| 1. |
- Bogefeldt, Johan, 1969-
(författare)
-
Low Back Pain : With Special Reference to Prevalence, Diagnosis, Treatment and Prognosis
- 2009
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Objectives. Ascertain if there has been a secular trend in 3-months prevalence of casually reported back pain. Evaluate if such back pain predicts concurrent health as well as future sick leave, disability pension, hospitalization and survival. Study differences in diagnostic assessment and labelling between physicians. Evaluate if a comprehensive manual therapy programme reduces sickness absence. Materials and methods. Combined population samples from 1973 to 2003 with a total of 12,891 observations with self-reported back pain and covariates. 7,074 of these individuals were followed for an average of 8.5 years and outcomes were self-reported health as well as official register data on sick leave, disability pension, hospitalisation and mortality. The Gotland Low Back Pain Study, a randomised controlled trial with participation of two general practitioners and two orthopaedic surgeons treating 160 patients with acute/subacute low back pain, with 10 weeks diagnostic evaluation and treatment and a two-year follow up. Results. Back pain prevalence increased 16% per ten years (OR 1.16, 95%CI 1.11-1.22). Back pain was negatively associated with self-rated health (p<0.0001), increased the risk of disability pension (p<0.002), and hospital admissions (p<0.0005), but not number of days in hospital, sick leave or mortality. General practitioners used terms from manual medicine and reported more pseudoradicular pain, while orthopaedic surgeons used non-specific pain labels, reported more true radicular pain and used more x-ray examinations. Among those on sick leave at baseline, manual therapy patients showed faster return to work (HR 1.62, 95%CI 1.006–2.60) and a lower point-prevalence of sick leave than reference patients at end of treatment period (ratio 0.35, 95% CI 0.13–0.97) but not after two years. Conclusions. There was a strong secular trend towards increase in self-reported back pain from 1973 to 2003. Such pain had a negative effect on some of the health outcomes and does not appear to be harmless. Physicians from different specialities labelled the condition differently. The manual therapy programme proved to be more effective than the established treatment regarding return to work.
|
|
| 2. |
- Bröms, Kristina, 1954-
(författare)
-
A Nationwide Study of Asthma and Allergy in Swedish Preschool Children : with Special Reference to Environment, Daycare, Prevalence, Co-ocurrence and Incidence
- 2010
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Aim: The aim of this project was to study the age and sex specific occurrence of atopic and non-atopic asthma and other atopic manifestations in a nationwide sample of Swedish pre-school children. Methods: All 70 allergen avoidance day-care centres (AADC) with 84 sections and 140 matched ordinary day-care centres with 440 sections in 62 municipalities across Sweden were sampled. In 2000 the staff at each section responded to a questionnaire on indoor and outdoor environment at the section. In 2002 parents of 5,886 children attending the AADCs and ODCs responded to a postal questionnaire regarding symptoms indicating prevalent asthma, allergic rhinitis, eczema, and food, furred pet and pollen allergy and other data in their children. In 2007, parents of 4255 children responded to an almost identical follow-up questionnaire. Results: The AADCs had far more strict rules than ODCs on furred pets and smoking at home and on perfume use, and the indoor environment was better, owing to better cleaning. The age specific asthma prevalence was curvilinear with a peak at age 3 of 11.4% among boys and 9.8% among girls. In addition the prevalence increased by municipality population density, a proxy for degree of urbanisation. There was a highly significant co-occurrence between all asthma-atopic manifestations, but there was no evidence of ordered sequence of manifestation onset. The asthma incidence was highly dependent on presence or absence of co-occurrence variables. Given the variable mix in the present study population, the annual asthma incidence ranged from 0.6% to 1.2%. Conclusions: AADCs had more strict rules and a better indoor environment than ODCs. The asthma prevalence was affected by age, sex and degree of urbanisation. There was close co-occurrence between all asthma and atopic manifestations but no evidence of ordered sequence of onsets. The annual asthma incidence was strongly dependent of co-occurrence conditions.
|
|
| 3. |
- Flejmer, Anna M.
(författare)
-
Radiation burden from modern radiation therapy techniques including proton therapy for breast cancer treatment - clinical implications
- 2016
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The purpose of this thesis was to study the clinical implications of modern radiotherapy techniques for breast cancer treatment. This was investigated in several individual studies.Study I investigated the implications of using the analytical anisotropic algorithm (AAA) from the perspective of clinical recommendations for breast cancer radiotherapy. Pencil beam convolution plans of 40 breast cancer patients were recalculated with AAA. The latter plans had a significantly worse coverage of the planning target volume (PTV) with the 93% isodose, higher maximum dose in hotspots, higher volumes of the ipsilateral lung receiving doses below 25 Gy and smaller volumes with doses above 25 Gy. AAA also predicted lower doses to the heart.Study II investigated the implications of using the irregular surface compensator (ISC), an electronic compensation algorithm, in comparison to three‐dimensional conformal radiotherapy (3D‐CRT) for breast cancer treatment. Ten breast cancer patients were planned with both techniques. The ISC technique led to better coverage of the clinical target volume of the tumour bed (CTV‐T) and PTV in almost all patients with significant improvement in homogeneity.Study III investigated the feasibility of using scanning pencil beam proton therapy for regional and loco‐regional breast cancer with comparison of ISC photon planning. Ten patients were included in the study, all with dose heterogeneity in the target and/or hotspots in the normal tissues outside the PTV. The proton plans showed comparable or better CTV‐T and PTV coverage, with large reductions in the mean doses to the heart and the ipsilateral lung.Study IV investigated the added value of enhanced inspiration gating (EIG) for proton therapy. Twenty patients were planned on CT datasets acquired during EIG and freebreathing (FB) using photon 3D‐CRT and scanning proton therapy. Proton spot scanning has a high potential to reduce the irradiation of organs‐at‐risk for most patients, beyond what could be achieved with EIG and photon therapy, especially in terms of mean doses to the heart and the left anterior descending artery.Study V investigated the impact of physiological breathing motion during proton radiotherapy for breast cancer. Twelve thoracic patients were planned on CT datasets during breath‐hold at inhalation phase and breath‐hold at exhalation phase. Between inhalation and exhalation phase there were very small differences in dose delivered to the target and cardiovascular structures, with very small clinical implication.The results of these studies showed the potential of various radiotherapy techniques to improve the quality of life for breast cancer patients by limiting the dose burden for normal tissues.
|
|
| 4. |
- Hedström, Per, 1963-
(författare)
-
Skönhet och skötsamhet : Konstnärliga utsmyckningar i svenska skolor 1870-1940
- 2004
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This thesis is about the permanent artistic decoration of Swedish school buildings during the period 1870–1940. Its main aim is to examine the ideals and values which the works installed can be said to convey. It takes its starting point in the major movement for the decoration of schools in Sweden that began around 1900, and that was part of a broader recognition of the importance of public art in the country.The thesis analyses the basic thinking behind the move to install art in schools. In Sweden, discussion on the subject was initiated by the writings and lectures of Carl G. Laurin and Ellen Key. The most important argument for the artistic decoration of schools was the general ennobling influence of art. Art represented beauty, and was thus associated with goodness and truth.The study covers some eighty permanent schemes, or individual works, in Swedish schools, created between 1877 and 1940. They are discussed, first, in a thematic section, with a focus on the different types of subject matter represented, and second, in a number of case studies. Among the subjects dealt with in the thematic analysis are characteristic themes such as sport and outdoor recreation and scenes reflecting school activities. Many of the works portray well-behaved children and young people, who are held up as good examples.The nine case studies analyse individual schemes in greater depth. They include examples that reflect the specific cultures and ideologies of, for instance, higher public grammar schools and girls’ schools. An important aspect of the case studies is their analysis of the reception of the schemes. The reviews examined include discussions of what types of subject were appropriate in art for children and young people.One conclusion drawn in the thesis is that a broader aim of the artistic decoration of schools seems to have been to mould a sense of identity. The images created depict children and young people themselves, regional landscapes and regional and national history.
|
|
| 5. |
- Steorn, Patrik, 1971-
(författare)
-
Nakna män : Maskulinitet och kreativitet i svensk bildkultur 1900-1915
- 2006
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- At the turn of the 20th century, there was a notion in Europe that urbanisation and industrialisation had drained the human race of spiritual and physical energy. A particular concern was that men were being emasculated. An image of naked, athletic men was created, which was perceived to depict a form of unadulterated masculinity in touch with nature.The aim of this dissertation is to demonstrate that “the image of the male nude” was a complex and multifaceted performance that depicted contradictory ideas of gender, sexuality, class, and ethnicity. In addition, it aims at demonstrating the extensiveness of this motif in early 1900’s Sweden, not only in art but also in mass-produced images. Another aim is to show that images of naked men were used for different purposes by different groups of viewers.The dissertation consists of three overall sections: Context, Image Culture, and Subject. Section I deals with the doctrines on mechanism and vitalism and with the discussions on homosexuality, gender differences, the working class, and nationalism in the late 1800’s and early 1900’s. Section II traces images of male bodies within the framework of sport cultures and bathing culture. Section III analyses the image of the male nude in the subject areas of antiquity, old Norse motifs, biblical motifs, allegorical personifications and symbolistic depictions.Sports magazines depicted muscular men as examples of activity; health journals and medical books used them as visualisations of health; in the art world they symbolized an artistic reawakening, while the images were objects of desire in male homosexual circles. A masculine, athletic, heterosexual, short-cropped, bourgeois Swedish man with a moustache became a nationalistic figurehead. Hardness and physical inaccessibility were accentuated, at the same time as the nudity enticed the viewer to see, in the very same bodies, physical accessibility and tactile gentleness.
|
|
