| 1. |
- Gateva, Vesela, et al.
(författare)
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A large-scale replication study identifies TNIP1, PRDM1, JAZF1, UHRF1BP1 and IL10 as risk loci for systemic lupus erythematosus
- 2009
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Ingår i: Nature Genetics. - : Springer Science and Business Media LLC. - 1061-4036 .- 1546-1718. ; 41:11, s. 1228-1233
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Tidskriftsartikel (refereegranskat)abstract
- Genome-wide association studies have recently identified at least 15 susceptibility loci for systemic lupus erythematosus (SLE). To confirm additional risk loci, we selected SNPs from 2,466 regions that showed nominal evidence of association to SLE (P < 0.05) in a genome-wide study and genotyped them in an independent sample of 1,963 cases and 4,329 controls. This replication effort identified five new SLE susceptibility loci (P < 5 x 10(-8)): TNIP1 (odds ratio (OR) = 1.27), PRDM1 (OR = 1.20), JAZF1 (OR = 1.20), UHRF1BP1 (OR = 1.17) and IL10 (OR = 1.19). We identified 21 additional candidate loci with P< or = 1 x 10(-5). A candidate screen of alleles previously associated with other autoimmune diseases suggested five loci (P < 1 x 10(-3)) that may contribute to SLE: IFIH1, CFB, CLEC16A, IL12B and SH2B3. These results expand the number of confirmed and candidate SLE susceptibility loci and implicate several key immunologic pathways in SLE pathogenesis.
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| 2. |
- Hicks, E.M., et al.
(författare)
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Controlling plasmon line shapes through diffractive coupling in linear arrays of cylindrical nanoparticles fabricated by electron beam lithography
- 2005
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Ingår i: Nano Letters. - : American Chemical Society (ACS). - 1530-6992 .- 1530-6984. ; 5:6, s. 1065-1070
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Tidskriftsartikel (refereegranskat)abstract
- The effect of diffractive coupling on the collective plasmon line shape of linear arrays of Ag nanoparticles fabricated by electron beam lithography has been investigated using Rayleigh scattering spectroscopy. The array spectra exhibit an intricate multi-peak structure, including a narrow mode that gains strength for interparticle distances that are close to the single particle resonance wavelength. A version of the discrete dipole approximation method provides an excellent qualitative description of the observed behavior.
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| 3. |
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| 4. |
- 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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| 5. |
- Alegret, Joan, 1977, et al.
(författare)
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Plasmonic properties of silver trimers with trigonal symmetry fabricated by electron-beam lithography
- 2008
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Ingår i: Journal of Physical Chemistry C. - : American Chemical Society (ACS). - 1932-7447 .- 1932-7455. ; 112:37, s. 14313-14317
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Tidskriftsartikel (refereegranskat)abstract
- We investigate the dipolar plasmon modes of nanoparticle trimers formed by three equal silver disks of diameter D = 100 nm located on the vertexes of an equilateral triangle. Samples were fabricated by electron-beam lithography and studied experimentally by dark-field spectroscopy. The results are found to be in good agreement with electrodynamical simulations based on the discrete dipole approximation (DDA). Similar to nanoparticle dimers, the trimer system exhibits two hybridized dipole resonances to the red and to the blue of the single particle resonance. However, the far-field spectra are polarization-insensitive for light incident normal to the plane of the trimer, and the peak shifts, which occur as the edge-to-edge distance d between the particles decrease, are smaller than for dimers. Moreover, we find that the dipolar displacement patterns are well described by linear combinations of bonding and antibonding symmetry adapted coordinates obtained through symmetry analysis based on the ideal D-3h point-group.
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| 6. |
- Billhult, Annika, et al.
(författare)
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The effect of massage on cellular immunity, endocrine and psychological factors in women with breast cancer -- a randomized controlled clinical trial.
- 2008
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Ingår i: Autonomic neuroscience : basic & clinical. - : Elsevier BV. - 1566-0702. ; 140:1-2, s. 88-95
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: The purpose of this study was to examine the effect of repeated effleurage massage treatments compared with a visit control group on circulating lymphocytes by studying the number and activity of peripheral blood NK cells, CD4+ and CD8+ T cells in women with breast cancer. Furthermore, the effect of repeated effleurage massage treatments on the levels of cortisol in saliva and oxytocin in plasma as well as degree anxiety, depression and quality of life was studied. DESIGN: A single centre, prospective, randomized, controlled trial. SETTINGS/LOCATION: The study was conducted in a radiation department, in a hospital in south-western Sweden. SUBJECTS: Twenty-two women (mean age=62) with breast cancer undergoing radiation were included in this study. INTERVENTIONS: The patients were randomly assigned to effleurage massage therapy (20 min of effleurage on ten occasions) or to control visits (ten 20-minute visits). OUTCOME MEASURES: Blood samples were collected before the first and last massage/control visit for analysis of peripheral blood NK, T cells and oxytocin. Saliva was analysed for cortisol. In addition, the patients completed the Hospital Anxiety and Depression Scale, Life Satisfaction Questionnaire and Spielbergers State Trait Anxiety Inventory prior to the first and last massage/control visit. RESULTS: Effleurage massage treatment had no significant effect on the number, frequencies or activation state of NK cells or CD4+ or CD8+ T cells. Furthermore, no significant changes between groups were detected on cortisol and oxytocin concentrations, anxiety, depression or quality of life. CONCLUSIONS: Significant effect of effleurage massage on cellular immunity, cortisol, oxytocin, anxiety, depression or quality of life could not be demonstrated in this study. Several possible explanations to the results of this study are discussed.
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| 7. |
- Billhult, Annika, et al.
(författare)
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The effect of massage on immune function and stress in women with breast cancer - A randomized controlled trial.
- 2009
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Ingår i: Autonomic neuroscience. - : Elsevier BV. - 1872-7484 .- 1566-0702. ; 150:1-2, s. 111-115
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To examine the short-term effects of light pressure effleurage on circulating lymphocytes by studying the number and activity of peripheral blood natural killer (NK) cells in patients with breast cancer compared to a control group. Furthermore, the effect of light pressure effleurage on salivary cortisol levels, heart rate and blood pressure was studied. DESIGN: Single centre, prospective, randomized and controlled study. METHODS: Thirty women, aged 50 to 75 years (mean 61 sd=7.2) with breast cancer undergoing radiation therapy in a hospital in southwestern Sweden were enrolled in the study. They were allocated to either receive massage in the form of a full-body light pressure effleurage treatment, or a control visit where they were given an equal amount of attention. Blood samples, saliva, notation of heart rate and blood pressure were collected before and after massage/control visit. Differences in change over time between groups were analyzed by Student's t-test. RESULTS: Light pressure effleurage massage decreased the deterioration of NK cell activity occurring during radiation therapy. Furthermore it lowered heart rate and systolic blood pressure. No effects were demonstrated on cortisol and diastolic pressure. CONCLUSIONS: A single full-body light pressure effleurage massage has a short-term effect on NK cell activity, systolic blood pressure and heart rate in patients with breast cancer. However, the long-term clinical importance of these findings needs to be further investigated.
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| 8. |
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| 9. |
- Chen, Si, 1985, et al.
(författare)
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Ultrahigh sensitivity made simple : nanoplasmonic label-free biosensing with an extremely low limit-of-detection for bacterial and cancer diagnostics.
- 2009
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Ingår i: Nanotechnology. - : Institute of Physics (IOP). - 0957-4484 .- 1361-6528. ; 20:43
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Tidskriftsartikel (refereegranskat)abstract
- We present a simple and robust scheme for biosensing with an ultralow limit-of-detection down to several pg cm(-2) (or several tens of attomoles cm(-2)) based on optical label-free biodetection with localized surface plasmon resonances. The scheme utilizes cost-effective optical components and comprises a white light source, a properly functionalized sensor surface enclosed in a simple fluidics chip, and a spectral analyzer. The sensor surface is produced by a bottom-up nanofabrication technique with hole mask colloidal lithography. Despite its simplicity, the method is able to reliably detect protein-protein binding events at low picomolar and femtomolar concentrations, which is exemplified by the label-free detection of the extracellular adherence protein (EAP) found on the outer surface of the bacterium Staphylococcus aureus and of prostate-specific antigen (PSA), which is believed to be a prostate cancer marker. These experiments pave the way towards an ultra-sensitive yet compact biodetection platform for point-of-care diagnostics applications.
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| 10. |
- Dahlin, Andreas, 1980, et al.
(författare)
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High-Resolution Microspectroscopy of Plasmonic Nanostructures for Miniaturized Biosensing
- 2009
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Ingår i: Analytical Chemistry. - : American Chemical Society. - 0003-2700 .- 1520-6882. ; 81:16, s. 6572-6580
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Tidskriftsartikel (refereegranskat)abstract
- In this article, we demonstrate how to perform microscale spectroscopy of plasmonic nanostructures in order to minimize the noise when determining the resonance peak wavelength. This is accomplished using an experimental setup containing standard optical components mounted on an ordinary light microscope. We present a detailed comparison between extinction spectroscopy in transmission mode and scattering spectroscopy under dark field illumination, which shows that extinction measurements provide higher signal-to-noise in almost all situations. Furthermore, it is shown that rational selection of nanostructure, hardware components, and data analysis algorithms enables tracking of the particle plasmon resonance wavelength from a 10 mu m x 50 mu m area with a resolution of 10(-3) nm in transmission mode. We investigate how the temporal resolution, which can be improved down to 17 Ins, affects, the noise characteristics. In addition, we show how data can be acquired from an area as small as 2 mu m x 10 mu m (similar to 240 particles) at the expense of higher noise on longer time scales. In comparison with previous work on macroscopic sensor designs, this represents a sensor miniaturization of 5 orders of magnitude, without any loss in signal-to-noise performance. As a model system, we illustrate biomolecular detection using gold nanodisks prepared by colloidal lithography. The microextinction measurements of nanodisks described here provide detection of protein surface coverages as low as 40 pg/cm(2) (less than0.1% of saturated binding). In fact, the miniaturized system provides a detection limit in terms of surface coverage comparable to state of the art macroscopic sensors, while simultaneously being as close to single protein molecule detection as sensors based on a single nanoparticle.
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| 11. |
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| 12. |
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| 13. |
- Graham, R. Robert, et al.
(författare)
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Three functional variants of IFN regulatory factor 5 (IRF5) define risk and protective haplotypes for human lupus
- 2007
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Ingår i: Proceedings of the National Academy of Sciences of the United States of America. - : Proceedings of the National Academy of Sciences. - 0027-8424 .- 1091-6490. ; 104:16, s. 6758-6763
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Tidskriftsartikel (refereegranskat)abstract
- Systematic genome-wide studies to map genomic regions associated with human diseases are becoming more practical. Increasingly, efforts will be focused on the identification of the specific functional variants responsible for the disease. The challenges of identifying causal variants include the need for complete ascertainment of genetic variants and the need to consider the possibility of multiple causal alleles. We recently reported that risk of systemic lupus erythematosus (SLE) is strongly associated with a common SNP in IFN regulatory factor 5 (IRF5), and that this variant altered spicing in a way that might provide a functional explanation for the reproducible association to SLE risk. Here, by resequencing and genotyping in patients with SLE, we find evidence for three functional alleles of IRF5: the previously described exon 1B splice site variant, a 30-bp in-frame insertion/deletion variant of exon 6 that alters a proline-, glutamic acid-, serine- and threonine-rich domain region, and a variant in a conserved polyA+ signal sequence that alters the length of the 3' UTR and stability of IRF5 mRNAs. Haplotypes of these three variants define at least three distinct levels of risk to SLE. Understanding how combinations of variants influence IRF5 function may offer etiological and therapeutic insights in SLE; more generally, IRF5 and SLE illustrates how multiple common variants of the same gene can together influence risk of common disease.
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| 14. |
- Granath, A. B., et al.
(författare)
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Water aerobics reduces sick leave due to low back pain during pregnancy
- 2006
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Ingår i: J Obstet Gynecol Neonatal Nurs. - : Elsevier BV. - 0884-2175. ; 35:4, s. 465-71
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To compare the effect of a land-based, physical exercise program versus water aerobics on low back or pelvic pain and sick leave during pregnancy. DESIGN: Randomized controlled clinical trial. SETTING: Three antenatal care centers. PARTICIPANTS: 390 healthy pregnant women. INTERVENTIONS: A land-based physical exercise program or water aerobic once a week during pregnancy. MAIN OUTCOME MEASURES: Sick leave, pregnancy-related low back pain or pregnancy-related pelvic girdle pain, or both. RESULTS: Water aerobics diminished pregnancy-related low back pain (p=.04) and sick leave due to pregnancy-related low back pain (p=.03) more than a land-based physical exercise program. CONCLUSIONS: Water aerobics can be recommended for the treatment of low back pain during pregnancy. The benefits of a land-based physical exercise program are questionable and further evaluation is needed.
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| 15. |
- Granath, Aina, et al.
(författare)
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Lactose intolerance and long-standing pelvic pain after pregnancy: a case control study
- 2007
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Ingår i: Acta Obstetricia et Gynecologica.. - : Wiley. - 0001-6349 .- 1600-0412. ; 86, s. 1273-1276
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Tidskriftsartikel (refereegranskat)abstract
- Background. Long-standing pelvic pain during pregnancy and after delivery (PPP) is common. Its causes are not fully understood. A scientifically, undocumented, clinical observation is PPP patients often reporting unspecific abdominal pain and adverse reactions to milk. The main objective in this pilot study was to investigate if lactose intolerance, celiac disease or allergic propensity are risk factors for developing pelvic pain after delivery. Methods. A matched, case control study, where consecutive patients consulting a registered physiotherapist specialised in treating women with postpartum pelvic pain were compared to matched controls. Results. Lactose intolerance was found in 10 of 15 patients, and in 3 of 15 matched, healthy controls (p=0.05). No difference was seen between groups in the prevalence of celiac disease or allergic propensity. Conclusion. This study suggests that lactose intolerance might be a possible risk factor for pelvic pain after delivery.
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| 16. |
- Gunnarsson, K, et al.
(författare)
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Programmable motion and separation of single magnetic particles on patterned magnetic surfaces
- 2005
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Ingår i: Advanced Materials. - : Wiley. - 0935-9648 .- 1521-4095. ; 17:14, s. 1730-1734
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Tidskriftsartikel (refereegranskat)abstract
- Motion of single micrometer-sized magnetic particles on patterned magnetic surfaces is controlled by a rotating magnetic field (see Figure and cover). Patterns of thin-film magnetic elements are tailored to form transport lines. Individual particles are separated by adding junctions to the transport lines. The method can improve existing applications in biotechnology and generate new ones in life sciences.
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| 17. |
- Gunnarsson, Linda K, 1971, et al.
(författare)
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Confined Plasmons in Nanofabricated Single Silver Particle Pairs: Experimental Observations of Strog Interparticle Interactions
- 2005
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Ingår i: Journal of Physical Chemistry B. - : American Chemical Society (ACS). - 1520-5207 .- 1520-6106. ; 109:3, s. 1079-1087
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Tidskriftsartikel (refereegranskat)abstract
- We report on the optical properties of single isolated silver nanodisks and pairs of disks fabricated by electron beam lithography. By systematically varying the disk size and surface separation and recording elastic scattering spectra in different polarization configurations, we found evidence for extremely strong interparticle interactions. The dipolar surface plasmon resonance for polarization parallel to the dimer axis exhibited a red shift as the interdimer separation was decreased; as expected from previous work, an extremely strong shift was observed. The scattering spectra of single particles and pairs separated by more than one particle radius can be well described by the coupled dipole approximation (CDA), where the particles are approximated as point dipoles using a modified dipole polarizability for oblate spheroids. For smaller particle separations (d
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| 18. |
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| 19. |
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| 20. |
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| 21. |
- Hagström, Bertil, 1947, et al.
(författare)
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More illness and less disease? A 20-year perspective on chronic disease and medication.
- 2006
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Ingår i: Scandinavian journal of public health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 34:6, s. 584-8
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The implication of medication is that a drug is given against an illness. Over the last few decades an expanding number of drugs have appeared that focus on reducing risk factors and lifestyle conditions. Aims: To investigate the apprehension in respect of chronic disease among the working population in a Swedish community in 2000 compared with 1980. METHODS: In 1980 and 2000 an analogous questionnaire assessing chronic diseases and medication was mailed to 250 randomly selected persons from a local population between 25 and 70 years of age. RESULTS: Some 80% of the persons (n = 201) replied in 1980 and 78% (n = 195) in 2000. Individuals declaring a chronic disease increased from 23% (46/201) in 1980 to 39.5% in 2000 (p = 0.0005). Corresponding figures for men were 20.6% (20/97) in 1980 and 40.8% (40/98) in 2000 (p = 0,004) and for women 25.0% (26/104) in 1980 and 38.1% (37/97) in 2000 (p = 0.064). Persons who regularly see a doctor increased from 13% to 26% (p = 0.002) and the use of drugs for chronic diseases increased from 19% to 33% (p = 0.002). In 2000 an average of 2.3 drugs per person were used among those with a chronic disease, an increase of 53% since 1980. CONCLUSION: Stated chronic diseases and use of drugs for such diseases increased greatly between1980 and 2000. Prescribing drugs for a "risk" with no apparent illness may be confused with the remedy for an illness.
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| 22. |
- Hansson, Anders, 1953-, et al.
(författare)
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Balancing - an equilibrium act between different positions : an exploratory study on general practitioners' comprehension of their professional role
- 2007
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Ingår i: Scandinavian Journal of Primary Health Care. - : Taylor & Francis. - 0281-3432 .- 1502-7724. ; 25:2, s. 80-85
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Tidskriftsartikel (refereegranskat)abstract
- Objective. There is a call to make the duties and working conditions of the GP more transparent. The aim of this study was to explore practising GPs’ personal experiences of their professional role and what they regard to be its salient characteristics. Design. An exploratory and descriptive study was undertaken by interviewing GPs and by performing a focus-group study of experienced GPs. The interviews were transcribed and analysed, and the text was categorized according to content analysis. Setting. The practice of the interviewed GPs. Subjects. Seven GPs in individual interviews and a focus group of experienced GPs. Results. A major theme, Balancing, was identified. It was derived from a number of opposing concepts to which different features were related. “The good shepherd” versus “The medical expert”; “Curing” versus “Caring”; “Short visits” versus “Long consultations”; “The personal doctor” versus “The society's doctor”. In many consultations the GP has to contemplate how to stay in focus between these diverse roles. Conclusion.General practice requires a balance to be achieved between a number of opposing conditions. In their clinical work GPs have to adjust to and integrate alternative perspectives. Problems of recruiting new GPs might be associated with dilemmas in this balancing act.
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| 23. |
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| 24. |
- Hom, Geoffrey, et al.
(författare)
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Association of systemic lupus erythematosus with C8orf13-BLK and ITGAM-ITGAX.
- 2008
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Ingår i: New England Journal of Medicine. - : Massachusetts Medical Society. - 0028-4793 .- 1533-4406. ; 358:9, s. 900-909
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Systemic lupus erythematosus (SLE) is a clinically heterogeneous disease in which the risk of disease is influenced by complex genetic and environmental contributions. Alleles of HLA-DRB1, IRF5, and STAT4are established susceptibility genes; there is strong evidence for the existence of additional risk loci.METHODS: We genotyped more than 500,000 single-nucleotide polymorphisms (SNPs) in DNA samples from 1311 case subjects with SLE and 1783 control subjects; all subjects were North Americans of European descent. Genotypes from 1557 additional control subjects were obtained from public data repositories. We measured the association between the SNPs and SLE after applying strict quality-control filters to reduce technical artifacts and to correct for the presence of population stratification. Replication of the top loci was performed in 793 case subjects and 857 control subjects from Sweden.RESULTS: Genetic variation in the region upstream from the transcription initiation site of the gene encoding B lymphoid tyrosine kinase (BLK) and C8orf13 (chromosome 8p23.1) was associated with disease risk in both the U.S. and Swedish case–control series (rs13277113; odds ratio, 1.39; P=1×10−10) and also with altered levels of messenger RNA in B-cell lines. In addition, variants on chromosome 16p11.22, near the genes encoding integrin alpha M (ITGAM, or CD11b) and integrin alpha X (ITGAX), were associated with SLE in the combined sample (rs11574637; odds ratio, 1.33; P=3×10−11).
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| 25. |
- Imsland, A.K, et al.
(författare)
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Temperature and salinity effects on plasma insulin-like growth factor-1 concentrations and growth in juvenile turbot (Scophthalmus maximus).
- 2007
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Ingår i: Aquaculture. - : Elsevier BV. - 0044-8486. ; 271:1-4, s. 546-552
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Tidskriftsartikel (refereegranskat)abstract
- The effects of temperature and salinity on plasma IGF-I levels and its interrelationship with growth, daily feed intake and feed conversion of juvenile turbot (initial mean weight 14 g) were investigated by rearing fish at 10, 14, 18 and 22 °C and 15, 25 and 33.5‰ for 3 months. The plasma IGF-I levels increased with increasing temperatures reaching a plateau around 18 °C. Further, both temperature and salinity had a significant effect on growth, daily feed intake and feed conversion efficiency in juvenile turbot. Growth, food consumption, and food conversion efficiency were highest at 18 °C and 15‰, and lowest at 10 °C and 33.5‰. Although there was a high variation between IGF-I values within all groups there was a positive relationship between IGF-I levels and specific growth rates and daily feed intake. The levels of IGF-I were almost three times higher for fish with higher growth rates than for those with lower growth. In addition, the results show evidence for an increased appetite in fish with high plasma IGF-I levels. Interestingly, there was no correlation between environmental salinity and IGF-I levels, although decreased salinity improves growth and feed conversion efficiency.
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| 26. |
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| 27. |
- Magnil, Maria, 1952, et al.
(författare)
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Prevalence of depressive symptoms and associated factors in elderly primary care patients: a descriptive study
- 2008
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Ingår i: Primary Care Companion to The Journal of Clinical Psychiatry. - 1523-5998. ; 104:6, s. 462-468
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Tidskriftsartikel (refereegranskat)abstract
- ACKGROUND: Depressive symptoms are common in older adults. A majority will be seen in primary care. The aim was to study the prevalence of and to explore factors associated with depressive symptoms in elderly primary care patients. METHOD: In consecutive patients aged 60 years and older attending a Swedish primary care center between February and December of 2003, depressive symptoms were identified as >/= 13 points on the Montgomery-Asberg Depression Rating Scale-Self-Rated version (MADRS-S). Somatic symptoms measured according to PRIME-MD, age, socioeconomic status, gender, somatic diagnoses, and medication were analyzed in relation to presence of depressive symptoms. RESULTS: Forty-six of 302 patients (15%) rated themselves in the depressed range. There were no differences between depressed and nondepressed patients concerning socioeconomic status, other illnesses, or medication except for use of sedatives/hypnotics being more common (OR = 2.7, 95% CI = 1.3 to 5.6) in depressed patients. Patients in the group scoring >/= 13 on the MADRS-S were more likely to have become widowed during the last year (OR = 6.0, 95% CI = 1.7 to 20.8) or to have indicated significant life events (OR = 4.3, 95% CI = 2.0 to 9.0), but were less likely to report having leisure time activities (OR = 0.2, 95% CI = 0.08 to 0.41) or perception of good health (OR = 0.1, 95% CI = 0.05 to 0.3). Patients being treated for depression did not have increased depression scores (OR = 1.4, 95% CI = 0.66 to 3.1). CONCLUSION: In a group of unselected primary care elderly patients, the prevalence of depressive symptoms was high. Use of sedatives/hypnotics was remarkably common in patients with depressive symptoms. Patients with ongoing treatment of depression did not have increased depression scores, indicating the good prognosis for treated depression in the elderly.
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| 28. |
- Nilsson, Gunnar H., et al.
(författare)
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Patients, general practitioners, diseases and health problems in urban general practice: a cross-sectional study on electronic patient records
- 2008
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Ingår i: Primary Health Care Research & Development. - : Cambridge University Press (CUP). - 1463-4236 .- 1477-1128. ; 9:02, s. 119-125
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Tidskriftsartikel (refereegranskat)abstract
- Background: Statistics from primary health care in Sweden, as well as from other Nordic countries, have been sparse. The electronic patient records (EPR) will be an increasingly important source of clinical information. The aim of this study was to investigate types of encounters, managed diseases and health problems, and characteristics of patients and general practitioners (GPs) in everyday general practice using EPR. Methods: A multi-centre, cross-sectional database study of EPR in primary health care in Stockholm, Sweden. Twenty-six randomly selected GPs with 20 randomly selected encounters each. Main outcome measures were the number and distribution of diseases and health problems, age and gender of patients and GPs, and type of encounter. Results: The mean age of the patients was 51.2 years, 30.2% were aged 75 years or older, and 57.5% were women. The mean number of managed problems per encounter was 1.4. The most common specific diagnoses were essential hypertension (9.3% of the encounters) and acute upper respiratory infections (8.8%). Older patients had more health problems in each encounter (P = 0.000001). GPs differed regarding the characteristics of their patients, including sex, age and number of health problems managed at each encounter. The patients of different GPs differed regarding sex, age and number of health problems managed. Female and male patients had different diagnostic panoramas and they had a tendency to encounter a GP of the same sex (odds ratio 1.5, P = 0.053). Conclusions: We found that two diagnoses (essential hypertension and acute upper respiratory infections), four diagnostic groups, women and the elderly are predominant. Female and male patients have different diagnostic panoramas and they have a tendency to encounter a GP of the same sex. GPs differ regarding the characteristics of their patients, including sex, age and number of health problems managed at each encounter.
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| 29. |
- Nordeman, Lena Margareta, et al.
(författare)
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Early access to physical therapy treatment for subacute low back pain in primary health care: a prospective randomized clinical trial.
- 2006
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Ingår i: The Clinical journal of pain. - : Ovid Technologies (Wolters Kluwer Health). - 0749-8047. ; 22:6, s. 505-11
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To evaluate the effects of early access (EA) to physical therapy treatment for patients with subacute low back pain compared to access with a 4-week waiting list. DESIGN: A prospective, randomized clinical trial. SETTING: Primary health care. PATIENTS: Sixty consecutive patients with subacute low back pain. INTERVENTIONS: Patients were randomized either to EA within 2 days for physical examination and individualized physical therapy treatment (n=32) or a control group with a 4-week waiting list (n=28). OUTCOME MEASURES: Self-administrated questionnaires were used for assessment at inclusion, at discharge, and at 6 months. Primary outcome measure was pain intensity assessed by Borg category scale for ratings of perceived pain. Secondary outcomes included the Orebro musculoskeletal pain screening questionnaire, the Roland and Morris disability questionnaire, sick-leave, visits to health care, and physical therapy. RESULTS: The results showed no significant differences in pain between the groups at discharge. At 6 months, the reduction of pain was significantly greater in the EA group compared to the control group (P=0.025). Changes in secondary outcome measures were not significantly different between groups. CONCLUSIONS: This study indicated that EA to physical therapy resulted in greater improvement in perceived pain at 6 months compared to later access. In this study, EA to physical therapy could be introduced by reorganization without additional resources.
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| 30. |
- Rembeck, Gun, 1955, et al.
(författare)
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Attitudes and feelings towards menstruation and womanhood in girls at menarche.
- 2006
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Ingår i: Acta paediatrica (Oslo, Norway : 1992). - : Wiley. - 0803-5253. ; 95:6, s. 707-14
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Tidskriftsartikel (refereegranskat)abstract
- AIM: To elucidate early adolescent girls' attitudes, thoughts and feelings towards menstruation and their bodies. METHODS: 309 12-y-old girls answered questionnaires. One part of the questionnaire dealt with thoughts and feelings towards menstruation. The other part dealt with thoughts and feelings towards menstruation and sex and ability to communicate on aspects of womanhood. RESULTS: Postmenarcheal girls were less positive towards menstruation than premenarcheal girls (p = 1 x 10(-6)). Many girls (43%) did not reaffirm the statement "I like my body" and almost one quarter stated being teased for their appearance. Many of the girls claimed that they had been called "cunt" (38%) or "whore" (46%). If called "cunt" or "whore", 17% stated that they felt alone, 76% felt anger and 50% were offended. Mothers were those with whom girls could most easily "chat" about their period. Sixty-seven per cent received information about menstruation from school nurses. CONCLUSION: Wanting to be an adult and liking that their body develops seem to be associated with a more positive feeling towards menstruation. Furthermore, mothers' timing and ability to communicate attitudes towards menstruation and the body are as important as those in a girl's immediate environment.
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| 31. |
- Rosenfeld, Mark, 1949, et al.
(författare)
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Active involvement and intervention in patients exposed to whiplash trauma in automobile crashes reduces costs: a randomized, controlled clinical trial and health economic evaluation.
- 2006
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Ingår i: Spine. - : Ovid Technologies (Wolters Kluwer Health). - 1528-1159 .- 0362-2436. ; 31:16, s. 1799-804
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Tidskriftsartikel (refereegranskat)abstract
- STUDY DESIGN: To examine and compare the costs and consequences in a partial economic evaluation of two competing interventions in patients exposed to whiplash trauma in automobile crashes. The interventions were an active involvement and intervention using early mobilization and a standard intervention of rest, recommended short-term immobilization in a cervical collar and a cautious, gradual self-exercise program according to a leaflet. The study was randomized and controlled. OBJECTIVES: The aim of the study was to compare the costs of an active involvement and intervention versus a standard intervention and to relate them to the clinical benefits in patients exposed to whiplash trauma in automobile crashes to facilitate decision-making regarding intervention and resource allocation. SUMMARY OF BACKGROUND DATA: There is very little known about the health economic aspects of various interventions in the target treatment group of patients. METHODS: Based on a prospective, randomized, clinical trial, data on clinical effectiveness and resources used for the active involvement and intervention and standard intervention were collected for a comparative analysis of the costs related to physical therapy treatment and sick leave. A cost-consequence analysis consisting of a modified cost-effectiveness analysis was used. RESULTS: The costs were significantly lower after 6 and 36 months with an active involvement and intervention as compared with the standard intervention. The active involvement and intervention were significantly superior in reducing experienced pain and reducing sick leave. CONCLUSIONS: For patients exposed to whiplash trauma in a motor vehicle collision, an active involvement and intervention were both less costly and more effective than a standard intervention.
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| 32. |
- Sigurdsson, Snaevar, et al.
(författare)
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Comprehensive evaluation of the genetic variants of interferon regulatory factor 5 (IRF5) reveals a novel 5 bp length polymorphism as strong risk factor for systemic lupus erythematosus
- 2008
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Ingår i: Human Molecular Genetics. - : Oxford University Press (OUP). - 0964-6906 .- 1460-2083. ; 17:6, s. 872-881
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Tidskriftsartikel (refereegranskat)abstract
- We analyzed a comprehensive set of single-nucleotide polymorphisms (SNPs) and length polymorphisms in the interferon regulatory factor 5 (IRF5) gene for their association with the autoimmune disease systemic lupus erythematosus (SLE) in 485 Swedish patients and 563 controls. We found 16 SNPs and two length polymorphisms that display association with SLE (P < 0.0005, OR > 1.4). Using a Bayesian model selection and averaging approach we identified parsimonious models with exactly two variants of IRF5 that are independently associated with SLE. The variants of IRF5 with the highest posterior probabilities (1.00 and 0.71, respectively) of being causal in SLE are a SNP (rs10488631) located 3' of IRF5, and a novel CGGGG insertion-deletion (indel) polymorphism located 64 bp upstream of the first untranslated exon (exon 1A) of IRF5. The CGGGG indel explains the association signal from multiple SNPs in the IRF5 gene, including rs2004640, rs10954213 and rs729302 previously considered to be causal variants in SLE. The CGGGG indel contains three or four repeats of the sequence CGGGG with the longer allele containing an additional SP1 binding site as the risk allele for SLE. Using electrophoretic mobility shift assays we show increased binding of protein to the risk allele of the CGGGG indel and using a minigene reporter assay we show increased expression of IRF5 mRNA from a promoter containing this allele. Increased expression of IRF5 protein was observed in peripheral blood mononuclear cells from SLE patients carrying the risk allele of the CGGGG indel. We have found that the same IRF5 allele also confers risk for inflammatory bowel diseases and multiple sclerosis, suggesting a general role for IRF5 in autoimmune diseases.
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| 33. |
- Stern, S., et al.
(författare)
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Sustainable development of food production : A case study on scenarios for pig production
- 2005
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Ingår i: Ambio. - 0044-7447 .- 1654-7209. ; 34:42099, s. 402-407
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Tidskriftsartikel (refereegranskat)abstract
- To study future, sustainable production systems, a stepwise method was used to create three future scenarios for pig production based on different sustainability goals. The first scenario focused on animal welfare and the natural behavior of the animals. The second targeted low impacts on the environment and the efficient use of natural resources. The third scenario aimed at product quality and safety. Each scenario fulfilled different aspects of sustainability, but there were goal conflicts because no scenario fulfilled all sustainability goals. The scenarios were then parameterized. The environmental impact was calculated using the life-cycle assessment (LCA) methodology, and the economic cost was calculated from the same data set. The cost per kilo of pork was highest for the animal welfare scenario and similar for the other two scenarios. The environmental scenario had the lowest environmental impact, and the product-quality scenario the highest. The results are discussed based on different future priorities. © Royal Swedish Academy of Sciences 2005.
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| 34. |
- Sundvall, Pär-Daniel, et al.
(författare)
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Evaluation of dipstick analysis among elderly residents to detect bacteriuria: a cross-sectional study in 32 nursing homes.
- 2009
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Ingår i: BMC geriatrics. - : Springer Science and Business Media LLC. - 1471-2318. ; 9
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Few studies have evaluated dipstick urinalysis for elderly and practically none present confidence intervals. Furthermore, most previous studies combine all bacteria species in a "positive culture". Thus, their evaluation may be inappropriate due to Yule-Simpson's paradox. The aim of this study was to evaluate diagnostic accuracy of dipstick urinalysis for the elderly in nursing homes. METHODS: In this cross-sectional study voided urine specimens were collected from 651 elderly individuals in nursing homes. Dipstick urinalysis for nitrite, leukocyte esterase and urine culture were performed. Sensitivity, specificity, positive and negative predictive values with 95% confidence intervals were calculated. Visual readings were compared to readings with a urine chemistry analyzer. RESULTS: 207/651 (32%) of urine cultures showed growth of a potentially pathogenic bacterium. Combining the two dipsticks improved test characteristics slightly compared to using only one of the dipsticks. When both dipsticks are negative, presence of potentially pathogenic bacteria can be ruled out with a negative predictive value of 88 (84-92)%. Visual and analyzer readings had acceptable agreement. CONCLUSION: When investigating for bacteriuria in elderly people at nursing homes we suggest nitrite and leukocyte esterase dipstick be combined. There are no clinically relevant differences between visual and analyzer dipstick readings. When dipstick urinalysis for nitrite and leukocyte esterase are both negative it is unlikely that the urine culture will show growth of potentially pathogenic bacteria and in a patient with an uncomplicated illness further testing is unnecessary.
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| 35. |
- Svedlindh, P., et al.
(författare)
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Vortex fluctuations in weak magnetic fields
- 2005
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Ingår i: Fluctuation and Noise Letters. - 0219-4775. ; 5:1, s. R1-R12
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Tidskriftsartikel (refereegranskat)abstract
- Flux-noise and ac susceptibility measurements have been performed on epitaxial films of YBa2Cu3O7. The validity of the fluctuation-dissipation-theorem is verified by the proportionality between flux noise and ac susceptibility results. The nominal zero-field flux-noise spectrum (S-phi (f)) can be characterized as follows: Below a temperature dependent frequency f(0)(T), the flux-noise spectrum is frequency independent. For frequencies f > f(0)(T), the flux-noise spectrum follows f(-x), with x approximate to 1.7 - 1.8. f(0) decreases by 4 orders of magnitude in a temperature interval of Delta T approximate to 0.5 K. Moreover, the flux-noise spectrum scales as fS(phi) = g(f/f(0)(T)), where g((.)) is a scaling function. The influence of weak perturbing magnetic fields was investigated. While the general characteristics of the flux-noise spectrum remain, the characteristic frequency f(0) increases by 3 - 4 orders of magnitude increasing the field from zero to 1 Oe. Flux-noise measurements performed using a compensating field to reduce the residual field in the experimental setup reveal new features of the measured noise spectra. The flux-noise is dominated by thermally generated vortex-antivortex pair fluctuations at temperatures below the mean-field transition temperature, while with decreasing temperature there is a transition to vortex fluctuations being dominated by field generated vortices.
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| 36. |
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| 37. |
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| 38. |
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| 39. |
- von Below, Bernhard, 1952, et al.
(författare)
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Medical students' and facilitators' experiences of an Early Professional Contact course: active and motivated students, strained facilitators.
- 2008
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Ingår i: BMC medical education. - : Springer Science and Business Media LLC. - 1472-6920. ; 8
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Today, medical students are introduced to patient contact, communication skills, and clinical examination in the preclinical years of the curriculum with the purpose of gaining clinical experience. These courses are often evaluated from the student perspective. Reports with an additional emphasis on the facilitator perspective are scarce. According to constructive alignment, an influential concept from research in higher education, the learning climate between students and teachers is also of great importance. In this paper, we approach the learning climate by studying both students' and facilitators' course experiences.In 2001, a new "Early Professional Contact" longitudinal strand through term 1-4, was introduced at the Sahlgrenska Academy, University of Gothenburg, Sweden. General practitioners and hospital specialists were facilitators.The aim of this study was to assess and analyse students' and clinical facilitators' experiences of the Early Professional Contact course and to illuminate facilitators' working conditions. METHODS: Inspired by a Swedish adaptation of the Course Experience Questionnaire, an Early Professional Contact Questionnaire was constructed. In 2003, on the completion of the first longitudinal strand, a student and facilitator version was distributed to 86 students and 21 facilitators. In the analysis, both Chi-square and the Mann-Whitney tests were used. RESULTS: Sixty students (70%) and 15 facilitators (71%) completed the questionnaire. Both students and facilitators were satisfied with the course. Students reported gaining iiration for their future work as doctors along with increased confidence in meeting patients. They also reported increased motivation for biomedical studies. Differences in attitudes between facilitators and students were found. Facilitators experienced a greater workload, less reasonable demands and less support, than students. CONCLUSION: In this project, a new Early Professional Contact course was analysed from both student and facilitator perspectives. The students experienced the course as providing them with a valuable introduction to the physician's professional role in clinical practice. In contrast, course facilitators often experienced a heavy workload and lack of support, despite thorough preparatory education. A possible conflict between the clinical facilitator's task as educator and member of the workplace is suggested. More research is needed on how doctors combine their professional tasks with work as facilitators.
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