| 1. |
- Ahgren, Bengt, et al.
(författare)
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Is choice of care compatible with integrated health care? An exploratory study in Sweden
- 2012
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Ingår i: International Journal of Health Planning and Management. - : Wiley. - 1099-1751 .- 0749-6753. ; 27:3, s. 162-172
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Tidskriftsartikel (refereegranskat)abstract
- Competitive and integrative policy actions are simultaneously being promoted in Swedish primary care; citizens' choice of care is launched while primary care is expected to integrate its activities with other providers for the creation of local health care. Competition tends, however, to fragment the provision of services. The aim of this study is, accordingly, to explore whether or not these policies are compatible in practice. For this purpose, strategically designed group interviews were conducted with citizens. When citizens make active choices, they are under the influence of self-perceived conditions: that is, the accessibility of the care, its continuity and the treatment offered by the care provider, conditions which, in turn, have a lot in common with the guiding principles of local health care. On the other hand, citizens who choose passively, because of not being in contact with primary care, have no difficulties in being disloyal to the chosen unit when becoming patients. In doing so, they also contribute to the fragmentation of local health care. Making entirely free choices when it comes to primary care seems to be incompatible with local health care. However, choice of care only partly equals the conditions of free choice. Choice of care and local health care would thus seem to be compatible, in practice, for the majority of patients. Copyright (c) 2012 John Wiley & Sons, Ltd.
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| 2. |
- Brodin, H, et al.
(författare)
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Rehabilitation in Schweden.
- 1999
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Ingår i: Phys Rehab Kur Med. ; 9, s. 25-
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Tidskriftsartikel (refereegranskat)
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| 3. |
- Emdin, Stefan, et al.
(författare)
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SweDCIS: Radiotherapy after sector resection for ductal carcinoma in situ of the breast. Results of a randomised trial in a population offered mammography screening.
- 2006
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Ingår i: Acta oncologica (Stockholm, Sweden). - : Informa UK Limited. - 0284-186X .- 1651-226X. ; 45:5, s. 536-43
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Tidskriftsartikel (refereegranskat)abstract
- We studied the effect of postoperative radiotherapy (RT) after breast sector resection for ductal carcinoma in situ (DCIS). The study protocol stipulated radical surgery but microscopically clear margins were not mandatory. We randomised 1,046 operated women to postoperative RT or control between 1987 and 1999. The primary endpoint was ipsilateral local recurrence. Secondary endpoints were contralateral breast cancer, distant metastasis and death. After a median follow-up of 5.2 years (range 0.1-13.8) there were 44 recurrences in the RT group corresponding to a cumulative incidence of 0.07 (95% confidence interval (CI) 0.05-0.10). In the control group there were 117 recurrences giving a cumulative incidence of 0.22 (95% CI 0.18-0.26) giving an overall hazard ratio of 0.33 (95% CI 0.24-0.47, p < 0.0001). Twenty two percent of the patients had microscopically unknown or involved margins. We found no evidence for different effects of RT on the relative risk of invasive or in situ recurrence. Secondary endpoints did not differ. Women undergoing sector resection for DCIS under conditions of population based screening mammography benefit from postoperative RT to the breast. Seven patients needed RT-treatment to prevent one recurrence.
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| 4. |
- Furberg, Bengt, et al.
(författare)
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P-Wave Analysis in Chronic Obstructive Lung Diseasewith Pulmonary Hypertension
- 1972
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Ingår i: Upsala Journal of Medical Sciences. - 0300-9734 .- 2000-1967. ; 77:3, s. 163-166
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Tidskriftsartikel (refereegranskat)abstract
- In a group of 24 patients with severe chronic obstructivelung disease and varying degrees of pulmonary hypertension,a study was made of the relationship betweenhaemodynamic data and the P wave as recorded both byconventional ECG and by a special recording method.An increased P-wave amplitude was recorded in 33%and 42% of the patients, respectively, with the twomethods. None of the 5 patients with marked pulmonaryhypertension and an elevated PCV pressure showed anincrease of the P-wave amplitude, while all 6 patientswith marked pulmonary hypertension but no elevationof the PCV pressure showed an increase of thii amplitudeon special recordimg. Changes in configuration ofthe P wave seem to be related to an increased PCVpressure.
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| 5. |
- Hamberg, Jern, et al.
(författare)
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Stretchability of the rectus femoris muscle: investigation of validity and intratester reliability of two methods including x-ray analysis of pelvic tilt.
- 1993
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Ingår i: Archives of Physical Medicine and Rehabilitation. - 0003-9993 .- 1532-821X. ; 74:3, s. 263-270
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Tidskriftsartikel (refereegranskat)abstract
- Validity and intratester reliability of two test methods designed to identify stretchability of the rectus femoris muscle (RFM) was investigated, combined with x-ray analysis of pelvic tilt in the sagittal plane. The first method is commonly used in clinical practice. The second is a new technique supposed to tilt the pelvis posteriorly and thus further separate the origin and insertion of the muscle. Investigation of validity and intratester reliability of the two methods was made by testing and retesting a random sample of 71 persons. The tests were performed with an equipment that automatically recorded the angle of knee flexion from a previously determined applied torque, indicating the end point of motion for that particular subject. Angle of knee flexion and subjective estimation of pain sensation due to stretch were recorded at each measurement. The pelvic tilt-analysis consisted of test-retest reliability of x-ray measurements, comparison between the methods in both starting and final position, and x-ray and electronic goniometer measurements. All applied torques were measured with a strain gauge. Two out of three criteria of validity favored the new method and the third pointed out the two methods as equal. The two methods as well as the x-ray measurements showed high reliability, and the hypothesis of a more posterior tilted pelvis in the new method was confirmed. The electronic goniometer was less sensitive than x-ray, but proposed to analyse pelvic tilt clinically. Methodology procedures for joint angle measurements are discussed.
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| 6. |
- Kodeda, Karl, et al.
(författare)
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Genomic CGH-assessed structural DNA alterations in rectal carcinoma as related to local recurrence following primary operation for cure.
- 2012
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Ingår i: International journal of oncology. - : Spandidos Publications. - 1791-2423 .- 1019-6439. ; 41:4, s. 1397-1404
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Tidskriftsartikel (refereegranskat)abstract
- Several factors determine overall outcome and possible local recurrence after curative surgery for rectal carcinoma. Surgical performance is usually believed to be the most pertinent factor, followed by adjuvant oncological treatment and tumor histopathology. However, chromosomal instability is common in colorectal cancer and tumor clones are assumed to differ in aggressiveness and potential of causing local recurrence. The aim of this study was, therefore, to evaluate if genetic alterations in primary rectal carcinoma are predictive of local recurrences. A large clinical database with linked bio-bank allowed for careful matching of two patient groups (R0) resected for rectal carcinoma. One group had developed early, isolated local recurrences and the other group seemed cured after 93months follow-up. DNA from the primary tumors was analysed with array-CGH (comparative genomic hybridization) including 55,000 genomic probes. DNA from all primary tumors in both groups displayed previously reported and well-recognised DNA aberrations in colorectal carcinoma. Significant copy number gains were confirmed in the 4q31.1-31.22 region in DNA from tumors with subsequent local recurrence. Twenty-two affected genes in this region code for products with high relevance in tumor biology (p53 regulation, cell cycle activity, transcription). DNA from rectal carcinoma displayed well-known aberrations as described for colon carcinoma with no obvious prediction of local rectal recurrence. Gains in the 4q31.1-31.22 DNA region are highly potential for local recurrence despite R0 resection to be confirmed in larger patient materials.
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| 7. |
- Kodeda, Karl, et al.
(författare)
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Local recurrence of rectal cancer: a population based cohort study of diagnosis, treatment and outcome.
- 2012
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Ingår i: Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland. - : Wiley. - 1463-1318. ; 14:5, s. 230-7
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Tidskriftsartikel (refereegranskat)abstract
- Aim: Local recurrence is an important endpoint of rectal cancer treatment, but details of this form of treatment failure are less well described. The aim of this study was to acquire deeper knowledge of local recurrence regarding symptoms, diagnostic work-up, clinical management, health-care utilization and outcome. Method: Of 671 patients with rectal cancer, 57 were diagnosed with local recurrence within 5 years after surgery. Their records were analysed. Results: At diagnosis of local recurrence 49(86%) of 57 patients were symptomatic and 40 (70%) were diagnosed between scheduled follow-up visits. The predominant symptom was pain. Forty five of the 57 (79%) had a palpable tumour. Most were deemed incurable at presentation and less than 10 (18%) were operated on with curative intent. Five years after the initial rectal cancer surgery, two patients were alive, with one free of disease. Despite the need for multiple interventions, including surgery, only 4 out of 40 patients were classified as being well palliated in the terminal stage. Conclusion: Follow-up after rectal cancer surgery by annual clinical examination is not sufficient to detect local recurrence when it is asymptomatic. Local recurrence of rectal cancer is often associated with intractable symptoms. These patients require frequent interventions and can rarely be cured if diagnosed at an advanced stage. Strategies for early detection of local recurrence and the management thereof require improvement.
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| 8. |
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| 9. |
- Lagerström, Christel, et al.
(författare)
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Recovery of isometric grip strength after Colles' fracture : a prospective two-year study
- 1999
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Ingår i: Scandinavian Journal of Rehabilitation Medicine. - 0036-5505 .- 1940-2228. ; 31:1, s. 55-62
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Tidskriftsartikel (refereegranskat)abstract
- Grip strength during short and sustained maximal voluntary isometric contractions was measured in 28 females and 5 males with displaced Colles' fracture involving the distal radio-ulnar joint. The patients were randomized into two groups, treated either through immobilization with plaster cast or with external fixation. The recovery of isometric grip strength was followed over a two-year period. A significant difference was registered between women with plaster casts and women with external fixators six weeks after the fracture. Regaining of grip strength occurred up to one year after the fracture. The pattern of recovery was slower for women with primary external fixation. Neither the dominant nor the non-dominant injured side regained short or sustained maximal voluntary isometric contraction. The dominant injured side showed no significant difference between sides but the non-dominant injured side remained significantly weaker. It is thus important to identify hand dominance. Pain during measurements was reduced after two years, but about one-fifth of the patients still perceived pain. The present findings may serve as guidance in physiotherapy for these patients.
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| 10. |
- Lemel, Mikael, et al.
(författare)
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Quantification of the Formaldehyde Emissions from Different HCCI Engines Running on a Range of Fuels
- 2005
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Ingår i: SAE Transactions, Journal of Fuels and Lubricants. - 400 Commonwealth Drive, Warrendale, PA, United States : SAE International. - 0096-736X. ; 114:4, s. 1347-1357
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- In this paper, the formaldehyde emissions from three different types of homogenous charge compression ignition (HCCI) engines are quantified for a range of fuels by means of Fourier Transform Infra Red (FTIR) spectroscopic analysis. The engines types are differentiated in the way the charge is prepared. The characterized engines are; the conventional port fuel injected one, a type that traps residuals by means of a Negative Valve Overlap (NVO) and finally a Direct Injected (DI) one. Fuels ranging from pure n-heptane to iso-octane via diesel, gasoline, PRF80, methanol and ethanol were characterized. Generally, the amount of formaldehyde found in the exhaust was decreasing with decreasing air/fuel ratio, advanced timing and increasing cycle temperature. It was found that increasing the source of formaldehyde i.e. the ratio of heat released in the cool-flame, brought on higher exhaust contents of formaldehyde. The application of a standard three-way catalyst completely removed formaldehyde from the exhaust stream.
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