract. In Sweden we have different sections which regulate the situation. One section in our reorganization law, lagen om företagsrekonstruktion, we also have two special sections in the law of Sale of Goods, which deals with contract when a debtor became insolvent or file for reorganization business. But we don't have any section in our liquidation law, konkurslagstiftningen, which in my opinion is very strange. We also have a problem with the legislation about swaps and netting which are regulated in a special law, lagen om handel med finansiella intrument. Particular attention is given to the advantages and disadvantages of the existing rules in Swedish legal system compared with 365 § in American Bankruptcy Code. From a national point of view such section should preferably include all types of contract in only one section which is nearly the same as the American model of section 365 §.
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2.
  • Gummesson, Christina, et al. (author)
  • Entrustable professional activities (EPAs) for undergraduate medical education : development and exploration of social validity
  • 2023
  • In: BMC Medical Education. - : BioMed Central (BMC). - 1472-6920. ; 23:1
  • Journal article (peer-reviewed)abstract
    • Background: The development of entrustable professional activities (EPAs) as a framework for work-based training and assessment in undergraduate medical education has become popular. EPAs are defined as units of a professional activity requiring adequate knowledge, skills, and attitudes, with a recognized output of professional labor, independently executable within a time frame, observable and measurable in its process and outcome, and reflecting one or more competencies. Before a new framework is implemented in a specific context, it is valuable to explore social validity, that is, the acceptability by relevant stakeholders.Aim: The aim of our work was to define Core EPAs for undergraduate medical education and further explore the social validity of the constructs.Method and material: In a nationwide collaboration, EPAs were developed using a modified Delphi procedure and validated according to EQual by a group consisting of teachers nominated from each of the seven Swedish medical schools, two student representatives, and an educational developer (n = 16). In the next step, social validity was explored in a nationwide survey. The survey introduced the suggested EPAs. For each EPA, the importance of the EPA was rated, as was the rater’s perception of the present graduates’ required level of supervision when performing the activity. Free-text comments were also included and analyzed.Results: Ten Core EPAs were defined and validated. The validation scores for EQual ranged from 4.1 to 4.9. The nationwide survey had 473 responders. All activities were rated as “important” by most responders, ranging from 54 to 96%. When asked how independent current graduates were in performing the ten activities, 6 to 35% reported “independent”. The three themes of the free text comments were: ‘relevant target areas and content’; ‘definition of the activities’; and ‘clinical practice and learning’.Conclusion: Ten Core EPAs were defined and assessed as relevant for Swedish undergraduate medical education. There was a consistent gap between the perceived importance and the certainty that the students could perform these professional activities independently at the time of graduation. These results indicate that the ten EPAs may have a role in undergraduate education by creating clarity for all stakeholders.
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3.
  • Özel, Faith, et al. (author)
  • Exploring gender dysphoria and related outcomes in a prospective cohort study: protocol for the Swedish Gender Dysphoria Study (SKDS)
  • 2023
  • In: Bmj Open. - : BMJ Publishing Group Ltd. - 2044-6055. ; 13:4
  • Journal article (peer-reviewed)abstract
    • Introduction There has been a drastic increase in the reported number of people seeking help for gender dysphoria in many countries over the last two decades. Yet, our knowledge of gender dysphoria and related outcomes is restricted due to the lack of high-quality studies employing comprehensive approaches. This longitudinal study aims to enhance our knowledge of gender dysphoria; different aspects will be scrutinised, focusing primarily on the psychosocial and mental health outcomes, prognostic markers and, secondarily, on the underlying mechanisms for its origin. Methods and analysis The Swedish Gender Dysphoria Study is an ongoing multicentre longitudinal cohort study with 501 registered participants with gender dysphoria who are 15 years old or older. Participants at different phases of their clinical evaluation process can enter the study, and the expected follow-up duration is three years. The study also includes a comparison group of 458 age- and county-matched individuals without gender dysphoria. Data on the core outcomes of the study, which are gender incongruence and experienced gender dysphoria, body satisfaction and satisfaction with gender-affirming treatments, as well as other relevant outcomes, including mental health, social functioning and life satisfaction, are collected via web surveys. Two different research visits, before and after starting on gender-affirming hormonal treatment (if applicable), are planned to collect respective biological and cognitive measures. Data analysis will be performed using appropriate biostatistical methods. A power analysis showed that the current sample size is big enough to analyse continuous and categorical outcomes, and participant recruitment will continue until December 2022. Ethics and dissemination The ethical permission for this study was obtained from the Local Ethical Review Board in Uppsala, Sweden. Results of the study will be presented at national and international conferences and published in peer-reviewed journals. Dissemination will also be implemented through the Swedish Gender Dysphoria Study network in Sweden.
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4.
  • Kirvalidze, Mariam, et al. (author)
  • Effectiveness of integrated person-centered interventions for older people's care: Review of Swedish experiences and experts’ perspective
  • 2024
  • In: Journal of Internal Medicine. - : John Wiley & Sons. - 1365-2796 .- 0954-6820. ; 295:6, s. 804-824
  • Journal article (peer-reviewed)abstract
    • Older adults have multiple medical and social care needs, requiring a shift toward an integrated person-centered model of care. Our objective was to describe and summarize Swedish experiences of integrated person-centered care by reviewing studies published between 2000 and 2023, and to identify the main challenges and scientific gaps through expert discussions. Seventy-three publications were identified by searching MEDLINE and contacting experts. Interventions were categorized using two World Health Organization frameworks: (1) Integrated Care for Older People (ICOPE), and (2) Integrated People-Centered Health Services (IPCHS). The included 73 publications were derived from 31 unique and heterogeneous interventions pertaining mainly to the micro- and meso-levels. Among publications measuring mortality, 15% were effective. Subjective health outcomes showed improvement in 24% of publications, morbidity outcomes in 42%, disability outcomes in 48%, and service utilization outcomes in 58%. Workshop discussions in Stockholm (Sweden), March 2023, were recorded, transcribed, and summarized. Experts emphasized: (1) lack of rigorous evaluation methods, (2) need for participatory designs, (3) scarcity of macro-level interventions, and (4) importance of transitioning from person- to people-centered integrated care. These challenges could explain the unexpected weak beneficial effects of the interventions on health outcomes, whereas service utilization outcomes were more positively impacted. Finally, we derived a list of recommendations, including the need to engage care organizations in interventions from their inception and to leverage researchers’ scientific expertise. Although this review provides a comprehensive snapshot of interventions in the context of Sweden, the findings offer transferable perspectives on the real-world challenges encountered in this field.
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5.
  • Browall, Maria, et al. (author)
  • The course of health related quality of life in postmenopausal women with breast cancer from breast surgery and up to five years post-treatment
  • 2013
  • In: Breast. - : Elsevier. - 0960-9776 .- 1532-3080. ; 49, s. S344-S345
  • Journal article (peer-reviewed)abstract
    • Background: Previous studies include too few patients over 70 years to be able to assess treatment effects on Health Related Quality Of Life (HRQOL) in the older age group. We aimed to follow HRQOL in postmenopausal women (55-80 years) with breast cancer receiving adjuvant treatment, until five years post-treatment, and compare with a general population.Patients and methods: The patient sample included 150 women (adjuvant CT n=75 and RT n=75) and two reference samples from the Swedish SF-36 norm database.Results: Data from baseline showed significantly higher levels of physical functioning and general health among the patients compared to the reference sample, and significantly lower levels of bodily pain, emotional role functioning and mental health. Longitudinal analyses showed significant changes in all scales, and three different patterns (a decrease-stable, a decrease-increase, and a stable- increase pattern) were identified.Conclusion: Postmenopausal women seem to successfully manage the effects of adjuvant treatment on HRQOL. 
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6.
  • Liedberg, Fredrik, et al. (author)
  • Period-specific mean annual hospital volume of radical cystectomy is associated with outcome and perioperative quality of care: a nationwide population-based study
  • 2019
  • In: Bju International. - : Wiley. - 1464-4096 .- 1464-410X. ; 53:Suppl. 221, s. 20-20
  • Journal article (peer-reviewed)abstract
    • Objective To investigate the association between hospital volume and overall survival (OS), cancer-specific survival (CSS), and quality of care of patients with bladder cancer who undergo radical cystectomy (RC), defined as the use of extended lymphadenectomy (eLND), continent reconstruction, neoadjuvant chemotherapy (NAC), and treatment delay of We used the Bladder Cancer Data Base Sweden (BladderBaSe) to study survival and indicators of perioperative quality of care in all 3172 patients who underwent RC for primary invasive bladder cancer stage T1-T3 in Sweden between 1997 and 2014. The period-specific mean annual hospital volume (PSMAV) during the 3 years preceding surgery was applied as an exposure and analysed using univariate and multivariate mixed models, adjusting for tumour and nodal stage, age, gender, comorbidity, educational level, and NAC. PSMAV was either categorised in tertiles, dichotomised (at >= 25 RCs annually), or used as a continuous variable for every increase of 10 RCs annually. Results PSMAV in the highest tertile (>= 25 RCs annually) was associated with improved OS (hazard ratio [HR] 0.87, 95% confidence interval [CI] 0.75-1.0), whereas the corresponding HR for CSS was 0.87 (95% CI 0.73-1.04). With PSMAV as a continuous variable, OS was improved for every increase of 10 RCs annually (HR 0.95, 95% CI 0.90-0.99). Moreover, higher PSMAV was associated with increased use of eLND, continent reconstruction and NAC, but also more frequently with a treatment delay of >3 months after diagnosis. Conclusions The current study supports centralisation of RC for bladder cancer, but also underpins the need for monitoring treatment delays associated with referral.
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7.
  • Kristofferzon, Marja-Leena, 1950-, et al. (author)
  • Evaluation of a Swedish version of the Watts Sexual Function Questionnaire (WSFQ) in persons with heart disease: A pilot study
  • 2010
  • In: European Journal of Cardiovascular Nursing. - Amsterdam : Elsevier. - 1474-5151 .- 1873-1953. ; 9:3, s. 168-174
  • Journal article (peer-reviewed)abstract
    • Background: As part of preparation for a Swedish multicentre study, exploring sexual and married life in patients with myocardial infarction and their partners, a Swedish validated instrument was required. Aims:The aim of this pilot study was to evaluate the validity and reliability of a Swedish version of the Watts Sexual Function Questionnaire (WSFQ) among persons with a heart disease.Methods:A convenience sample of 79 persons (47 men and 32 women) living with a heart disease was recruited from the members of the National Association of Heart and Lung Patients. They completed a Swedish version of the WSFQ on two occasions. Results:Two separate factor analyses each revealed a two-factor structure on both occasions: “Sexual appetite” and “Sexual expectations ”with gender-neutral questions and “Sexual sensitiveness” and “Sexual ability” with gender-specific questions. Cronbach's alpha coefficients ranged from 0.48 to 0.86 and test – retest values for all but one question exceeded 0.70.Conclusions:The Swedish version of the WSFQ showed good validity and stability and acceptable internal homogeneity. Extended evaluations of the questionnaire are recommended.   
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8.
  • Svedberg, Petra, 1973-, et al. (author)
  • Psychometric evaluation of “The 25-item Sex after MI Knowledge Test” in a Swedish context
  • 2012
  • In: Scandinavian Journal of Caring Sciences. - Malden, USA : Wiley. - 0283-9318 .- 1471-6712. ; 26:1, s. 203-208
  • Journal article (peer-reviewed)abstract
    • The patients’ sexual life after a myocardial infarction is important for his/her quality of life. In spite of this, many patients are in doubt regarding their sex life after a myocardial infarction (MI) and the sexual information received, and counselling from health care providers has been seen to be insufficient. The purpose of this study was to evaluate the psychometric properties of ‘The 25-item Sex after MI Knowledge Test’ in a Swedish context. A convenience sample was recruited. The scale was translated into Swedish and completed by 79 former patients from The Heart and Lung Patients’ National Association on two occasions, with an interval of 2 weeks. The scale was tested for face and content validity, internal consistency and test–retest reliability. The result in this study indicates that the instrument has good face and content validity and displayed a moderate internal consistency (alpha 0.61). The instrument showed some level of instability in test–retest reliability with 60% of the items presenting moderate or strong agreement between the test and retest. Further studies that use this instrument in larger and more diverse samples are thus needed.
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9.
  • Wide, Sverre, et al. (author)
  • Redaktören har ordet
  • 2015
  • In: Sociologisk forskning. - Falun : Sveriges Sociologförbund. - 0038-0342 .- 2002-066X. ; 135:1, s. 1-1
  • Journal article (other academic/artistic)
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10.
  • Ekström, Magnus, et al. (author)
  • Exertional breathlessness related to medical conditions in middle-aged people: the population-based SCAPIS study of more than 25,000 men and women.
  • 2024
  • In: Respiratory research. - : BioMed Central (BMC). - 1465-993X .- 1465-9921. ; 25:1
  • Journal article (peer-reviewed)abstract
    • Breathlessness is common in the population and can be related to a range of medical conditions. We aimed to evaluate the burden of breathlessness related to different medical conditions in a middle-aged population.Cross-sectional analysis of the population-based Swedish CArdioPulmonary bioImage Study of adults aged 50-64years. Breathlessness (modified Medical Research Council [mMRC]≥2) was evaluated in relation to self-reported symptoms, stress, depression; physician-diagnosed conditions; measured body mass index (BMI), spirometry, venous haemoglobin concentration, coronary artery calcification and stenosis [computer tomography (CT) angiography], and pulmonary emphysema (high-resolution CT). For each condition, the prevalence and breathlessness population attributable fraction (PAF) were calculated, overall and by sex, smoking history, and presence/absence of self-reported cardiorespiratory disease.We included 25,948 people aged 57.5±[SD] 4.4; 51% women; 37% former and 12% current smokers; 43% overweight (BMI 25.0-29.9), 21% obese (BMI≥30); 25% with respiratory disease, 14% depression, 9% cardiac disease, and 3% anemia. Breathlessness was present in 3.7%. Medical conditions most strongly related to the breathlessness prevalence were (PAF 95%CI): overweight and obesity (59.6-66.0%), stress (31.6-76.8%), respiratory disease (20.1-37.1%), depression (17.1-26.6%), cardiac disease (6.3-12.7%), anemia (0.8-3.3%), and peripheral arterial disease (0.3-0.8%). Stress was the main factor in women and current smokers.Breathlessness mainly relates to overweight/obesity and stress and to a lesser extent to comorbidities like respiratory, depressive, and cardiac disorders among middle-aged people in a high-income setting-supporting the importance of lifestyle interventions to reduce the burden of breathlessness in the population.
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