| 1. |
- Haraldsson, Katarina, et al.
(författare)
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Adolescent Girls' Experiences of Underlying Social Processes Triggering Stress in Their Everyday Life : A grounded theory study
- 2011
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Ingår i: Stress and Health. - Chichester : John Wiley & Sons. - 1532-3005 .- 1532-2998. ; 27:2, s. E61-E70
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to generate a theoretical model of underlying social processes that trigger stress in adolescent girls’ everyday life. In-depth interviews regarding the experiences of stress at home, school and during leisure time were conducted with 14 17-year-old schoolgirls. Data were analysed by means of the grounded theory method. Stress was triggered in the interaction between responsibility and the way in which the girls were encountered. Triggered emotional reactions took the form of four dimensions of stress included ambivalence, frustration, despair and downheartedness. These reactions were dependent on whether the girls voluntary assumed responsibility for various situations or whether they were forced, or felt they were being forced, to assume responsibility in interaction with an encounter characterized by closeness or distance. These forms of stress reactions could appear in one dimension and subsequently shift to another. From the public health perspective, the generated stress model can be used in the planning and implementation of future actions to prevent stress and promote well-being related to stress in adolescent girls.
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| 2. |
- Tillman, Carl, et al.
(författare)
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High-resolution spectroscopy of laser-produced plasmas in the photon energy range above 10 keV.
- 1997
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Ingår i: Nuclear Instruments & Methods in Physics Research. Section A: Accelerators, Spectrometers, Detectors, and Associated Equipment. - 0167-5087. ; 394:3, s. 387-396
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Tidskriftsartikel (refereegranskat)abstract
- X-rays from a laser-produced plasma were analysed using single-photon counting germanium detectors. Special attention was given to the extremely high photon flux, requiring either a long source-detector distance and narrow collimated measurement geometry in order to avoid severe pile-up of pulses in the spectrometer, or the use of a Compton scattering geometry. With the use of these techniques, individual characteristic K-lines were resolved for the first time. Efficiencies for the conversion of the laser light into X-rays were determined, being up to 10−4 for Bremsstrahlung, and up to 10−5 for the characteristic K-line emission. Electron temperatures of not, vert, similar100 keV were assessed.
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| 3. |
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| 4. |
- Abs, Roger, et al.
(författare)
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Determinants of cardiovascular risk in 2589 hypopituitary GH-deficient adults - a KIMS database analysis.
- 2006
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Ingår i: European Journal of Endocrinology. - : Oxford University Press (OUP). - 0804-4643 .- 1479-683X. ; 155:1, s. 79-90
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The aim of the present study was to clarify the relationship between GH deficiency (GHD) andsome cardiovascular risk factors and to analyse the effect of GH replacement therapy in a large numberof patients over a prolonged period of time.Design: Data for analysis were retrieved from KIMS (Pfizer International Metabolic Database). Serumconcentrations of total cholesterol, high-density lipoprotein (HDL)-cholesterol, low-density lipoprotein(LDL)-cholesterol and triglycerides were obtained from 2589 patients at baseline and from 1206patients after 1 and 2 years of GH replacement therapy. Body mass index (BMI), waist and hip, restingblood pressure and body composition were also measured.Results: At baseline, the unfavourable effects of GHD were most obvious in the lipid profiledemonstrating elevated mean total and LDL-cholesterol, in the increased waist circumference and theelevated BMI. The cholesterol concentration, BMI and body composition were significantly adverselyaffected by a number of factors, including age, sex and the use of anti-epileptic drugs. The therapeuticeffect of GH was essentially uniform across the whole population. GH replacement reduced significantlythe mean total and LDL-cholesterol, the waist circumference and the fat mass and was maintainedduring 2 years.Conclusions: This analysis of a large number of patients confirmed that GHD adults present with anincreased cardiovascular risk. The sustained improvement of the adverse lipid profile and bodycomposition suggests that GH replacement therapy may reduce the risk of cardiovascular disease andthe premature mortality seen in hypopituitary patients with untreated GHD.
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| 5. |
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| 6. |
- Adler, Andrew F., et al.
(författare)
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hESC-Derived Dopaminergic Transplants Integrate into Basal Ganglia Circuitry in a Preclinical Model of Parkinson's Disease
- 2019
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Ingår i: Cell Reports. - : Elsevier BV. - 2211-1247. ; 28:13, s. 5-3473
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Tidskriftsartikel (refereegranskat)abstract
- Cell replacement is currently being explored as a therapeutic approach for neurodegenerative disease. Using stem cells as a source, transplantable progenitors can now be generated under conditions compliant with clinical application in patients. In this study, we elucidate factors controlling target-appropriate innervation and circuitry integration of human embryonic stem cell (hESC)-derived grafts after transplantation to the adult brain. We show that cell-intrinsic factors determine graft-derived axonal innervation, whereas synaptic inputs from host neurons primarily reflect the graft location. Furthermore, we provide evidence that hESC-derived dopaminergic grafts transplanted in a long-term preclinical rat model of Parkinson's disease (PD) receive synaptic input from subtypes of host cortical, striatal, and pallidal neurons that are known to regulate the function of endogenous nigral dopamine neurons. This refined understanding of how graft neurons integrate with host circuitry will be important for the design of clinical stem-cell-based replacement therapies for PD, as well as for other neurodegenerative diseases. Adler et al. graft hESC-derived dopaminergic progenitors into a rat model of Parkinson's disease. They find grafts correctly innervate host targets and receive appropriate synaptic input after intranigral and intrastriatal placement. Furthermore, the same host neurons projecting toward endogenous dopamine neurons are found to also connect to the grafts.
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| 7. |
- Ahlén, Gerd, 1951, et al.
(författare)
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Physician patient questionnaire to assess physician patient agreement at the consultation.
- 2007
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Ingår i: Family practice. ; 24:5, s. 498-503
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: The primary aim of this study was to validate an instrument of physician-patient agreement in the consultation. A secondary aim was to assess this agreement. METHOD: The setting was a county in the southwest of Sweden with a cross-sectional survey of primary care patients and physicians using separate coded questionnaires. Forty-six physicians and 316 patients aged 16 or more with a new complaint lasting 1 week or more. Thirteen items were evaluated and index of proportional agreement for the dichotomized answers agree (P(pos)) and disagree (P(neg)) was calculated. RESULTS: In 10 of the 13 items, a high level of agreement between physician and patient was seen. Discussion. Index of proportional agreement was useful in finding statements in a questionnaire on agreement for both physicians and patients that could be used for educational purposes and as a check-up for the GP in daily practice.
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| 8. |
- Aldrin-Kirk, Patrick, et al.
(författare)
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Chemogenetic modulation of cholinergic interneurons reveals their regulating role on the direct and indirect output pathways from the striatum
- 2018
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Ingår i: Neurobiology of Disease. - : Elsevier BV. - 0969-9961. ; 109, s. 148-162
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Tidskriftsartikel (refereegranskat)abstract
- The intricate balance between dopaminergic and cholinergic neurotransmission in the striatum has been thoroughly difficult to characterize. It was initially described as a seesaw with a competing function of dopamine versus acetylcholine. Recent technical advances however, have brought this view into question suggesting that the two systems work rather in concert with the cholinergic interneurons (ChIs) driving dopamine release. In this study, we have utilized two transgenic Cre-driver rat lines, a choline acetyl transferase ChAT-Cre transgenic rat and a novel double-transgenic tyrosine hydroxylase TH-Cre/ChAT-Cre rat to further elucidate the role of striatal ChIs in normal motor function and in Parkinson's disease. Here we show that selective and reversible activation of ChIs using chemogenetic (DREADD) receptors increases locomotor function in intact rats and potentiate the therapeutic effect of L-DOPA in the rats with lesions of the nigral dopamine system. However, the potentiation of the L-DOPA effect is accompanied by an aggravation of L-DOPA induced dyskinesias (LIDs). These LIDs appear to be driven primarily through the indirect striato-pallidal pathway since the same effect can be induced by the D2 agonist Quinpirole. Taken together, the results highlight the intricate regulation of balance between the two output pathways from the striatum orchestrated by the ChIs.
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| 9. |
- Aldrin-Kirk, Patrick, et al.
(författare)
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DREADD Modulation of Transplanted DA Neurons Reveals a Novel Parkinsonian Dyskinesia Mechanism Mediated by the Serotonin 5-HT6 Receptor
- 2016
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Ingår i: Neuron. - : Elsevier BV. - 0896-6273. ; 90:5, s. 955-968
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Tidskriftsartikel (refereegranskat)abstract
- Transplantation of DA neurons is actively pursued as a restorative therapy in Parkinson's disease (PD). Pioneering clinical trials using transplants of fetal DA neuroblasts have given promising results, although a number of patients have developed graft-induced dyskinesias (GIDs), and the mechanism underlying this troublesome side effect is still unknown. Here we have used a new model where the activity of the transplanted DA neurons can be selectively modulated using a bimodal chemogenetic (DREADD) approach, allowing either enhancement or reduction of the therapeutic effect. We show that exclusive activation of a cAMP-linked (Gs-coupled) DREADD or serotonin 5-HT6 receptor, located on the grafted DA neurons, is sufficient to induce GIDs. These findings establish a mechanistic link between the 5-HT6 receptor, intracellular cAMP, and GIDs in transplanted PD patients. This effect is thought to be mediated through counteraction of the D2 autoreceptor feedback inhibition, resulting in a dysplastic DA release from the transplant.
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| 10. |
- Andersson, Sven-Olof, 1943-
(författare)
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Time and general practice consultations : aspects of length, attendance and quality
- 1995
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The consultation is the GP’s form of work. How long a consultation should be, and what short/long consultations imply with regard to the satisfaction of patient and doctor has been much debated. The aim of this thesis was to study consultations with regard to content and time consumption in a short term and long term perspective. Three studies were carried out.1. Consultations with the members of a group of GPs were investigated, where patients and doctors separately assessed different aspects of the consultation, and their ratings were related to the real length of the consultations. The following questions were posed: Was there time enough? Could the patient tell the doctor about her/his problems? Were the problems physical or psychological? 2. Nurses at the primary care health centres were interviewed about their considerations in booking short or long appointments for the patients. 3. Patients who frequently attended one health centre during one year and consumed much time were studied. Quantitative and qualitative methods were used.The results of the first study (Papers I-III) show that the average length of the consultations was 21 minutes; there was considerable variation (ranging from 3 to 60 minutes). (About 600 consultations with 7 male doctors were registered in two batches). The doctors’ mean consultation length also varied widely, from 13-28 minutes. Consultations dealing with psychological problems were longer than those dealing with physical problems. Older patients had longer consultations than younger patients, and female patients had somewhat longer consultations than male patients. The patients were generally more satisfied with the consultations than the doctors were, and there were no clear affinities between long consultations and high satisfaction. Male patients and patients with physical problems mainly received short consultations, whereas patients with ”mixed" problems and older patients received long consultations.The single factors most decisive for the length of a consultation were ‘the doctor factor’, the character of the problem and the age of the patient. "Good” consultations (operational definition) were associated primarily with ‘the doctor factor’, and the real length of the consultations was less important.The interviews with ten experienced primary care nurses (Paper IV) showed that the nurses worked in two perspectives: in the ”immediate” perspective, appointments were booked according to rules which directly impacted the length of the visit, and in the "reflective" perspective, appointments were booked with a view to the quality of the work at the health centre and the long-term time consumption. Other factors of importance were the patient’s age and problem(s), the doctor’s experience and working style, and the current situation at the health centre.Frequent attenders (FAs) at one health centre (Paper V) were compared with a contrast group of matched patients (CPs). The FAs represented 1.7% of the population of the catchment area and made 15% of the visits. The FAs were a heterogeneous group where small boys, women of working age and pensioners of both sexes were overrepresented. The FAs had higher consultation frequency than the CPs during the year of investigation, but few remained FAs for longer periods. The FAs had more problems and more complex problems than the CPs. Complaints regarding the musculo-skeletal organs, and psychosocial problems were common among these patients, often in combination.The present work thus shows that longer consultations do not naturally imply higher patient satisfaction. Other factors than the time factor, in particular ‘the doctor factor’ seem to be more important. ‘The doctor factor’, the characteristics of the patients, the type of problem and the situation at the health centre also have a bearing on consultation length and time consumption in a short-term as well as long-term perspective. The implications of these factors and their relative importance are discussed, but further studies of certain issues, such as ‘the doctor factor’, are necessary.
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