| 321. |
- Jagudina, Zaira, 1959
(författare)
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Social Movements and Gender in Post-Soviet Russia. The Case of the Soldier's Mothers NGOs
- 2009
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This dissertation provides a study of gender processes in the maternal human rights movement of the Soldiers’ Mothers NGOs, which were created in the arena of the military draft politics in post-Soviet Russia. It also includes an analysis of the depoliticized and gendered civil society of the formalized NGOs, which provides a broader social context for the soldiers’ mothers’ movement. The dissertation is founded on a combination of ideas borrowed from three theoretical perspectives. First, the concept ‘woman’ is approached as an analytical and political category constructed through the social locations by gender, class, region and culture within the framework of a military nation-state. The conventional maternal femininity, ‘naturally’ linked with caring labor, is produced as a part of the modern nation-states’ ideologies of militarism and patriotic duty. Second, participants in social movements create an oppositional sub-universe of meaning and try to deintegrate from the dominant beliefs, social norms, and rules of feeling. Finally, gender processes affect the political opportunities, mobilizing structures and collective identity construction in social movements. The case study´s primary empirical material is 22 semi-structural qualitative interviews conducted in 2000-2005 with 17 members of two organizations of the Soldiers’ Mothers, located in two different large cities. In addition, a participant observation of these two organizations and a discourse analysis of 35 articles in the Russian press were carried out, as well as 36 interviews with members of other human rights NGOs in Russia. The impact of gender processes upon the Soldiers’ Mothers movement is analyzed in relation to three dimensions: institutional and ideological structures, mobilizing social and organizational resources, and collective identity framing. In the context of the ongoing military operations and the depoliticizing trends in civil society, mothers of soldiers were supposed to work in the social serviceoriented NGOs as a helpmate to the military officials. Through the rituals of storytelling and interactions with their allies and their constituency, the Soldiers’ Mothers activists have deintegrated from the mainstream norms of women’s civic duty. The goals of the Soldiers’ Mothers NGOs have been reframed by connecting the maternal frame with the counter-discursive rhetoric of human rights, rooted in the Soviet legacy of political dissent. The feelings of fear, shame and anxiety are managed, and solidarity, pride and hope are instilled among the activists and parts of their constituency. Challenging the post-Soviet traditionalist gender ideology, the activists create a more critical identity of soldier’s mothers based on an anti-draft/military ideology. This ideology varies among local civic groups, depending on their access to material, human and symbolic resources. Relying on informal social networks, the activists sustain the autonomous status of their groups. From the viewpoints of the local grassroots’, the Soldiers’ Mothers activists reframe the concept ‘gender’ in the elitist feminism imported by Western donors in the NGO sector. The key findings in this dissertation suggest different revisions and expansions of earlier empirical research of the Soldiers’ Mothers NGOs and development of theories of gendered social movements.
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| 322. |
- Jain, S., et al.
(författare)
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Diagnostic potential of nanoparticle aided assays for MUC16 and MUC1 glycovariants in ovarian cancer
- 2022
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Ingår i: International Journal of Cancer. - : Wiley. - 0020-7136 .- 1097-0215. ; 151:7, s. 1175-1184
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Tidskriftsartikel (refereegranskat)abstract
- Our study reports the discovery and evaluation of nanoparticle aided sensitive assays for glycovariants of MUC16 and MUC1 in a unique collection of paired ovarian cyst fluids and serum samples obtained at or prior to surgery for ovarian carcinoma suspicion. Selected glycovariants and the immunoassays for CA125, CA15-3 and HE4 were compared and validated in 347 cyst fluid and serum samples. Whereas CA125 and CA15-3 performed poorly in cyst fluid to separate carcinoma and controls, four glycovariants including MUC16(MGL), MUC16(STn), MUC1(STn) and MUC1(Tn) provided highly improved separations. In serum, the two STn glycovariants outperformed conventional CA125, CA15-3 and HE4 assays in all subcategories analyzed with main benefits obtained at high specificities and at postmenopausal and early-stage disease. Serum MUC16(STn) performed best at high specificity (90%-99%), but sensitivity was also improved by the other glycovariants and CA15-3. The highly improved specificity, excellent analytical sensitivity and robustness of the nanoparticle assisted glycovariant assays carry great promise for improved identification and early detection of ovarian carcinoma in routine differential diagnostics.
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| 323. |
- Jakobsson, Eva, 1960, et al.
(författare)
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Clinical problems at the end of life in a Swedish population, including the role of advancing age and physical and cognitive function.
- 2008
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Ingår i: Scandinavian journal of public health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 36:2, s. 177-82
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Tidskriftsartikel (refereegranskat)abstract
- AIMS: To improve the understanding of specific clinical problems at the end of life, including the role of advancing age, physical function and cognitive function. METHODS: The study is part of an explorative survey of data relevant to end-of-life healthcare services during the last 3 months of life of a randomly selected sample of the population of a Swedish county. Data were selected through retrospective reviews of death certificates and medical records, and comprise information from 12 municipalities and 229 individuals. RESULTS: A range of prevalent concerns was found. Overall deterioration, urinary incontinence, constipation, impaired skin integrity, anxiety and sleep disturbances were significantly associated with dependency on others for activities of daily living; pulmonary rattles and swallowing disturbances were associated with cognitive disorientation; excepting cough, advancing age did not have significant impacts on these prevalent clinical concerns. CONCLUSIONS: A range of distressing conditions constitute a common pathway for many individuals at or near the end of life. The incorporation of health promotion as a principle of palliative care will probably benefit individuals at the end of life, and includes a proactive focus and emphasis on enhanced well-being at the time of diagnosis of a life-threatening illness. For individuals with physical and cognitive limitations imparting a state of dependency, it is reasonable to provide assurance of care for individuals' specific needs by professionals with both training for and competence in this special and sometimes unique clinical environment.
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| 324. |
- Jakobsson, Eva
(författare)
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End-of-life care in a Swedish county : patterns of demographic and social conditions, clinical problems and health care use
- 2006
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- There is broad consensus in both international and national policy statements that care provided at end-of-life should be different from care provided during other periods of life. There is a need for comprehensive knowledge about the broad population of individuals who access the public health care system during the last period of life. The purpose of this thesis therefore, is to make a contribution to a broader understanding of the nature of end of-life and end-of-life care for these individuals. The study was undertaken through retrospective examinations of death certificates, medical records and nursing records in a randomly selected sample of adults who accessed the public health care system, and who died in the County of Västra Götaland, Sweden, during 2001. The sample consisted of 229 persons. The majority of individuals in this study were aged eighty or more at time of death. Men died four years younger, and were significantly more likely to live apart from their partners at time of death, whereas women were significantly more likely to live alone. There were also significant differences in residential environment at time of death, with one-half residing in private homes and the other half in residential care facilities, and this environment was significantly associated with many of the variables analyzed in this study. The group in residential care facilities was, on average, nearly 10 years older than those in private homes. The most common places of death were acute care hospitals and residential care facilities. The less old persons more often died at acute care hospitals whereas the oldest group more commonly died at residential care facilities. The likelihood of inpatient care during last three months of life, including the expected number of hospital admissions, was significantly higher among residents of private homes than among individuals in residential care facilities. However, the presence of mental disorder(s), mainly dementia, was associated with less utilization of both inpatient and hospital-based outpatient care, regardless of residence. Conversely, the likelihood of using outpatient primary care services was significantly higher among residents of residential care facilities than among those in private homes. Factors such as advancing age, ADL-dependency, and living alone increased the likelihood of receiving care at residential care facilities, whereas presence of neoplasm(s) and musculoskeletal disease(s) increased the likelihood of care in a private home. The mean number of all health care services used was 2.67. A wide range of highly prevalent symptoms and problems was identified in the study group, especially among persons who were ADL-dependent. A specific turning point, reflecting onset of the dying process and reorientation of care, was documented in almost three-quarters of the medical or nursing records. Two thirds of these turning points were documented within the last week of life. Findings from this study provide policymakers, health care providers, and professional caregivers with both a reminder and a framework which may contribute to a more mindful and comprehensive understanding of commonplace end-of-life concerns. It is, in fact, suggested that the public health care system as a whole take greater note of the present situation and that it proactively focus on the development of standards for end-of-life care. Its content should be formulated and based on systematic and detailed insights into the identities of the individuals who utilize the health care system at the end of life, where and from whom they receive care, and most importantly, the nature of their problems and needs. Moreover, steps must be taken to continually audit end-of-life care provided by the public health care system, with an objective to constantly improve the scope, quality, and trustworthiness of its services
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| 325. |
- Jakobsson, Eva, 1960, et al.
(författare)
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End-of-life in a Swedish population: demographics, social conditions and characteristics of places of death.
- 2006
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Ingår i: Scandinavian journal of caring sciences. - : Wiley. - 0283-9318 .- 1471-6712. ; 20:1, s. 10-7
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Tidskriftsartikel (refereegranskat)abstract
- The objectives of this study were to identify and describe the demographics and social conditions as well as characteristics of the places of death in a randomly selected sample that died in a county in Sweden during 2001. The present study reports part of the findings from a larger study undertaken during 2003 using a survey design of retrospective reviews of death certificates, medical records, and nursing records. Among several noteworthy findings are: first, an examination of these individuals' living arrangements reveal not only a large and vulnerable group that lives alone at the end-of-life but also a group living separated from their partners near end-of-life; second, individuals differ with respect to residence prior to death, that is private homes versus residential care facilities, imparting highly different contexts of care at the end-of-life; and third, a high prevalence of institutionalized deaths demonstrates that places of death other than hospitals and residential care facilities are uncommon, if not rare. It is concluded that increased attention to the social circumstances of the time period surrounding individuals' at the end-of-life is essential. There is need to develop more integrated models of care for dying people. Contemporary services available are not designed to meet a wide range of peoples' needs at the end-of-life. Home-based care, residential care and hospital care must be adapted to the changing patterns of dying. The services available should be organized to the benefit of the users rather than around the providers. This is the first study of its kind of a Swedish sample and while the data are limited to one county in Sweden its findings may contribute to a deeper understanding of demographic and social patterns at the end-of-life in general.
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| 326. |
- Jakobsson, Eva, et al.
(författare)
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The turning point : Identifying end-of-life care in everyday health care practice
- 2007
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Ingår i: Contemporary Nurse. - : EContent Management Pty Ltd. - 1037-6178 .- 1839-3535. ; 27:1, s. 107-118
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Tidskriftsartikel (refereegranskat)abstract
- There is a broad consensus among international policy statements that care provided at end-of-life should be different from care provided during other periods of life which assumes a turning point which reflects the onset of the dying process and the associated care reorientation. Few studies derived from empirical data have described this turning point from a clinical perspective. With the purpose to increase the clinical understanding about the nature Of such turning points this study explores this phenomenon as determined from health-care records Of a representative sample of adults who accessed the public health care system, and who died in the County of Vastra Gotaland, Sweden, during 2001 (n = 229). Record entries reflecting a turning point, that is recognition as being at the end-of-life and a message about a switch from curative, life-extending or rehabilitative care to an emphasis on palliation, were found in slightly less than 70% of the records while slightly more than 30% lacked such descriptions. The record entries were analyzed with content analysis. As a whole, the descriptions were largely relying on a biomedical discourse and typically put in terms of signs of declining processes, undefined serious condition, Prognostications of fatal outcome or justifications of given up active treatments. The procedures which followed the recognition of a turning point revealed that nurses and physicians typically emphasize procedures directed to the patients' families, on re-orientation Of treatments and on approaches to further care. The picture of the patients' last time of life as reflected from these record entries is that end-of-life is described in biomedical and factual-oriented terms. The end-of-life care was broadly described in vague terms with lack Of concrete care plans. Holistic and good end-of-life care as revealed in this study is indistinguishable, highly embedded in a medical model of care and, hence, an abstract and unknown territory without specific content.
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| 327. |
- Jakobsson, Eva, 1960, et al.
(författare)
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The turning point: Clinical identification of dying and reorientation of care.
- 2006
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Ingår i: Journal of palliative medicine. - : Mary Ann Liebert Inc. - 1096-6218 .- 1557-7740. ; 9:6, s. 1348-58
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Tidskriftsartikel (refereegranskat)abstract
- Palliative care is increasingly organized within the setting of formal health care systems but the demarcation has become unclear between, on the one hand, care directed at cure and rehabilitation and palliative care aimed at relief of suffering on the other. With the purpose to increase the understanding about the turning point reflecting identification of dying and reorientation of care, this study explores this phenomenon as determined from health care records of a representative sample (n = 229). A turning point was identified in 160 records. Presence of circulatory diseases, sporadic confinement to bed, and deterioration of condition had a significant impact upon the incidence of such turning point. The time interval between the turning point and actual death ranged between one and 210 days. Thirty percent of these turning points were documented within the last day of life, 33% during the last 2-7 days, 19.5% during the last 8-30 days, 13% during the last 31-90 days, and 4.5% during the last 91-210 days of life. The time interval between the turning point and actual death was significantly longer among individuals with neoplasm(s) and significantly shorter among individuals suffering from musculoskeletal diseases. Perhaps this reflects a discrepancy between the ideals of palliative care, and a misinterpretation of the meaning of palliative care in everyday clinical practice. The findings underscore that improvement in timing of clinical identification of dying and reorientation of care will likely favour a shift from life-extending care to palliative care.
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| 328. |
- Jakobsson, Eva, et al.
(författare)
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Utilization of health-care services at the end-of-life
- 2006
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Ingår i: Health Policy. - : Elsevier. - 0168-8510 .- 1872-6054. ; 82:3, s. 276-287
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Tidskriftsartikel (refereegranskat)abstract
- End-of-life care poses a growing clinical and policy concern since most people who are dying utilize health-care services during this period of life. Hence, end-of-life care is a common and integral part of the care provided by health-care systems. There is a growing call for the implementation of a palliative approach as an integral part of all end-of-life care. The purpose of this study was thus to provide policy-makers, health-care providers and professional caregivers with increased knowledge about mainstream patterns of health-care utilization during end-of-life. The patterns of use of health-care services in a Swedish population who accessed the health-care system during their last 3 months of life were in this study examined through a retrospective examinations of medical and nursing records (n = 229). We found high prevalences of use of both hospital care, primary care and care provided in people's homes and nearly three quarters of the persons included in the study used between two and three health-care services. However, the probability of using different health-care services was found to be strongly depending on demographic, social, functional and disease related characteristics. The study reveals a considerable use of different health-care services during end-of-life. It is hence essential to, on one hand delineate how such health-care services best can support people at the end-of-life, and on the other hand develop policies which facilitate the process of dying, both in hospitals as well as in peoples’ homes. Implications for policy are discussed.
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| 329. |
- Jangsten, Elisabeth, 1954, et al.
(författare)
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Afterpains : A Comparison Between Active and Expectant Management of the Third Stage of Labor
- 2011
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Ingår i: Birth. - : Wiley-Blackwell. - 0730-7659 .- 1523-536X. ; 38:4, s. 294-301
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Tidskriftsartikel (refereegranskat)abstract
- Background: Management of the third stage of labor, the period following the birth of the infant until delivery of the placenta, is crucial. Active management using synthetic oxytocin has been advocated to decrease blood loss. It has been suggested, but not studied, that oxytocin may increase afterpains. The aim of this study was to compare womens experience of pain intensity when the third stage of labor was managed actively and expectantly and their experience of afterpains. Methods: A single-blind, randomized, controlled trial was performed at two delivery units in Sweden in a population of healthy women with normal, singleton pregnancies, gestational age of 34 to 43 weeks, cephalic presentation, and expected vaginal delivery. Women (n = 1,802) were randomly allocated to either active management or expectant management of the third stage of labor. Afterpains were assessed by Visual Analog Scale (VAS) and the Pain-o-Meter (POM-WDS) 2 hours after delivery of the placenta and the day after childbirth. Results: At 2 hours after childbirth, women in the actively managed group had lower VAS pain scores than expectantly managed women (p = 0.014). Afterpains were scored as more intense the day after, compared with 2 hours after, childbirth in both groups. Multiparas scored more intense afterpains, compared with primiparas, irrespective of management (p < 0.001). Conclusions: Active management of the third stage of labor does not provoke more intense afterpains than expectant management. (BIRTH 38: 4 December 2011)
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| 330. |
- Jansson, Hanna, 1975, et al.
(författare)
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The crystal structure of the spinach plastocyanin double mutant G8D/L12E gives insight into its low reactivity towards photosystem 1 and cytochrome f
- 2003
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Ingår i: Biochimica et Biophysica Acta. - : Elsevier BV. - 0005-2728 .- 1879-2650. ; 1607:2-3, s. 203-210
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Tidskriftsartikel (refereegranskat)abstract
- Plastocyanin (Pc) is a copper-containing protein, which functions as an electron carrier between the cytochrome b6f and photosystem 1 (PS1) complexes in the photosynthetic electron transfer (ET) chain. The ET is mediated by His87 situated in the hydrophobic surface in the north region of Pc. Also situated in this region is Leu12, which mutated to other amino acids severely disturbs the ET from cytochrome f and to PS1, indicating the importance of the hydrophobic surface. The crystal structure of the Pc double mutant G8D/L12E has been determined to 2.0 Å resolution, with a crystallographic R-factor of 18.3% (Rfree=23.2%). A comparison with the wild-type structure reveals that structural differences are limited to the sites of the mutations. In particular, there is a small but significant change in the hydrophobic surface close to His87. Evidently, this leads to a mismatch in the reactive complex with the redox partners. For PS1 this results in a 20 times weaker binding and an eightfold slower ET as determined by kinetic measurements. The mutations that have been introduced do not affect the optical absorption spectrum. However, there is a small change in the EPR spectrum, which can be related to changes in the copper coordination geometry.
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