| 1. |
- Ekberg, Kerstin, et al.
(författare)
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Lättare psykisk ohälsa
- 2015
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Ingår i: Återgång i arbete. Processer, bedömningar och åtgärder. - Lund : Studentlitteratur AB. ; , s. 111-127, s. 111-128
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Bokkapitel (populärvet., debatt m.m.)
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| 2. |
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| 3. |
- Johansson, Karl-Axel, et al.
(författare)
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The quality assurance process for the ARTSCAN head and neck study - a practical interactive approach for QA in 3DCRT and IMRT.
- 2008
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Ingår i: Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology. - : Elsevier BV. - 0167-8140 .- 1879-0887. ; 87:2, s. 290-9
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Tidskriftsartikel (refereegranskat)abstract
- AIM: This paper describes the quality assurance (QA) work performed in the Swedish multicenter ARTSCAN (Accelerated RadioTherapy of Squamous cell CArcinomas in the head and Neck) trial to guarantee high quality in a multicenter study which involved modern radiotherapy such as 3DCRT or IMRT. MATERIALS AND METHODS: The study was closed in June 2006 with 750 randomised patients. Radiation therapy-related data for every patient were sent by each participating centre to the QA office where all trial data were reviewed, analysed and stored. In case of any deviation from the protocol, an interactive process was started between the QA office and the local responsible clinician and/or physicist to increase the compliance to the protocol for future randomised patients. Meetings and workshops were held on a regular basis for discussions on various trial-related issues and for the QA office to report on updated results. RESULTS AND DISCUSSION: This review covers the 734 patients out of a total of 750 who had entered the study. Deviations early in the study were corrected so that the overall compliance to the protocol was very high. There were only negligible variations in doses and dose distributions to target volumes for each specific site and stage. The quality of the treatments was high. Furthermore, an extensive database of treatment parameters was accumulated for future dose-volume vs. endpoint evaluations. CONCLUSIONS: This comprehensive QA programme increased the probability to draw firm conclusions from our study and may serve as a concept for QA work in future radiotherapy trials where comparatively small effects are searched for in a heterogeneous tumour population.
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| 4. |
- Ahlgren, Katrin, 1970-
(författare)
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Narrativa identiteter och levande metaforer i ett andraspråksperspektiv
- 2014
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This thesis consists of two separate yet connected studies which investigate how some adult second language speakers of Swedish with various backgrounds reflect on their experiences of language use. The studies are based on the same empirical data, which consists of questionnaires, diaries, essays and observations, but primarily of conversations conducted with a time interval of six years. This data is analysed from a theoretical framework based on Paul Ricœur’s ideas of interpretation, narrative analysis and identity creation, which recur as a leitmotif throughout the thesis.In the first study, data from three second language speakers are analysed by means of the concept of narrative identity, shedding light on the interplay between a static and a dynamic identity. The result is presented in the form of life narratives, which are commented on in relation to those strategies the participants express in relation to their second language use. The analysis shows a development over time moving from defiance to acceptance, from avoidance to flexibility and from planning to simplification. Adult language learning stands out as an arduous and time-consuming process with major consequences for the learner’s ego, a conclusion confirmed and clarified in the metaphor analysis of the second study in which language learning is related to hard work, a constant struggle and a long and strenuous journey. Here it also becomes evident that the participants equate language learning and language use to physical exertion and challenge as well as to individual achievement. This becomes particularly clear in the linked chains of metaphors in which language use is compared with skiing down the steepest slopes or appearing on stage.The participants in both studies are quoted by means of an ethnopoetic method which aims to bring out the creative aspects of their language use and to give second language speakers a voice – a voice which does not need to be corrected and gives the narratives a new dimension.
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| 5. |
- Baumann, Pia, et al.
(författare)
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Factors important for efficacy of stereotactic body radiotherapy of medically inoperable stage I lung cancer. A retrospective analysis of patients treated in the Nordic countries.
- 2006
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Ingår i: Acta oncologica (Stockholm, Sweden). - : Informa UK Limited. - 0284-186X .- 1651-226X. ; 45:7, s. 787-95
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Tidskriftsartikel (refereegranskat)abstract
- We reviewed results of SBRT treatment of 138 patients with medically inoperable stage I NSCLC treated during 1996-2003 at five different centres in Sweden and Denmark. Mean age was 74 years (range 56-90) with 69 men and 72 women. SBRT was delivered using a 3D conformal multifield technique and a stereotactic body frame. Doses delivered were 30-48 Gy (65% isodose at the periphery of planning target volume, PTV) in 2-4 fractions. Equivalent dose in 2 Gy fractions (EQD2) was in the range of 50-100 Gy. Mean gross tumour volume (GTV) was 39 cm3 (2-436), and planning target volume was 101 cm3 (11-719). Overall response rate (CR, PR) was 61% (84/138). SD was noted in 36% (50/138). During a median follow-up period of 33 months (1-107), 16 (12%) local failures occurred, ten of which also included distant metastases. Local failure was associated with tumour size, target definition and central or pleura proximity. Distant metastases occurred in 25% (35/138) of the patients. Ninety-one (65%) patients died during follow-up of which 55 patients (60%) died of other causes than lung cancer. Three- and 5-year overall survival was 52 and 26% respectively. Lung cancer specific 3- and 5-year overall survival was 66 and 40% respectively. Fifty nine percent (83/138) of the patients had no side effects. Fourteen patients experienced grade 3-4 toxicity according to radiation therapy oncology group (RTOG). EQD2 (> v.s.<55.6 Gy) showed a statistically significant benefit survival for the higher doses. SBRT for stage I NSCLC results in favourable local control not inferior to fractionated RT and with acceptable toxicity.
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| 6. |
- Baumann, Pia, et al.
(författare)
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Outcome in a prospective phase II trial of medically inoperable stage I non-small-cell lung cancer patients treated with stereotactic body radiotherapy.
- 2009
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Ingår i: Journal of clinical oncology : official journal of the American Society of Clinical Oncology. - 1527-7755 .- 0732-183X. ; 27:20, s. 3290-6
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: The impact of stereotactic body radiotherapy (SBRT) on 3-year progression-free survival of medically inoperable patients with stage I non-small-cell lung cancer (NSCLC) was analyzed in a prospective phase II study. PATIENTS AND METHODS: Fifty-seven patients with T1NOMO (70%) and T2N0M0 (30%) were included between August 2003 and September 2005 at seven different centers in Sweden, Norway, and Denmark and observed up to 36 months. SBRT was delivered with 15 Gy times three at the 67% isodose of the planning target volume. RESULTS: Progression-free survival at 3 years was 52%. Overall- and cancer-specific survival at 1, 2, and 3 years was 86%, 65%, 60%, and 93%, 88%, 88%, respectively. There was no statistically significant difference in survival between patients with T1 or T2 tumors. At a median follow-up of 35 months (range, 4 to 47 months), 27 patients (47%) were deceased, seven as a result of lung cancer and 20 as a result of concurrent disease. Kaplan-Meier estimated local control at 3 years was 92%. Local relapse was observed in four patients (7%). Regional relapse was observed in three patients (5%). Nine patients (16%) developed distant metastases. The estimated risk of all failure (local, regional, or distant metastases) was increased in patients with T2 (41%) compared with those with T1 (18%) tumors (P = .027). CONCLUSION: With a 3-year local tumor control rate higher than 90% with limited toxicity, SBRT emerges as state-of-the-art treatment for medically inoperable stage I NSCLC and may even challenge surgery in operable instances.
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| 7. |
- Baumann, Pia, et al.
(författare)
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Stereotactic body radiotherapy for medically inoperable patients with stage I non-small cell lung cancer - a first report of toxicity related to COPD/CVD in a non-randomized prospective phase II study.
- 2008
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Ingår i: Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology. - : Elsevier BV. - 0167-8140 .- 1879-0887. ; 88:3, s. 359-67
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND AND AIMS: In a retrospective study using stereotactic body radiotherapy (SBRT) in medically inoperable patients with stage I NSCLC we previously reported a local control rate of 88% utilizing a median dose of 15Gyx3. This report records the toxicity encountered in a prospective phase II trial, and its relation to coexisting chronic obstructive pulmonary disease (COPD) and cardio vascular disease (CVD). MATERIAL AND METHODS: Sixty patients were entered in the study between August 2003 and September 2005. Fifty-seven patients (T1 65%, T2 35%) with a median age of 75 years (59-87 years) were evaluable. The baseline mean FEV1% was 64% and median Karnofsky index was 80. A total dose of 45Gy was delivered in three fractions at the 67% isodose of the PTV. Clinical, pulmonary and radiological evaluations were made at 6 weeks, 3, 6, 9, 12, 18, and 36 months post-SBRT. Toxicity was graded according to CTC v2.0 and performance status was graded according to the Karnofsky scale. RESULTS: At a median follow-up of 23 months, 2 patients had relapsed locally. No grade 4 or 5 toxicity was reported. Grade 3 toxicity was seen in 12 patients (21%). There was no significant decline of FEV1% during follow-up. Low grade pneumonitis developed to the same extent in the CVD 3/17 (18%) and COPD 7/40 (18%) groups. The incidence of fibrosis was 9/17 (53%) and pleural effusions was 8/17 (47%) in the CVD group compared with 13/40 (33%) and 5/40 (13%) in the COPD group. CONCLUSION: SBRT for stage I NSCLC patients who are medically inoperable because of COPD and CVD results in a favourable local control rate with a low incidence of grade 3 and no grade 4 or 5 toxicity.
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| 8. |
- Bengtsson Malmeblad, Lena, et al.
(författare)
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Avstämningsmötet. En utredningsmetod?
- 2007
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Avstämningsmötet är en metod inom Försäkringskassan som syftar till att ge bättre beslutsunderlag för deras bedömningar av sjukskrivnas arbetsförmåga och rehabiliteringsbehov. Målet är att förkorta sjukskrivningstider och snabbare få människor tillbaka i arbete. I och med den kraftigt ökade sjukfrånvaron i slutet av 1990-talet uppmärksammades att Försäkringskassans tillämpning av sjukförsäkringens regelverk varierar mellan olika delar av landet och även mellan olika lokalkontor. Som en konsekvens påbörjades ett omfattande arbete med att professionalisera handläggningen genom att utveckla gemensamma metoder och arbetssätt. År 2005 gjordes en skärpning av lagstiftningen genom att starkare reglera de tidsgränser inom vilka ett avstämningsmöte skall hållas och man etablerade produktionsmål inom Försäkringskassan i termer av antal avstämningsmöten inom 90 dagar i sjukskrivningen. I denna studie har 11 handläggare inom Försäkringskassan intervjuats om sin syn på avstämningsmötet som utredningsmetod och på vilket sätt den påverkar den sjukskrivnes återgång i arbete. Studien fokuserar på det första avstämningsmötet i sjukskrivningen, sex av dessa genomfördes före 90-dagars gränsen och fem genomfördes senare i sjukskrivningsprocessen. Analyserna av intervjuerna resulterade i fem huvudområden som berör upplevelser av produktionskraven, förberedelser respektive genomförande av avstämningsmötet, läkarens roll vid avstämningsmötet samt mötets betydelse för återgång i arbete. Handläggarna upplever en konflikt mellan kravet på att hålla produktionsmålet på avstämningsmöte inom 90 dagar och sin professionella bedömning av när ett avstämningsmöte passar in i rehabiliteringsprocessen. Ur handläggarnas perspektiv har det skett en värderingsförskjutning från en helhetssyn på rehabiliteringsprocessen med individen i centrum, till mer kortsiktiga produktionsmål som fragmenterar processen. Produktionskraven leder också till att vissa sjukskrivningsärenden som bedöms vara lämpade för ett avstämningsmöte måste prioriteras bort då de passerat tidsgränsen, medan man genomför andra möten, där både handläggaren och läkaren anser att det kommer för tidigt i rehabiliteringsprocessen. Avstämningsmötena riskerar att bli formaliserade och rutindrivna aktiviteter, snarare än allsidiga bedömningar. Den formaliserade agendan vid avstämningsmötet tycks kunna leda till att deltagarna upplever en osäkerhet om mötets syfte, eller tolkar syftet annorlunda än handläggaren. Handläggaren uppfattar sig tappa kontrollen över mötet. Av tidsskäl gör man ofta avkall på att kalla läkaren till mötet, trots att mötet syftar till att diskutera arbetsförmåga och sjukskrivningens omfattning. Såväl strukturen, den reglering som styr avstämningsmötet, som handläggarnas egna erfarenheter av hur kontakter med läkare fungerar, bidrar till att handläggarna utvecklar olika strategier för att undvika att bli beroende av läkarnas fysiska deltagande i mötet. Det medicinska underlaget är centralt i bedömningen av individens arbetsförmåga, den ofta förekommande frånvaron av läkare, liksom den stora variationen i hur de fördjupade Sassam-utredningarna genomförs, skapar därför dilemman, som dock även kan innebära en handlingsfrihet för handläggaren i prioriteringar av ärenden. Rapporten visar sammanfattningsvis handläggares dilemman i sin roll att översätta politiska beslut och mål till vardagens praktik. Resultaten visar också deras möjligheter att prioritera och hantera dessa dilemman inom ramen för en ökad administrativ kontroll.
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| 9. |
- Boström, Per, 1982-
(författare)
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”Det här är ju dött tåg liksom…” : en studie av metaforer för ROMANTISK KÄRLEK i talad svenska
- 2018
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The purpose of this study is to investigate the metaphorization of ROMANTIC LOVE in spoken Swedish. The study is based on 4 semi-structured focus group conversations with participants in two age groups; 24–33 and 50–54. A Swedish short film and questions related to the film were used as stimuli for the conversations. Research questions asked are 1) How is the concept of ROMANTIC LOVE metaphorized in the recorded group conversations? 2) How does the metaphorization vary between the conversations? and 3) What cultural model for ROMANTIC LOVE in the conversations can be reconstructed based on identified metaphorizations? The study is situated within Cognitive Linguistics and the framework of Conceptual Metaphor Theory and a Discourse Dynamics Approach to Metaphor. Consequently, metaphor is seen as a cognitive, linguistic, socio-cultural and discursive phenomenon, where metaphorization is a dynamic process that develops, adapts and flows within the conversations and between the participants. Accordingly, the identified metaphorizations are considered to be influenced by the speakers and their embodied experiences, their embodied cognition, the discourse event, and socio-cultural aspects of metaphorization. The focus of the present study, ROMANTIC LOVE, is considered as a dynamic concept based on philosophical, feminist, psychological and metaphorical research. Metaphors are identified through a discourse dynamic version of MIP and MIPVU.From the analyses, 6 systematic metaphors are proposed, where ROMANTIC LOVE is metaphorized as a PHYSICAL OBJECT (incl. as a POSSESSION and as a LIVING ORGANISM), as a CONTAINER (incl. CONSTRUCTION and BODY as a CONTAINER), as TRAVELLING together (with primary focus on TRAVELLING together rather than SOURCE or TARGET), as a UNITY (with focus on how a UNITY is ESTABLISHED, MAINTAINED and DISSOLVED, ideally by two COMPATIBLE partners), as a PHYSICAL and NATURAL FORCE and as a DISEASE (where LOVE can affect a person’s perception and sanity). In addition, ROMANTIC LOVE is, in a small number of expressions, metaphorized as a CRIME, as a PHYSICAL CONFLICT and as a GAME. The variation in metaphorization is small between the conversations. Some metaphorizations seem to be related to the age of the participants. ROMANTIC LOVE ismoreover something people usually have influence over and in some ways can control. In total, 780 metaphorical expressions and 9 source domains are identified. Departing from the interplay betweenmetaphorization and culture, a cultural model for ROMANTIC LOVE is reconstructed, where a multifaceted, embodied and experiential concept of ROMANTIC LOVE emerges.
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| 10. |
- Christensen, Torben, et al.
(författare)
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Factors controlling large scale variations in methane emissions from wetlands
- 2003
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Ingår i: Geophysical Research Letters. - 0094-8276 .- 1944-8007. ; 30:7
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Tidskriftsartikel (refereegranskat)abstract
- [1] Global wetlands are, at estimate ranging 115-237 Tg CH4/yr, the largest single atmospheric source of the greenhouse gas methane (CH4). We present a dataset on CH4 flux rates totaling 12 measurement years at sites from Greenland, Iceland, Scandinavia and Siberia. We find that temperature and microbial substrate availability (expressed as the organic acid concentration in peat water) combined explain almost 100% of the variations in mean annual CH4 emissions. The temperature sensitivity of the CH4 emissions shown suggests a feedback mechanism on climate change that could validate incorporation in further developments of global circulation models.
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