| 1. |
- Henningsson, Anna J, 1972-
(author)
-
Clinical, epidemiological and immunological aspects of Lyme borreliosis with special focus on the role of the complement system
- 2011
-
Doctoral thesis (other academic/artistic)abstract
- Lyme borreliosis (LB) is the most common vector-borne disease in the Northern Hemisphere. The infection is caused by spirochetes belonging to the Borrelia burgdorferi sensu lato complex, and it is transmitted to humans by ticks. LB is associated with several clinical manifestations, of which erythema migrans (EM) and neuroborreliosis (NB) are the most common inEurope. The course of the disease is usually benign, but can vary between individuals. The underlying pathogenic mechanisms are not fully understood, but the prognosis is probably determined by a complex interplay between the bacteria and the host’s immune response. Previous studies have indicated that a strong initial T helper (Th) 1-response followed by a Th2 response is beneficial for the clinical outcome in LB.The aims of this thesis were to follow the incidence of NB inJönköping County,Sweden, over time, to search for clinical and laboratory markers associated with the risk of developing long-lasting post-treatment symptoms, and to explore the role of the complement system as well as the relative balance between Th-associated cytokine/chemokine responses in LB.The number of NB cases, diagnosed by cerebrospinal fluid (CSF) analysis, increased from 5 to 10/100,000 inhabitants/year in Jönköping County during 2000-2005. Post-treatment symptoms persisting more than 6 months occurred in 13 %, and were associated with higher age, longer-lasting symptoms prior to treatment, higher levels of Borrelia-specific IgG in CSF, and reported symptoms of radiculitis. Facial palsy, headache and fever were frequent manifestations in children, whereas unspecific muscle and joint pain were the most commonly reported symptoms in older patients.Complement activation occurred both locally in the skin in EM and in CSF of NB patients. However, no activation could be detected in blood in NB patients. Elevated levels of C1q, C4 and C3a in CSF, along with correlation between C1q and C3a levels, suggest complement activation via the classical pathway locally in the central nervous system in NB. In vitro experiments with two clinical Borrelia isolates revealed that B. garinii LU59 induced higher complement activation in human plasma compared to B. afzelii K78 that recruited more of complement regulator factor H. To elucidate the role of complement in the phagocytosis process, experiments were performed using whole blood from healthy donors incubated with fluorescence-labelled spirochetes and different complement inhibitors. The results illustrated a central role of complement for phagocytosis of Borrelia spirochetes.We also studied the relative contribution of different Th-associated cytokines/chemokine responses in NB. The results support the notion that early NB is dominated by a Th1 response, eventually accompanied by a Th2 response. IL-17A was increased in CSF in half of the patients with confirmed NB, suggesting a hitherto unknown role of Th17 in NB.In conclusion, the risk of developing long-lasting post-treatment symptoms tend to increase mainly with age and duration of symptoms prior to treatment in NB. The complement system seems to play an important role in host defence to recognize and kill Borrelia spirochetes. However, complement activation in inappropriate sites or to an excessive degree may cause tissue damage, and therefore, the role of complement in relation to disease course needs to be studied further. Likewise, the role of Th17 in LB pathogenesis and host defence should be further evaluated in prospective studies.
|
|
| 2. |
- Jonsson, Karin, 1980-
(author)
-
Fångna i begreppen? : Revolution, tid och politik i svensk socialistisk press 1917–1924
- 2017
-
Doctoral thesis (other academic/artistic)abstract
- This thesis studies the uses of the concept of revolution in Swedish socialist press from 1917 to 1924. Political revolution and civil wars shook several countries. The Russian February and October Revolutions were soon followed by uprisings in countries such as Germany and Finland.While the social and political history of this period, with its mass demonstrations for bread and voting rights, often called the Swedish revolution, has been covered extensively in existing research, we know much less about the theoretical understanding of revolution among Swedish socialists. This thesis examines the concept of revolution from a perspective inspired by the Begriffsgeschichte of German historian Reinhart Koselleck. This foundation in the history of concepts aims at understanding how Swedish socialists, in a wide sense, understood their own time, how they related to the past and what they expected from the future, during the years of the First World War and the immediately following years. By focusing on what might be the most central, but also the most contested and most difficult to define, concept I hope to complement earlier research focusing on the social and political history of the period and its socialist movements.The main purpose of the thesis is to analyse how the labour movement understood revolution with particular weight placed upon the theoretical and ideological tensions between revolution and reform, determinism and voluntarism and localized and universal revolution. The starting point is the political and social changes in Sweden and abroad at that time and the place of the political press as opinion leaders capable of negotiating the space of political action. A secondary aim is to discuss how focusing on temporality can inspire new perspectives on the use of conceptual history.My research shows that how the concept of revolution was used was shaped both by already established notions regarding the socialist revolution as well as by the political situation at hand. The October Revolution forced a sharpening of its meaning, wherein different factions elaborated their understanding of it in relation to each other, which in turn determined how the concept was used fom that point on.
|
|
| 3. |
|
|
| 4. |
- Hägglund, Josefin
(author)
-
Demokratins stridslinjer : Carl Lindhagen och politikens omvandling, 1896–1923
- 2023
-
Doctoral thesis (other academic/artistic)abstract
- Carl Lindhagen was one of Sweden’s most well-known politicians at the beginning ofthe 20th century. He entered parliament as a Liberal in 1897 but joined the Social Democrats in 1909. In 1917 he became a key figure in forming the Left Socialist party,which became the Swedish Communist Party in 1921 – although it expelled him in that moment. He returned to the Social Democrats in 1923. During those years, Sweden gradually moved towards universal suffrage, including most men in 1909 and women in 1921. As an MP, Lindhagen was a central actor in debates concerning democracy, combining the roles of the visionary political thinker and the hands-on political practitioner, and doing so in ways that would spark both enthusiasm and controversy among his contemporaries. This dissertation examines how Lindhagen interpreted the transformation of politics 1896–1923, how he envisioned a future of “true” democracy and the steps he took to realize his ideals. In his perspective, the constitutional reforms of the 1910s and the 1920s only achieved “formal” democracy. From the early 1910s he preferred to label himself as a ”humanist”, seeing Liberalism and Socialism as temporary forces, contributing elements to a historical process approaching the universal values of “humanism”. In 1919 he also created a party transcending organization for “humanist politics”, gathering like-minded people among Left Socialists, Social Democrats, and Liberal leftists.This study concentrates on Lindhagen’s most active and influential years, finding its central sources in texts which he wrote, modified, used and reused, for many purposes within the parliament and in his party organizations, as well as in addressing a general public. Three chronological parts follow Lindhagen through his political affiliations, 1896–1909,1909–1917, and 1917–1923. The study shows a remarkable amount of continuity in Lindhagen’s attitudes and positions, although he elaborated them, as well as the language he used to express them, due to new experiences, situations, and political environments. This makes him a tellingly complex case in the historiography of Liberalism, Social Democracy, and Communism in Sweden. Adding to this telling complexity is also the way in which Lindhagen gradually focused more and more on political parties as a central political problem, stressing that a condition for “true democracy” was practical measures of democracy at alllevels in the political process, especially within the political parties which took theirmodern form during the era studied in the dissertation.
|
|
| 5. |
- Wissendorff Ekdahl, Anne
(author)
-
Frail and Elderly Hospital Patients : The Challenge of Participation in Medical Decision Making
- 2012
-
Doctoral thesis (other academic/artistic)abstract
- Background: In research, patient participation in medical decision-making has been shown to be associated with higher patient satisfaction and improvement of treatment outcomes. But when it comes to patient participation when being old and frail there are pitfalls and the research in this area is sparse.The aim of this thesis is to explore participation in medical decision making of the frail elderly patient in hospital from the perspectives of patients themselves and the health care staff. In this thesis frail, elderly patients is defined as individuals 75 years old or older, who during the past 12 months have received inpatient hospital care three or more times and who have three or more diagnoses in three or more diagnostic groups according to the classification system ICD-10.The participants were frail patients’ in hospital or newly discharged and it was health care personnel working with frail elderly patients. In three of the studies the method was mainly qualitative (Paper I, III, IV) and in one (Paper II) quantitative. The qualitative methods were one-to-one tape-recorded interviews of 25 patients (Paper I and IV), 18 personnel (III and IV), 5 focus group interviews of physicians (Paper III) and 26 days of observations in hospital wards (IV). Chosen methodologies of analysis were content analysis and Grounded Theory. The quantitative study (II) was a cross-sectional survey using telephone interviews with patients (n= 156). This material was descriptively analysed and examined using weighted kappa statistics.Results: The results reported in Paper II show that elderly patients generally want to participate more in medical decision making than they do, though preferences for degree of participation are highly individualized – both findings important to consider in clinical practice.According to the patients important key concepts of patient participation in medical decision making are to be listened to and to be informed (Paper I). The main reasons for not being able to participate included having many illnesses and generally, overall bad medical condition (Paper II). Also, cited as a problem was difficulty in understanding medical information, for example when given by a foreign-speaking physician (Paper I, II and IV). Frail, elderly patients complained that they were less informed than was their preference (Paper I, II and IV).Moderate agreement was obtained between patient’s preferred and actual roles in medical decision making. Patients often expressed gratitude and confidence in their health care (Paper I and IV), but also, sympathy for stressed health care personnel who had so much to do.The frail elderly patients do sometimes feel like a burden to the health care (Paper I and IV). The professionals gave expressions of trying to avoid taking care of frail elderly patients and at the same time expressions of frustration and bad conscience not being able to take good care of them due to lack of time and lack of beds (Paper III, IV). Especially the physicians felt they were trapped between the needs of the patients’ and the remunerations system rewarding time-constricted health care production (number of investigations, operations, easy accessibility) – not a time-consuming holistic view on all illnesses and medications including communication with the patients and all caregivers involved (Paper III).Both patients and the professionals perceive the hospital as some kind of “institution of power”, difficult to challenge, and the decisions of which one has to accept.Conclusion: In this thesis there are shown a number of challenges to participation in medical decision making by frail, elderly patients, which thus limits quality of care for this patient group. Health care is revealed as not well adapted to meet these patients’ complex needs. A model is presented that explains how the organisation of health care, and the reimbursement system, does not facilitate a holistic view. The health care professionals appear to adapt to the organisation and the remuneration system, which leads to practices, such as, rapid discharges and a tendency to examine the patient for only one or a few problems. Finally a suggestion for a model to improve care of frail elderly patients is presented. This model includes the need of more hospital wards being able to work with a holistic view, better skills in gerontology and geriatrics and a more adapted remuneration system for the frail, elderly patients.
|
|
| 6. |
- Åkerman, Johan, 1966-
(author)
-
Lokala fack i globala företag : Electrolux verkstadsklubb i Motala och koncernfacket 1925-1985
- 2003
-
Doctoral thesis (other academic/artistic)abstract
- Since the 1970's the union movement has regarded international business as a threat to union interests, democratic values and national independence. The union movement has mentioned two methods of defence against influence of international businesses: to introduce societal restrictions on a national or international level and to establish international (corporate) group unions. At the same time it is important to note that international entrepreneurship has occurred much earlier than 1970. The overall aim with this dissertation is to study labour union practice in an international corporate group in the years 1925-1985.The main sources of information are collected from the union archives, which are located in Folkrörelsearkivet in Motala. The Electrolux local union in Motala was founded in 1925, the same year as the corporation started in Motala. Despite the fact that the group structure was affecting the activity at the corporation to a considerable degree, the local union did not take interest in these questions until the 1960's. The jointwork council agreement and the council that was established in Motala were crucial to lift the perspective of the local union to also include group issues. The Electrlux group union was founded in 1946, initiated by the local union in Motala. The primary motive for this was to create a new forum where traditional union issues could be pursued towards the group management. During the 197o's and the 198o's the group union activities changed. There aretwo explanations for this change. The Electrolux group was expanding drastically, new and bigger companies were purchased and the group extended its product areas. The other explanation is the vast changes in labour-market policy that occurred in Sweden at this time. In that way the group union increased their insight in the group activities, and also improved their prerequisites for organising their activity. The group union extended its activity to embrace also the Nordic countries. The dissertation shows that the Electrolux group union had large difficulties meeting the challenges generated by the group structure. This was mainly caused by a number of structural obstacles. Union division; the national differences regarding organisation, culture, language and ideology were too big. There were also structural obstacles for the solidarity between the union organisations. Solidarity with colleagues collided with national and regional egoism. The union structure was also an obstacle. Irrespective of the organisation of the national unions, from line of business, political view or occupation it was obvious that international corporations were organised based on a different principal.
|
|
