| 1. |
- Girma Kebede, Betlehem, et al.
(författare)
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Communicative challenges among physicians, patients, and family caregivers in cancer care: An exploratory qualitative study in Ethiopia
- 2020
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Ingår i: PLoS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 15:3
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Tidskriftsartikel (refereegranskat)abstract
- Background: Cancer is a growing concern in Ethiopia. Though communication is essential for the treatment process, few studies have looked at communication in Ethiopian cancer care. Due to the large number of patients and scarcity of resources, it is vital to understand how to manage consultations in order to effectively help as many patients as possible in this challenging work environment. Thus, research is needed to analyze and understand the communicative challenges experienced by physicians, patients, and family caregivers, in order to successfully handle patient care in practice. Objective We explore communication in Ethiopian cancer care and present the main challenges faced by physicians, patients, and family caregivers. Methods This explorative qualitative study was conducted at the Oncology Department of the Tikur Anbessa (Black Lion) Specialized Teaching Hospital (TASH) in Addis Ababa, Ethiopia. A triangulation of data collection methods was used: 91 audio-recorded, semi-structured interviews and 21 video-recordings of authentic interactions during hospital rounds. The aim was to obtain as complete a picture as possible of communication from the perspectives of physicians, patients, and family caregivers. The interviews were analyzed using thematic content analysis and the identified themes were supported by excerpts from the transcribed recordings. Results Eight themes emerged from the data. Workload and time pressure, in combination with restricted space for privacy, limited the possibilities for physicians to deliver detailed information and provide emotional support. Furthermore, patient literacy levels, in combination with no or little cancer awareness, financial problems, reliance on traditional and religious treatments, the stigma of cancer, and a fatalistic attitude, resulted in delays in patients seeking care and participating in positive health behaviors, and, subsequently, often resulted in an unwillingness to openly discuss problems with physicians and adhere to treatment. The study also illustrates the paramount role of family in physician-patient communication in Ethiopia. Though family caregivers provide a valuable interpreting support when patients have limited language skills, they can also prevent patients from sharing information with physicians. Another important finding is that family caregivers were often responsible for making decisions about treatment and avoided telling patients about a poor prognosis, believing that conveying bad news may upset them. All of these themes have important implications for the role of ethically acceptable communication in patient-centered care. Conclusions This study has identified a number of serious challenges for successful and ethically acceptable health communication in Ethiopian cancer care. The study contributes to our understanding of the complexity around the role of family, combined with patients’ dependency on family members for communication, support, and access to care, which creates particular ethical dilemmas for the medical staff. The questions raised by this study concern how to organize consultations to achieve patient-centered health communication, while maintaining a constructive alliance with the family and not jeopardizing the patient’s continued access to care. The integration of communication training for medical students in Ethiopia, with a focus on ethical guidelines for family-centered patient consultation suitable for these circumstances, would be an essential step.
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| 2. |
- Kullenberg, Christopher, 1980, et al.
(författare)
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What are analog bulletin boards used for today? Analysing media uses, intermediality and technology affordances in Swedish bulletin board messages using a citizen science approach
- 2018
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Ingår i: PLoS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 13:8
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Tidskriftsartikel (refereegranskat)abstract
- Analog bulletin boards are omnipresent in Swedish urban areas, yet little systematic knowledge about this communication medium exists. In the shadow of the rapid emergence of digital media the analog bulletin board has received less attention than its digital successors, many of them having incorporated similar functionality with novel technical solutions. In this study we used a citizen science method to collect 1167 messages from bulletin boards around Sweden aided by school children and teachers, with the purpose of shedding new light on what is communicated on the boards, by whom, using what types of technologies and in what way the messages refer to other media. Results show that the most common messages are invitations to events, such as concerts, lectures and sports events, followed by buy-and-sell ads for goods and services. The most frequent sender is an association, for example NGOs, sports associations or religious communities. Almost half of the sampled messages were professionally printed, about forty per cent were made by home printers. Only six per cent of the messages were handwritten, almost exclusively by private persons as senders. Moreover, we show how the analog bulletin board has adapted to recent changes in media technology—a media landscape which is saturated with electronic- and mobile media. Further, the bulletin board still holds a firm place in a media ecology where local communication is in demand, and exists in parallel with electronic media. Close to forty percent of the messages contained hyperlinks to web pages and we found (and removed for anonymization purposes) more than six hundred phone numbers from the dataset.
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| 3. |
- Boethius, Adam, et al.
(författare)
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Human encroachment, climate change and the loss of our archaeological organic cultural heritage : Accelerated bone deterioration at Ageröd, a revisited Scandinavian Mesolithic key-site in despair
- 2020
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Ingår i: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 15:7
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Tidskriftsartikel (refereegranskat)abstract
- Ancient organic remains are essential for the reconstruction of past human lifeways and environments but are only preserved under particular conditions. Recent findings indicate that such conditions are becoming rarer and that archaeological sites with previously good preservation, are deteriorating. To investigate this, we returned to the well-known Swedish Mesolithic site Agerod I. Here we present the result of the re-excavation and the osteological analyses of the bone remains from the 1940s, 1970s and 2019 excavation campaigns of the site, to document and quantify changes in bone preservation and relate them to variations in soil conditions and on-site topography. The results indicate that the bone material has suffered from accelerated deterioration during the last 75 years. This has led to heavily degraded remains in some areas and complete destruction in others. We conclude that while Agerod can still be considered an important site, it has lost much of the properties that made it unique. If no actions are taken to secure its future preservation, the site will soon lose the organic remains that before modern encroachment and climate change had been preserved for 9000 years. Finally, because Agerod has not been subjected to more or heavier encroachment than most other archaeological sites, our results also raise questions of the state of organic preservation in other areas and call for a broad examination of our most vulnerable hidden archaeological remains.
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| 4. |
- Boethius, Adam, et al.
(författare)
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Quantifying archaeo-organic degradation - A multiproxy approach to understand the accelerated deterioration of the ancient organic cultural heritage at the Swedish Mesolithic site Ageröd
- 2020
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Ingår i: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 15:9
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Tidskriftsartikel (refereegranskat)abstract
- Despite a growing body of evidence concerning accelerated organic degradation at archaeological sites, there have been few follow-up investigations to examine the status of the remaining archaeological materials in the ground. To address the question of archaeo-organic preservation, we revisited the Swedish, Mesolithic key-site Ageröd and could show that the bone material had been subjected to an accelerated deterioration during the last 75 years, which had destroyed the bones in the areas where they had previously been best preserved. To understand why this has happened and to quantify and qualify the extent of the organic degradation, we here analyse the soil chemistry, bone histology, collagen preservation and palaeobotany at the site. Our results show that the soil at Ageröd is losing, or has already lost, its preservative and buffering qualities, and that pH-values in the still wet areas of the site have dropped to levels where no bone preservation is possible. Our results suggest that this acidification process is enhanced by the release of sulphuric acid as pyrite in the bones oxidizes. While we are still able to find well-preserved palaeobotanical remains, they are also starting to corrode through re-introduced oxygen into the archaeological layers. While some areas of the site have been more protected through redeposited soil on top of the archaeological layers, all areas of Ageröd are rapidly deteriorating. Lastly, while it is still possible to perform molecular analyses on the best-preserved bones from the most protected areas, this opportunity will likely be lost within a few decades. In conclusion, we find that if we, as a society, wish to keep this valuable climatic, environmental and cultural archive, both at Ageröd and elsewhere, the time to act is now and if we wait we will soon be in a situation where this record will be irretrievably lost forever.
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| 5. |
- Jon-And, Anna, 1976-, et al.
(författare)
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A model of contact-induced language change : Testing the role of second language speakers in the evolution of Mozambican Portuguese
- 2019
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Ingår i: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 14:4
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Tidskriftsartikel (refereegranskat)abstract
- Language change is accelerated by language contact, especially by contact that occurs when a group of speakers shifts from one language to another. This has commonly been explained by linguistic innovation occurring during second language acquisition. This hypothesis is based on historical reconstructions of instances of contact and has not been formally tested on empirical data. In this paper, we construct an agent-based model to formalize the hypothesis that second language speakers are responsible for accelerated language change during language shift. We compare model predictions to a unique combination of diachronic linguistic and demographic data from Maputu, Mozambique. The model correctly predicts an increased proportional use of the novel linguistic variants during the period we study. We find that a modified version of the model is a better fit to one of our two datasets and discuss plausible reasons for this. As a general conclusion concerning typological differences between contact-induced and non-contact-induced language change, we suggest that multiple introductions of a new linguistic variant by different individuals may be the mechanism by which language contact accelerates language change.
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| 6. |
- Blennow, Kristina, et al.
(författare)
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Are values related to culture, identity, community cohesion and sense of place the values most vulnerable to climate change?
- 2019
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Ingår i: PLoS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 14:1
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Tidskriftsartikel (refereegranskat)abstract
- Values related to culture, identity, community cohesion and sense of place have sometimes been downplayed in the climate change discourse. However, they have been suggested to be not only important to citizens but the values most vulnerable to climate change. Here we test four empirical consequences of the suggestion: (i) at least 50% of the locations citizens' consider to be the most important locations in their municipality are chosen because they represent these values, (ii) locations representing these values have a high probability of being damaged by climate change induced sea level rise, (iii) citizens for which these values are particularly strongly held less strongly believe in the local effects of climate change, and (iv) citizens for which these values are particularly strongly held less strongly believe that they have experienced the effects of climate change. The tests were made using survey data collected in 2014 from 326 citizens owning property in Höganäs municipality, Sweden, and included values elicited using a new methodology separating instrumental values from end values, and using the former (which strictly speaking should be seen as estimates of usefulness rather than as aims in themselves) as stepping stones to pinpoint the latter, that represent the true interests of the respondents. The results provide the first evidence that, albeit frequent, values related to culture, identity, community cohesion and sense of place are not the values most vulnerable to climate change. This in turn indicates a need to further investigate the vulnerability of these values to climate change, using a methodology that clearly distinguishes between instrumental and end values.
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| 7. |
- El-Alti, Leila, 1986, et al.
(författare)
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Caregiver perspectives on patient capacities and institutional pathways to person centered forensic psychiatric care
- 2022
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Ingår i: PLoS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 17:9
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Tidskriftsartikel (refereegranskat)abstract
- The ethical discourse surrounding patients’ agential capacities, vis-à-vis their active participation in shared decision-making (SDM) in forensic psychiatric (FP) contexts, is an unexplored area of inquiry. The aim of this paper is to explore caregivers’ perceptions of patient agential capacities and institutional pathways and barriers to person centered care (PCC) in the context of FP. Following an exploratory qualitative design, we conducted eight semi-structured interviews with hands-on caregivers at an in-patient FP facility in Sweden. A deductive framework method of analysis was employed, and four themes emerged: “Fundamental Variability in Patient Capacity”, “Patient Participation: Narration or Compliance?”, “Antagonism Rooted in Power Struggles”, and “System Structure Thwarts Patient Release”. While the results generally paint a bleak picture for the possibility of a person-centered FP care, we describe a constrained version of PCC with high-level SDM dynamics which promotes a certain degree of patient empowerment while allowing care strategies, within set restrictions, to promote patient adherence and treatment progress.
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| 8. |
- Frei, K. M., et al.
(författare)
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A matter of months: High precision migration chronology of a Bronze Age female
- 2017
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Ingår i: Plos One. - : Public Library of Science (PLoS). - 1932-6203. ; 12:6
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Tidskriftsartikel (refereegranskat)abstract
- Establishing the age at which prehistoric individuals move away from their childhood residential location holds crucial information about the socio dynamics and mobility patterns in ancient societies. We present a novel combination of strontium isotope analyses performed on the over 3000 year old "Skrydstrup Woman" from Denmark, for whom we compiled a highly detailed month-scale model of her migration timeline. When combined with physical anthropological analyses this timeline can be related to the chronological age at which the residential location changed. We conducted a series of high-resolution strontium isotope analyses of hard and soft human tissues and combined these with anthropological investigations including CT-scanning and 3D visualizations. The Skrydstrup Woman lived during a pan-European period characterized by technical innovation and great social transformations stimulated by long-distance connections; consequently she represents an important part of both Danish and European prehistory. Our multidisciplinary study involves complementary biochemical, biomolecular and microscopy analyses of her scalp hair. Our results reveal that the Skrydstrup Woman was between 17-18 years old when she died, and that she moved from her place of origin -outside present day Denmark- to the Skrydstrup area in Denmark 47 to 42 months before she died. Hence, she was between 13 to 14 years old when she migrated to and resided in the area around Skrydstrup for the rest of her life. From an archaeological standpoint, this one-time and one-way movement of an elite female during the possible "age of marriageability" might suggest that she migrated with the aim of establishing an alliance between chiefdoms. Consequently, this detailed multidisciplinary investigation provides a novel tool to reconstruct high resolution chronology of individual mobility with the perspective of studying complex patterns of social and economic interaction in prehistory.
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| 9. |
- Gerardi, Fabricio Ferraz, et al.
(författare)
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Lexical phylogenetics of the Tupi-Guarani family : Language, archaeology, and the problem of chronology
- 2023
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Ingår i: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 18:6
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Tidskriftsartikel (refereegranskat)abstract
- Tupi-Guarani is one of the largest branches of the Tupian language family, but despite its relevance there is no consensus about its origins in terms of age, homeland, and expansion. Linguistic classifications vary significantly, with archaeological studies suggesting incompatible date ranges while ethnographic literature confirms the close similarities as a result of continuous inter-family contact. To investigate this issue, we use a linguistic database of cognate data, employing Bayesian phylogenetic methods to infer a dated tree and to build a phylogeographic expansion model. Results suggest that the branch originated around 2500 BP in the area of the upper course of the Tapajos-Xingu basins, with a split between Southern and Northern varieties beginning around 1750 BP. We analyse the difficulties in reconciling archaeological and linguistic data for this group, stressing the importance of developing an interdisciplinary unified model that incorporates evidence from both disciplines.
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| 10. |
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