| 1. |
- Alerby, Eva, et al.
(author)
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Ömsesidig samverkan mellan pedagogisk forskning och pedagogisk praktik
- 2010
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In: Utbildning på vetenskaplig grund. - Stockholm : Lärarförbundet. - 9789197808835 ; , s. 22-32
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Book chapter (other academic/artistic)abstract
- Vad innebär det i praktiken att skolans och förskolans verksamhet skall vila på vetenskaplig grund och beprövad erfarenhet? Det vi tycker är intressant att lyfta fram är på vilket sätt forskningen bedrivs, hur forskningsfrågorna kommer till och hur resultaten kommer den pedagogiska praktiken tillgodo. I denna artikel diskuterar och problematiserar vi relationen mellan den pedagogiska forskningen och förskolans och skolans verksamhet. Diskussionerna exemplifieras från ett konkret forsknings- och samverkansprojekt, där forskning och praktik har gått hand i hand. Vidare ger en forskare, en doktorand, en lärarutbildare, en skolledare och en lärare sin personliga syn på samverkan mellan pedagogisk forskning och praktik.
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| 2. |
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| 3. |
- Brinkmalm, Gunnar, et al.
(author)
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An online nano-LC-ESI-FTICR-MS method for comprehensive characterization of endogenous fragments from amyloid β and amyloid precursor protein in human and cat cerebrospinal fluid.
- 2012
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In: Journal of mass spectrometry : JMS. - : Wiley. - 1096-9888 .- 1076-5174. ; 47:5, s. 591-603
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Journal article (peer-reviewed)abstract
- Amyloid precursor protein (APP) is the precursor protein to amyloid β (Aβ), the main constituent of senile plaques in Alzheimer's disease (AD). Endogenous Aβ peptides reflect the APP processing, and greater knowledge of different APP degradation pathways is important to understand the mechanism underlying AD pathology. When one analyzes longer Aβ peptides by low-energy collision-induced dissociation tandem mass spectrometry (MS/MS), mainly long b-fragments are observed, limiting the possibility to determine variations such as amino acid variants or post-translational modifications (PTMs) within the N-terminal half of the peptide. However, by using electron capture dissociation (ECD), we obtained a more comprehensive sequence coverage for several APP/Aβ peptide species, thus enabling a deeper characterization of possible variants and PTMs. Abnormal APP/Aβ processing has also been described in the lysosomal storage disease Niemann-Pick type C and the major large animal used for studying this disease is cat. By ECD MS/MS, a substitution of Asp7 → Glu in cat Aβ was identified. Further, sialylated core 1 like O-glycans at Tyr10, recently discovered in human Aβ (a previously unknown glycosylation type), were identified also in cat cerebrospinal fluid (CSF). It is therefore likely that this unusual type of glycosylation is common for (at least) species belonging to the magnorder Boreoeutheria. We here describe a detailed characterization of endogenous APP/Aβ peptide species in CSF by using an online top-down MS-based method.
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| 4. |
- Christianson, Monica, et al.
(author)
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"Eyes wide shut" - sexuality and risk in HIV-positive youth in Sweden : a qualitative study
- 2007
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In: Scandinavian Journal of Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 35:1, s. 55-61
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Journal article (peer-reviewed)abstract
- Aims: This study explores the perception of sexual risk-taking behaviour in young HIV+ women and men in Sweden and their understanding of why they caught HIV. Method: In-depth interviews were conducted with 10 HIV+ women and men aged 17—24 years, 7 born in Sweden and 3 immigrants. Interviews were tape-recorded, transcribed verbatim, and analysed according to the stages of grounded theory. Results: The core category varying agency in the gendered sexual arena illustrated a spectrum of power available to these informants during sexual encounters. Two subcategories contextualized sexual practice: sociocultural blinds and from consensual to forced sex. Lack of adult supervision as a child, naïve views, being in love, alcohol and drugs, the macho ideal, and cultures of silence surrounding sexuality both individually and structurally all blinded them to the risks, making them vulnerable. Grouping narratives according to degree of consensus in sexual encounters demonstrated that sexual risks happened in a context of gendered power relations. Conclusion: This pioneering study reveals mechanisms that contribute to vulnerability and varied agency that may help in understanding why and how young people are at risk of contracting HIV. Public health strategies, which consider the role of gender and social background in the context of risky behaviours, could be developed from these findings.
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| 5. |
- Christianson, Monica, et al.
(author)
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"One-night stands" - risky trips between lust and trust : qualitative interviews with Chlamydia trachomatis infected youth in north Sweden
- 2003
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In: Scandinavian Journal of Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 31:1, s. 44-50
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Journal article (peer-reviewed)abstract
- Aim: The aim of the study was to get a deeper understanding of sexual risk-taking, by interviewing young people diagnosed with Chlamydia trachomatis. Method: This qualitative study was conducted at a youth clinic in Umeå, Sweden. Five young women and four men, aged 18—22, participated. In-depth interviews were performed. Open questions around certain themes were posed, such as thoughts about getting CT, sexual encounters, and attitudes towards condoms. Interviews were tape-recorded and transcribed verbatim. Data were analysed according to grounded theory. Norms, events, and emotions were explored. The goal was to develop credible and applicable concepts concerning sexual relationships, risk-taking, and experiences of CT. Results: Informants revealed that behind their sexual risk-taking was a drive to ``go steady''. Lust and trust were the guidelines if sex was going to take place. When discussing ``one-night stands'' gender stereotypes occurred. Females were expected to be less forward compared with males. We found an uneven distribution of responsibility concerning condoms. Males expected females to be ``condom promoters''. By catching CT, females experienced guilt, while males felt content through knowing ``the source of contamination''. Conclusion: An important public health issue is to implement how males should play an equal part in reproductive health. General CT screening of males is one suggestion.
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| 6. |
- Christianson, Monica
(author)
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What's behind sexual risk taking? : exploring the experiences of chlamydia-positive, HIV-positive, and HIV-tested young women and men in Sweden
- 2006
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Doctoral thesis (other academic/artistic)abstract
- The overall aim was to explore the experiences of sexual risk taking among Chlamydia Trachomatis positive (CT+), HIV positive (HIV+), and HIV tested young women and men. The specific aims were to explore, from a gender perspective, the course of events, the norms, considerations and emotions involved in sexual risk taking in CT+, explore the perception of sexual risk taking in HIV+ youth, and their understanding of why they caught HIV and look at how the Law of Communicable Diseases Act impacts their sexuality. Moreover, to investigate why young adults test for HIV, how they construct the HIV risk, and what implications testing has for them.42 informants between 17-24 years of age were recruited from a youth clinic in Umeå and from three infection clinics for HIV patients in Sweden.In depth interviews and focus group interviews were tape-recorded, transcribed verbatim and analyzed according to a Grounded Theory approach.The finding revealed that behind sexual risk taking, there was a drive to go steady, where lust and trust guided if sex would take place. In one-night stands women were expected to be less forward compared with men. We found an uneven responsibility concerning condom use where men expected women to be "condom promoters". By catching CT, women experienced guilt, while men felt content through knowing "the source of contamination".Among the HIV+ youth, socio-cultural factors such as; lack of adult supervision, naivité, love, alcohol, drugs, the macho ideal and cultures of silence blinded the informants to the risks and made them vulnerable. By grouping narratives according to degree of consensus in sexual encounters, this demonstrated that sexual risks happened in a context of gendered power relations where the informants had varied agency. The Law of Communicable Diseases Act implied both support and burden for these HIV+ youth. A lot of responsibility was put on them and to be able to handle the infromation duty they tried to switch off lust, switch off the disease, or balance lust and obedience.Among the HIV tested youth, HIV was seen a distant threat. Many had event-driven reasons for testing for HIV; multiple partners being one. Risk zones, like bars were perceived to be a milieu that often was expected to include one-night stands. Responsibility for testing was a gendered issue; "natural" for women, while men rather escaped from responsibility and had a testing resistance. Receiving a "green card" confirmed healthiness and provided relief, and made the informants felt "clean". They could restart with new ambitious, including reconsidering risk.The findings can be used in public health and in health care sectors that work with young people. We present suggestions on how to decrease the spread of STIs:To implement how men could play an equal part in sexual and reproductive health.Promote general CT screening for men.Liberal HIV testing among both young women and men.Promote safer sex behaviour from the uninfected youth, especially focusing on men??.Consider the role of gender and social background in the context of risky behaviours.Give lots of positive rewards concerning HIV disclosure to diminish the risk for HIV transmission.
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| 7. |
- Eriksson, Carola, et al.
(author)
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Content of childbirth-related fear in Swedish women and men : analysis of an open-ended question
- 2006
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In: Journal of midwifery & women's health. - : Wiley. - 1526-9523 .- 1542-2011. ; 51:2, s. 112-118
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Journal article (peer-reviewed)abstract
- The content of childbirth-related fear as described by 308 women and 194 men was analyzed and compared in relation to intensity of fear. The content of fear was similarly described by women and men and concerned the following main categories: the labor and delivery process, the health and life of the baby, the health and life of the woman, own capabilities and reactions, the partner's capabilities and reactions, and the professionals' competence and behavior. Among women, the labor and delivery process was the most frequently reported among the 6 categories of fears, whereas the health and life of the baby was the most frequent among the men. Fears related to own capabilities and reactions were described significantly more often by women with intense fear than by women with mild to moderate fear. The greatest difference between men with intense versus mild to moderate fear was a more frequent expression of concern for the health and life of the woman. Both women and men had fears related to not being treated with respect and not receiving sufficient medical care. This finding suggests that part of the problem with childbirth-related fear is located within the health care system itself.
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| 8. |
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| 9. |
- Ferreira, Daniel, et al.
(author)
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Brain changes in Alzheimer's disease patients with implanted encapsulated cells releasing nerve growth factor
- 2015
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In: Journal of Alzheimer's Disease. - 1387-2877 .- 1875-8908. ; 43, s. 1059-1072
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Journal article (peer-reviewed)abstract
- © 2015-IOS Press and the authors. New therapies with disease-modifying effects are urgently needed for treating Alzheimer's disease (AD). Nerve growth factor (NGF) protein has demonstrated regenerative and neuroprotective effects on basal forebrain cholinergic neurons in animal studies. In addition, AD patients treated with NGF have previously shown improved cognition, EEG activity, nicotinic binding, and glucose metabolism. However, no study to date has analyzed brain atrophy in patients treated with NGF producing cells. In this study we present MRI results of the first clinical trial in patients with AD using encapsulated NGF biodelivery to the basal forebrain. Six AD patients received the treatment during twelve months. Patients were grouped as responders and non-responders according to their twelve-months change in MMSE. Normative values were created from 131 AD patients from ADNI, selecting 36 age-and MMSE-matched patients for interpreting the longitudinal changes in MMSE and brain atrophy. Results at baseline indicated that responders showed better clinical status and less pathological levels of cerebrospinal fluid (CSF) Aβ1-42. However, they showed more brain atrophy, and neuronal degeneration as evidenced by higher CSF levels of T-tau and neurofilaments. At follow-up, responders showed less brain shrinkage and better progression in the clinical variables and CSF biomarkers. Noteworthy, two responders showed less brain shrinkage than the normative ADNI group. These results together with previous evidence supports the idea that encapsulated biodelivery of NGF might have the potential to become a new treatment strategy for AD with both symptomatic and disease-modifying effects.
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| 10. |
- Gustafsson-Larsson, Susanne, et al.
(author)
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Bun-baking mums and subverters: The agency of network participants in a Rural Swedish county
- 2007
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In: Women's Studies. - : Elsevier BV. - 0277-5395 .- 1879-243X. ; 30:1, s. 48-58
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Journal article (peer-reviewed)abstract
- During the 1990s rural Swedish women positioned themselves as women and formed networks aimed at addressing various local and most often gender-related problems that limited their quality of life. The aim of this article is to empirically describe and theoretically discuss the idea of agency in the context of women's social practices of networking and to examine how the participants either reproduce or transform the gendered structures that shape them. The empirical data for this article consist primarily of discussions with focus groups and interviews with network participants. Through interpretations, a pattern of gendered power-relations was illuminated, which both influenced and constrained the participants' activities. We have interpreted the participants' networking agency as acts of protest against everything that limits their living conditions. As women develop strategies through networking, their resistance seems to become increasingly significant for the ongoing transformations of the gender order.
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| 11. |
- Halim, Adnan, et al.
(author)
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Site-specific characterization of threonine, serine, and tyrosine glycosylations of amyloid precursor protein/amyloid {beta}-peptides in human cerebrospinal fluid.
- 2011
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In: Proceedings of the National Academy of Sciences of the United States of America. - : Proceedings of the National Academy of Sciences. - 1091-6490. ; 108:29, s. 11848-53
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Journal article (peer-reviewed)abstract
- The proteolytic processing of human amyloid precursor protein (APP) into shorter aggregating amyloid β (Aβ)-peptides, e.g., Aβ1-42, is considered a critical step in the pathogenesis of Alzheimer's disease (AD). Although APP is a well-known membrane glycoprotein carrying both N- and O-glycans, nothing is known about the occurrence of released APP/Aβ glycopeptides in cerebrospinal fluid (CSF). We used the 6E10 antibody and immunopurified Aβ peptides and glycopeptides from CSF samples and then liquid chromatography-tandem mass spectrometry for structural analysis using collision-induced dissociation and electron capture dissociation. In addition to 33 unglycosylated APP/Aβ peptides, we identified 37 APP/Aβ glycopeptides with sialylated core 1 like O-glycans attached to Thr(-39, -21, -20, and -13), in a series of APP/AβX-15 glycopeptides, where X was -63, -57, -52, and -45, in relation to Asp1 of the Aβ sequence. Unexpectedly, we also identified a series of 27 glycopeptides, the Aβ1-X series, where X was 20 (DAEFRHDSGYEVHHQKLVFF), 19, 18, 17, 16, and 15, which were all uniquely glycosylated on Tyr10. The Tyr10 linked O-glycans were (Neu5Ac)(1-2)Hex(Neu5Ac)HexNAc-O- structures with the disialylated terminals occasionally O-acetylated or lactonized, indicating a terminal Neu5Acα2,8Neu5Ac linkage. We could not detect any glycosylation of the Aβ1-38/40/42 isoforms. We observed an increase of up to 2.5 times of Tyr10 glycosylated Aβ peptides in CSF in six AD patients compared to seven non-AD patients. APP/Aβ sialylated O-glycans, including that of a Tyr residue, the first in a mammalian protein, may modulate APP processing, inhibiting the amyloidogenic pathway associated with AD.
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| 12. |
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| 13. |
- Hamberg, Katarina, et al.
(author)
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Scientific rigor in qualitative research : examples from a study of women´s health
- 1994
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In: Family Practice. - : Oxford University Press. - 0263-2136 .- 1460-2229. ; 11, s. 176-181
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Journal article (peer-reviewed)abstract
- The increase in qualitative research in family medicine raises a demand for critical discussions about design, methods and conclusions. This article shows how scientific claims for truthful findings and neutrality can be assessed. Established concepts such as validity, reliability, objectivity and generalization cannot be used in qualitative research. Alternative criteria for scientific rigour, initially introduced by Lincoln and Guba, are presented: credibility, dependability, confirmability and transferability. These criteria have been applied to a research project, a qualitative study with in-depth interviews with female patients suffering from chronic pain in the locomotor system. The interview data were analysed on the basis of grounded theory. The proposed indicators for scientific rigour were shown to be useful when applied to the research project. Several examples are given. Difficulties in the use of the alternative criteria are also discussed.
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| 14. |
- Hamberg, Katarina, et al.
(author)
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The impact of marital relationship on the rehabilitation process in a group of women with long-term musculoskeletal disorders.
- 1997
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In: Scandinavian Journal of Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 25:1, s. 17-25
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Journal article (peer-reviewed)abstract
- This qualitative study investigated problems in the rehabilitation of women with long-term, musculoskeletal pain disorders. Data were collected by repeated semi-structured interviews and doctor-patient encounters during two years, and analysed in a gender perspective. The “marriage contract”, i.e. the pattern of division of duties and power structure within the marital relationship, was of obvious importance to the implementation of rehabilitation measures. We explored situations where the rehabilitation measures disagreed with the terms and patterns in the “marriage contract”. The participants' ways of coping with the contract in these delicate situations could be described as three type strategies; accepting the terms, negotiating for new terms, and breaking the contract. The crucial impact of the “marriage contract” and the type strategies on the rehabilitation process are exemplified.
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| 15. |
- Hansson, Maire, et al.
(author)
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Telomerase activity in effusions: a comparison between telomere repeat amplification protocol in situ and conventional telomere repeat amplification protocol assay.
- 2008
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In: Archives of pathology & laboratory medicine. - 1543-2165. ; 132:12, s. 1896-1902
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Journal article (peer-reviewed)abstract
- CONTEXT: We previously found telomere repeat amplification protocol (TRAP) in situ helpful in the diagnosis of malignancy in effusions, whereas varying sensitivities and specificities for malignancy were reported by investigators using extract-based TRAP. OBJECTIVE: To compare the 2 methods and to elucidate the discrepancies between them. DESIGN: Twenty-three effusions were analyzed. Telomerase activity of whole cell lysate was measured with a Telo TAGGG telomerase polymerase chain reaction ELISA PLUS kit with modifications to exclude polymerase chain reaction inhibitors. TRAP in situ was performed on cytospins. An estimate of total TRAP activity in the specimen was made based on the amount of positive cells, their fluorescence intensity, and the proportion of different cell types in the specimen. The estimate was compared with the level of telomerase activity in cell lysate-based TRAP. RESULTS: TRAP in situ: Thirteen of 14 malignant cases and 2 of 2 equivocal cases showed moderate/strong reactivity. Five of 7 benign effusions were negative; in 2 of 7, mesothelial cells showed weak reactivity. Cell lysate-based TRAP assay: In 4 cases no internal standard was detected, indicating the presence of polymerase chain reaction inhibitors. The relative telomerase activities were 33.1 to 72.7 with a considerable overlap between malignant (48 +/- 9, mean +/- SD) and benign (43 +/- 9) cases. CONCLUSIONS: The TRAP in situ results correlated to final diagnoses, whereas the cell lysate-based TRAP assay did not differentiate between malignant and benign cases. The varying proportions of positive cells and the variation in fluorescence intensity in the TRAP in situ slides explained some of the discrepancies. The problems encountered with TRAP performed on cell lysates are partly overcome using TRAP in situ.
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| 16. |
- Hendrikx, Tijn, et al.
(author)
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Sense of coherence in three cross-sectional studies in Northern Sweden 1994, 1999 and 2004 : patterns among men and women
- 2008
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In: Scandinavian Journal of Public Health. - Oslo : Taylor & Francis. - 1403-4948 .- 1651-1905. ; 36:4, s. 340-345
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Journal article (peer-reviewed)abstract
- Aims: To explore changes in sense of coherence (SOC) over a 10-year period in the general population in northern Sweden.Methods: Three cross-sectional surveys from 1994 (n=1802), 1999 (n=1698) and 2004 (n=1777), conducted within the northern Sweden MONICA Project, were compared. Participants answered questions about gender, age, experience of disease, perceived health, psychosocial factors and Antonovsky's SOC scale with 13 items.Results: A small, but significant, decrease in SOC medians and a shift of cumulative distributions towards slightly lower SOC values were seen both in the total study population and in its male and female subgroups between 1994 and 1999. No changes were seen between 1999 and 2004, with the exception of women between 25 and 44 years of age, who showed a continuous decrease.Conclusions: The present study shows that SOC at a population level in northern Sweden, within a 10-year span, is relatively stable, not withstanding minor changes. These small changes might be attributed to societal changes in Sweden during the 1990s and an increase in "minor'' psychiatric complaints in the Swedish population as a whole during the same period.
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| 17. |
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| 18. |
- Johansson, Eva E., et al.
(author)
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"I've been crying my way" : qualitative analysis of a group of female patients' consultation experiences
- 1996
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In: Family Practice. - : Oxford University Press. - 0263-2136 .- 1460-2229. ; 13:6, s. 498-503
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Journal article (peer-reviewed)abstract
- Background and objectives What do women patients, sick-listed for biomedically undefined musculoskeletal disorders, expect and experience when they consult a doctor? With the purpose to learn more about this, a qualitative interview study was conducted.Methods Twenty women participated. They were patients at an urban health care centre in northern Sweden. Data were gained through repeated, semi-structured interviews, and analysed according to grounded theory.Results The participants described an atmosphere of distrust in the consultation. They had felt ignored, disregarded and rejected by doctors, and had worked out strategies to keep up medical attention in their search for a creditable diagnosis. They were somatizing, claiming under cover, and pleading, to catch the doctor's interest. In addition, they upheld their self-respect by mystifying and martyrizing themselves and their symptoms, and by condemning physicians as ignorant.Discussion The patient's consultation experiences are discussed from different aspects; the biomedical framework, the power asymmetry, and the gendered positions of patient and doctor. The findings indicate the importance of making doctors aware of the context behind frustrations in doctor-patient interaction.
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| 19. |
- Johansson, Eva, et al.
(author)
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Gender bias in female physician assessments : Women considered better suited for qualitative research
- 2002
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In: Scandinavian Journal of Primary Health Care. - : Informa UK Limited. - 0281-3432 .- 1502-7724. ; 20:2, s. 79-84
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Journal article (peer-reviewed)abstract
- OBJECTIVE: To analyse whether physician assessment of scientific quality is biased by gender. DESIGN: Two fictive research abstracts on back pain treatment were constructed, one with a quantitative and one with a qualitative design. Authorship was assigned to either a woman or a man. SUBJECTS: 1637 randomly selected Swedish physicians were asked to judge the scientific quality of the two designs in a structured assessment form. MAIN OUTCOME MEASURES: The assessments of 1364 abstracts (286 female and 394 male assessors) were analysed by chi-square test and logistic regression. RESULTS: The quantitative design was judged the same, regardless of the gender of the author or assessor. The qualitative design, however, was ranked as more accurate, trustworthy, relevant and interesting with a female author. Women assessors upgraded female authors more than male authors, while male assessors reflected no gender differences. Assessor speciality interacted with judgement; physicians in primary care appreciated the qualitative abstract more than hospital physicians did (OR 2.78; 95% CI 1.97-3.92). CONCLUSION: Gender seems to affect scientific evaluations. The results are worth considering in situations where research is judged and interpreted, in medical tutoring, research guidance, peer reviewing and certainly in forming evaluation committees for research funding.
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| 20. |
- Johansson, Eva, et al.
(author)
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"How could I even think of a job?" : ambiguities in working life in a group of female patients with undefined musculoskeletal pain
- 1997
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In: Scandinavian Journal of Primary Health Care. - : Taylor & Francis. - 0281-3432 .- 1502-7724. ; 15:4, s. 169-174
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Journal article (peer-reviewed)abstract
- Objective - To explore the meaning of working life for a group of women sick-listed because of undefined, musculoskeletal pain disorders.Design - Repeated thematic interviews, analysed qualitatively according to grounded theory.Setting and participants - Twenty female patients, impaired by biomedically undefined pain and musculoskeletal disorders, were successively recruited at an urban primary health care centre in northern Sweden.Main findings - There were discrepancies between work aspirations and work experiences concerning economic maintenance, social interaction, and personal recognition. The women had low-income jobs in fields threatened by redundancy, such as cleaning, care, and service. Family considerations had a strong impact on organization and priorities in paid work. In a situation of pain and sick leave, family orientation strengthened and work aspirations declined. Social and personal recognition was sought in the unpaid ’duties at home, and economic refuge in ‘the state as supporter’.Implications - To understand women with undefined musculoskeletal pain as patients, we must also understand their aspirations and experiences as workers, mothers, and spouses. ‘Family considerations’, ’diminishing paid work’, and ’the state as supporter’ are important concepts for understanding the women’s sick role process.
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| 21. |
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| 22. |
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| 23. |
- Lundberg, Thorbjörn, et al.
(author)
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Digital imaging and telemedicine as a tool for studying inflammatory conditions in the middle ear : evaluation of image quality and agreement between examiners
- 2008
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In: International Journal of Pediatric Otorhinolaryngology. - : Elsevier BV. - 0165-5876 .- 1872-8464. ; 72:1, s. 73-79
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Journal article (other academic/artistic)abstract
- Objective: To evaluate digital imaging of the tympanic membrane by telemedicine technology and study interpersonal agreement in assessing image quality.Methods: In an open consecutive study, 64 children aged 2-16 years who attended three rural health care centres in Northern Sweden with otalgia were examined with video endoscopic photography of their tympanic membrane in a telemedical environment. One hundred and twenty-four images were stored in a central database and Later assessed independently regarding image quality by an ENT specialist, a general practitioner and a registrar in general practice. The overall image quality was graded (0-2) regarding assessment of signs of tympanic membrane inflammation. ALL images were also assessed regarding 8 different components, four image-related components and four anatomically related components.Results: Overall image quality was good, with 82.3% of acceptable or excellent quality. The position and thickness of the TM were found to be the most important factors of the images to be able to assess inflammatory disease. Image quality tended to be higher later in the study as a sign of improved skills of examiners. Interpersonal agreement between examiners was acceptable. Overall grade showed k 0.56, 0.49 and 0.66 respectively, and focus, light and existence of obscuring objects were the components with the highest agreement.Conclusions: The image quality of video endoscopy of the tympanic membrane was good overall. Interpersonal agreement in evaluating image quality was acceptable but not excellent. The use of digital imaging of good quality in clinical studies can offer an objective clinical evaluation of the TM in retrospect by independent reviewers using strict criteria.
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| 24. |
- Lökk, Johan, et al.
(author)
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Controversies around vitamin B12 in Sweden. : Attitudes and values behind clinical decision-making in primary health care 1996
- 1997
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In: Hematology. - 1024-5332 .- 1607-8454. ; 2:4, s. 341-350
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Journal article (peer-reviewed)abstract
- Over a five-year period, 1991-1995, the vitamin B12 market in Sweden increased three-fold, from approximatelyy 2 million U.S. dollars to approximately 6 million U.S. dollars. Most prescriptions, approximately 60%, originated from primary health care. The attitudes, values and knowledge of the family physicians/general practitioners were elucidated by a questionnaire study with visuo-analogue opinion scales, evaluating 24 basic statements on problems associated with the management of vitamin B12 deficiency. The questionnaire was sent to a representative sample of 506 family physicians/general practitioners. Response rate was 74%. Dropout analysis supported the view that responders provided a representative sample of Swedish FP/GPs. Analysis of the answers was compatible with the hypothesis that the mentioned increase in Swedish B12 market reflected increased awareness in primary health care about the biochemical, pathophysiological and social problems associated with vitamin B12 deficiency.
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| 25. |
- Lökk, Johan, et al.
(author)
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Shifts in B12 opinions in primary health care of Sweden.
- 2001
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In: Scandinavian Journal of Public Health. - 1403-4948 .- 1651-1905. ; 29:2, s. 122-128
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Journal article (peer-reviewed)abstract
- AIMS: The diagnosis and management of vitamin B12 deficiency varies between countries and within countries. The aim of the study was to map current attitudes and values behind clinical decision-making in Swedish primary health care, which has a unique B12 tradition: two patients out of three are treated with oral high-dose cyanocobalamin. Most patients with B12-associated problems are managed in primary health care by general practitioners (GPs). METHODS: The study was designed to elucidate possible opinion shifts among GPs during the period 1996-1998. GPs (n=499), stratified and randomized, received a questionnaire with 24 statements on B12-associated clinical and laboratory problems, to be evaluated by a visuo-analogue scale. RESULTS: The majority of GPs in primary health care in Sweden accepted homocysteine and methylmalonic acid (MMA) as markers for functional deficiency of vitamin B12. The evaluation of classical markers of B12 deficiency was wary and balanced. There was a consensus of the need for B12 therapy to risk groups such as patients with atrophic gastritis or previous gastric surgery. The answers also appeared to reflect an improvement of professional knowledge and competence concerning B12-associated problems among Swedish GPs between 1996 and 1998. CONCLUSIONS: The overriding conclusion was that B12-associated opinions of Swedish GPs were stable within the period studied, with marginal improvements of knowledge and competence.
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