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- Nilsson, Thomas, 1954, et al.
(author)
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The precarious practice of forensic psychiatric risk assessments
- 2009
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In: International Journal of Law and Psychiatry. - : Elsevier BV. - 0160-2527. ; 32:6, s. 400-407
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Journal article (peer-reviewed)abstract
- The development of forensic psychiatric risk assessments is discussed from a clinical point of view using the example of Sweden. A central task in forensic psychiatry has traditionally been to identify dangerous, mentally disordered subjects considered to be prone to commit violent acts. Over time, “dangerousness” has been reworded into “risk”. Nevertheless, such assessments have generally been based on the psychiatric factors characterising the individual patient, while group interaction, situational factors, or social and cultural circumstances, such as the availability of alcohol and drugs, have been largely overlooked. That risk assessments have a focused on people with a diagnosis of “mental disorder” and been used as grounds for coercive measures and integrity violations has somehow been accepted as a matter of course in the public and political debate. Even the basic question whether offenders with a mental disorder are really more prone to criminal recidivism than other offenders seems to have been treated light-handedly and dealt with merely by epidemiological comparisons between groups of persons with broad ranges of psychosocial vulnerability and the general population. Legal texts, instructions and guidelines from the authorities in charge are often vague and general, while actors in the judicial system seem to put their trust in psychiatric opinions. The exchange of professional opinions, general public expectations, and judicial decision processes poses a huge risk for misunderstandings based on divergent expectations and uses of terminology.
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- Söderström, Marie, et al.
(author)
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Weekday and weekend patterns of diurnal cortisol, activation and fatigue among people scoring high for burnout
- 2006
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In: SJWEH Supplements. - 1795-9926 .- 1795-9918. ; :2, s. 35-40:2, s. 35-40
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Journal article (peer-reviewed)abstract
- Objectives The present pilot study attempted to investigate the diurnal pattern of cortisol, subjective activation, and mental fatigue among workers scoring high for burnout. The purpose was also to relate the cortisol data to objective sleep data.Methods One group with high (N=9) burnout scores and one with low (N=11) such scores were compared during a workday and a day off.Results The high-burnout group showed higher awakening cortisol during the workday than during the weekend. They also showed higher ratings for activation and mental fatigue during the weekend than the low-burnout group. A higher frequency of arousals during the prior sleep was associated with a higher diurnal amplitude and an earlier diurnal peak of cortisol during the workday.Conclusions The present results, which, due to the small sample size, should be interpreted with caution, may indicate that stress-induced frequency of arousal during sleep could contribute to the diurnal amplitude of cortisol. Furthermore, increased activation and mental fatigue during the weekend may reflect impaired recovery, which is of possible importance in the burnout process.
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- Gosman-Hedström, Gunilla, 1947
(author)
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Vårdalinstitutets tematiska rum om stroke
- 2007
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In: Förbundet Sveriges Arbetsterapeuter At - Forum och Nordisk kongress för arbetsterapeuter. Stockholm 19-20 April, Sweden.
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Conference paper (peer-reviewed)
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- Fredenberg, Erik, 1979-
(author)
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Spectral Mammography with X-Ray Optics and a Photon-Counting Detector
- 2009
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Doctoral thesis (other academic/artistic)abstract
- Early detection is vital to successfully treating breast cancer, and mammography screening is the most efficient and wide-spread method to reach this goal. Imaging low-contrast targets, while minimizing the radiation exposure to a large population is, however, a major challenge. Optimizing the image quality per unit radiation dose is therefore essential. In this thesis, two optimization schemes with respect to x-ray photon energy have been investigated: filtering the incident spectrum with refractive x-ray optics (spectral shaping), and utilizing the transmitted spectrum with energy-resolved photon-counting detectors (spectral imaging). Two types of x-ray lenses were experimentally characterized, and modeled using ray tracing, field propagation, and geometrical optics. Spectral shaping reduced dose approximately 20% compared to an absorption-filtered reference system with the same signal-to-noise ratio, scan time, and spatial resolution. In addition, a focusing pre-object collimator based on the same type of optics reduced divergence of the radiation and improved photon economy by about 50%. A photon-counting silicon detector was investigated in terms of energy resolution and its feasibility for spectral imaging. Contrast-enhanced tumor imaging with a system based on the detector was characterized and optimized with a model that took anatomical noise into account. Improvement in an ideal-observer detectability index by a factor of 2 to 8 over that obtained by conventional absorption imaging was found for different levels of anatomical noise and breast density. Increased conspicuity was confirmed by experiment. Further, the model was extended to include imaging of unenhanced lesions. Detectability of microcalcifications increased no more than a few percent, whereas the ability to detect large tumors might improve on the order of 50% despite the low attenuation difference between glandular and cancerous tissue. It is clear that inclusion of anatomical noise and imaging task in spectral optimization may yield completely different results than an analysis based solely on quantum noise.
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- Toschke, Audré M., et al.
(author)
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Paternal smoking is associated with a decreased prevalence of type 1 diabetes mellitus among offspring in two national British birth cohort studies (NCDS and BCS70)
- 2007
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In: Journal of Perinatal Medicine. - Berlin : Walter de Gruyter. - 0300-5577 .- 1619-3997. ; 35:1, s. 43-7
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Journal article (peer-reviewed)abstract
- AB Aims: An association between paternal age and type 1 diabetes (IDDM) among their offspring was recently reported as well as transgenerational responses in humans. This paper aims to assess the association of markers for prenatal exposures with IDDM. Methods: We analysed data from two birth cohorts in Great Britain on 5214 cohort members from the National Child Development Study (NCDS) and 6068 members of the 1970 British Birth Cohort Study (BCS70) with full information on IDDM and explanatory variables using multivariate logistic regression. Results: IDDM prevalence was 0.7% (95% CI 0.5-1.0%; n = 38) in the NCDS and 0.4% (95% CI 0.3-0.6%; n = 27) in the BCS70 cohort. Paternal age was not associated with IDDM possibly due to lack of sample power. Unex-pectedly, a lowered prevalence of IDDM was observed among offspring of smoking fathers in both cohorts, with a combined odds ratio of 0.44 (95% CI 0.25-0.75). This association could not be explained by maternal smoking prior to, during or after pregnancy, number of siblings, parental social class, maternal and paternal age, or cohort. Maternal smoking in pregnancy did not alter the IDDM prevalence among offspring. Conclusions: This unexpected finding may be explained by germ-line mutations or other mechanisms associated with paternal smoking. This phenomenon should be investigated and these results should not be used as a justification for smoking. Paternal exposures may be important in determining IDDM risk.
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- Peerzada, Jehanna M., et al.
(author)
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Delivery room decision-making for extremely preterm infants in Sweden
- 2006
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In: Pediatrics. - : American Academy of Pediatrics (AAP). - 0031-4005 .- 1098-4275. ; 117:6, s. 1988-1995
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Journal article (peer-reviewed)abstract
- OBJECTIVE: To assess neonatologists' attitudes and practices regarding treatment of extremely preterm infants in the delivery room, particularly in response to parental wishes. STUDY DESIGN: Cross-sectional survey of all neonatologists in Sweden registered with the Swedish Pediatric Society. RESULTS: The response rate was 71% (88 of 124 neonatologists). At 24[1/7] to 24[6/7] weeks of gestation, 68% of neonatologists considered treatment clearly beneficial; at 25[1/7] to 25[6/7] weeks of gestation, 93% considered it clearly beneficial. When respondents consider treatment clearly beneficial, 97% reported that they would resuscitate in the delivery room despite parental requests to withhold treatment. At or below 23[0/7] weeks of gestation, 94% of neonatologists considered treatment futile. Nineteen percent reported that they would provide what they consider futile treatment at parental request. When respondents consider treatment to be of uncertain benefit, 99% reported that they would resuscitate when parents request it, 99% reported that they would resuscitate when parents are unsure, and 25% reported that they would follow parental requests to withhold treatment. CONCLUSION: Although neonatologists' attitudes and practices varied, respondents to our survey in general envisioned little parental role in delivery room decision-making for extremely preterm infants.
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| 8. |
- Anderzén-Carlsson, Agneta, et al.
(author)
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How physicians and nurses handle fear in children with cancer
- 2007
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In: Journal of Pediatric Nursing. - : Elsevier BV. - 0882-5963 .- 1532-8449. ; 22:1, s. 71-80
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Journal article (peer-reviewed)abstract
- Previous research on fear in children with cancer has often focused on interventions to alleviate fear related to medical procedures and less on how to meet the challenges related to existential fear. This study aimed to describe how experienced nurses and physicians handle fear in children with cancer. Ten nurses and physicians with more than 10 years of experience in child oncology from a university hospital in Sweden were interviewed, and a qualitative content analysis was performed on the data. Nurses' and physicians' handling of fear encompasses commitment and closeness and yet also a distancing from fear and its expressions
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| 9. |
- Wickford, Jenny, 1979, et al.
(author)
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Physiotherapy in Afghanistan - Needs and challenges for development.
- 2008
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In: Disabil Rehabil.. - : Informa UK Limited. - 0963-8288 .- 1464-5165. ; 30:4, s. 305-313
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Journal article (peer-reviewed)abstract
- Purpose. The aim of this paper is to describe and analyse the current situation of the physiotherapy component of the Rehabilitation of Afghans with Disability (RAD) programme, in order to identify the needs and challenges for further development. Method. The study was conducted as a field study with an anthropological approach by means of participant observation, unstructured and semi-structured interviews and photography. Results. The therapists in RAD work in isolation with little opportunity for further education or professional development. Their approach is mainly medical, where the work is dictated by the patients' expectations and doctors' recommendations. They use primarily passive methods of treatment, and their work is affected by cultural, religious and situational factors. They demonstrate a low capacity of clinical reasoning in their practical work. Conclusions. There is a need for further development of physiotherapy in Afghanistan. Active and individually adapted treatment methods, clinical reasoning processes and evidence-based practice should be encouraged. There are several challenges in this, based on Afghan culture and traditions, gender issues, religious factors, an authoritative society, a medical approach in treatment, and isolation and limitations in access to information. By means of an Action Research project the physiotherapists could be included in further development and research to promote a sustainable and culturally relevant development.
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