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| 2. |
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| 3. |
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| 4. |
- Stenström, Pernilla, et al.
(author)
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Total colonic aganglionosis: : a multicenter study of surgical treatment and patient-reported outcomes up to adulthood
- 2020
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In: BJS Open. - : Oxford University Press (OUP). - 2474-9842. ; 4:5, s. 943-953
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Journal article (peer-reviewed)abstract
- Background: Surgery for total colonic aganglionosis (TCA) is designed to preserve continence and achieve satisfactory quality of life. This study evaluated a comprehensive group of clinical and social outcomes.Methods: An international multicentre study from eight Nordic hospitals involving examination of case records and a patient-reported questionnaire survey of all patients born with TCA between 1987 and 2006 was undertaken.Results: Of a total of 116 patients, five (4 center dot 3 per cent) had died and 102 were traced. Over a median follow-up of 12 (range 0 center dot 3-33) years, bowel continuity was established in 75 (73 center dot 5 per cent) at a median age of 11 (0 center dot 5-156) months. Mucosectomy with a short muscular cuff and straight ileoanal anastomosis (SIAA) (29 patients) or with aJpouch (JIAA) (26) were the most common reconstructions (55 of 72, 76 per cent). Major early postoperative complications requiring surgical intervention were observed in four (6 per cent) of the 72 patients. In 57 children aged over 4 years, long-term functional bowel symptoms after reconstruction included difficulties in holding back defaecation in 22 (39 per cent), more than one faecal accident per week in nine (16 per cent), increased frequency of defaecation in 51 (89 per cent), and social restrictions due to bowel symptoms in 35 (61 per cent). Enterocolitis occurred in 35 (47 per cent) of 72 patients. Supplementary enteral and/or parenteral nutrition was required by 51 (55 per cent) of 93 patients at any time during follow-up. Of 56 responders aged 2-20 years, true low BMI for age was found in 20 (36 per cent) and 13 (23 per cent) were short for age.Conclusion: Reconstruction for TCA was associated with persistent bowel symptoms, and enterocolitis remained common. Multidisciplinary follow-up, including continuity of care in adulthood, might improve care standards in patients with TCA.
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| 6. |
-
A decade of research on school principals : cases from 24 countries
- 2016. - 1
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Editorial collection (peer-reviewed)abstract
- This book provides a unique map of the focus and directions of contemporary research on school leadership since 2000 in 24 countries. Each of these directions has its own particular cultural, educational and policy history. Taken together, the various chapters in the volume provide a rich and varied mosaic of what is currently known and what is yet to be discovered about the roles and practices of principals, and their contributions to the improvement of teaching and the learning and achievement of students. The particular foci and methodological emphases of the research reported illustrate the different phases in the development of educational policies and provision in each country. This collection is an important addition to existing international research that has shown beyond any reasonable doubt that the influence of school principals is second only to that of teachers in their capacity to impact students’ progress and achievement and to promote equity and social justice.
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| 7. |
- Abrandt Dahlgren, Madeleine, et al.
(author)
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From senior student to novice worker : learning trajectories in political science, psychology and mechanical engineering.
- 2006
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In: Studies in Higher Education. - Abingdon, England : Routledge. - 0307-5079 .- 1470-174X. ; 31:5, s. 569-586
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Journal article (peer-reviewed)abstract
- This longitudinal study focuses on the transition from higher education to working life. Research has hitherto described the transition in rather general terms, and there is still only limited knowledge about how graduates construe themselves as professionals, or how they experience the transition to the sociocultural contexts of working life. In this study, the transition is viewed as a trajectory between different communities of practice. Three different Master’s programmes at Linköping University are focused on and compared: political science, psychology and mechanical engineering. The specific aims are to: (i) identify aspects of identity and knowledge formation as reported by informants, both as...
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| 11. |
- Abrandt Dahlgren, Madeleine, et al.
(author)
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The transition from higher education to work life: a comparison between a problem-based learning programme and conventional programmes in Higher education
- 2005
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In: Symposium at the 33nd Congress of the Nordic Educational Research Association (NERA). Oslo, March 2005..
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Conference paper (other academic/artistic)abstract
- This longitudinal study focuses on the transition from higher education (HE) to worklife. Generally, the transition is considered to have become more complicated due to the changing conditions for work in a supercomplex society. More specifically, there is also still sparse knowledge about how students in PBL programmes cope with the transition process. Previous research on the topic has suggested that there is a need for more complex studies of the relationship between HE and work. The aim of the study is twofold, (i) to describe the way students experience their programme as seniors and later their work situation as novice workers, and (ii) if there are differences regarding these experiences in comparison between a PBL programme (psychology) and conventional progammes (mechanical engineering and political science). The transition from HE to worklife in the three programmes is analysed according to five dimensions; relation to space/areas of operation, identity/tracjectory, professional role characteristics, transition process and relationships between education and work. The results indicate that the PBL-programme is preparing for worklife in a rational way, both regarding generic skills and substantive knowledge. The conventional programmes stand out as preparing for worklife either by providing generic skills or by having a ritual character.
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| 12. |
- Abrandt Dahlgren, Madeleine, 1956-, et al.
(author)
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The transition from higher education to worklife : The outcomes of a PBL programme and a conventional programme
- 2005
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In: PBL in Context. Bridging Work and Education,2005. - Tampere : Tampere University Press. ; , s. 23-
-
Conference paper (peer-reviewed)abstract
- PBL IN CONTEXT - BRIDGING WORK AND EDUCATION The aim of the conference is to provide an innovative international forum for discussion and for generating and sharing new ideas for the pedagogical development of working life and education. We welcome teachers from different disciplines, researchers, developers and trainers of working life to come together to the land of the midnight sun. The main themes of the conference are Problem-based learning in context: * Epistemology and Praxis * Curriculum and learning environments * Professional Development and Learning management * Evaluation and Assessment The conference is also a continuation for PBL conferences organized 1995 and 2000 by University of Linköping, Sweden.
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| 13. |
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| 14. |
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| 15. |
- Al-Alawi, Kamila, et al.
(author)
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Are the resources adoptive for conducting team-based diabetes management clinics? : An explorative study at primary health care centers in Muscat, Oman
- 2018
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In: Primary Health Care Research and Development. - : Cambridge University Press. - 1463-4236 .- 1477-1128. ; 20, s. 1-28
-
Journal article (peer-reviewed)abstract
- AIM: The aim of this study is to explore the perceptions among primary health center staff concerning competencies, values, skills and resources related to team-based diabetes management and to describe the availability of needed resources for team-based approaches.BACKGROUND: The diabetes epidemic challenges services available at primary health care centers in the Middle East. Therefore, there is a demand for evaluation of the available resources and team-based diabetes management in relation to the National Diabetes Management Guidelines.METHOD: A cross-sectional study was conducted with 26 public primary health care centers in Muscat, the capital of Oman. Data were collected from manual and electronic resources as well as a questionnaire that was distributed to the physician-in-charge and diabetes management team members.FINDINGS: The study revealed significant differences between professional groups regarding how they perceived their own competencies, values and skills as well as available resources related to team-based diabetes management. The perceived competencies were high among all professions. The perceived team-related values and skills were also generally high but with overall lower recordings among the nurses. This pattern, along with the fact that very few nurses have specialized qualifications, is a barrier to providing team-based diabetes management. Participants indicated that there were sufficient laboratory resources; however, reported that pharmacological, technical and human resources were lacking. Further work should be done at public primary diabetes management clinics in order to fully implement team-based diabetes management.
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| 16. |
- Al-Alawi, Kamila, et al.
(author)
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Care providers' perceptions towards challenges and opportunities for service improvement at diabetes management clinics in public primary health care in Muscat, Oman : a qualitative study
- 2019
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In: BMC Health Services Research. - : BioMed Central. - 1472-6963. ; 19
-
Journal article (peer-reviewed)abstract
- BackgroundThe literature has described several challenges related to the quality of diabetes management clinics in public primary health care centres in Oman. These clinics continue to face challenges due to the continuous growth of individuals diagnosed with type 2 diabetes. We sought to explore the challenges faced in these clinics and discuss opportunities for improvement in Oman.MethodsThis qualitative study was designed to include non-participant observations of diabetic patients and care providers during service provision at diabetes management clinics, as well as semi-structured interviews with care providers, at five purposively selected public primary health care centres. Care providers included physicians, nurses, dieticians, health educators, pharmacists, an assistant pharmacist, a psychologist, and a medical orderly. The data were analysed using qualitative content analysis.ResultsThe study disclosed three different models of service delivery at diabetes management clinics, which, to varying degrees, face challenges related to health centre infrastructure, technical and pharmaceutical support, and care providers' interests, knowledge, and skills. Challenges related to the community were also found in terms of cultural beliefs, traditions, health awareness, and public transportation.ConclusionThe challenges encountered in diabetes management clinics fall within two contexts: health care centres and community. Although many challenges exist, opportunities for improvement are available. However, improvements in the quality of diabetic clinics in primary health care centres might take time and require extensive involvement, shared responsibilities, and implications from the government, health care centres, and community.
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| 17. |
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| 18. |
- Al-Alawi, Kamila, 1974-
(author)
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Team-based approach in the management of diabetes at primary health care level in Muscat, Oman : challenges and opportunities
- 2019
-
Doctoral thesis (other academic/artistic)abstract
- Introduction: The growth of type 2 diabetes is considered an alarming epidemic in Oman. The efficient team-based approach to diabetes management in primary health care is an essential component for providing ideal diabetic care. This thesis aimed to explore the current situation related to team-based management of type 2 diabetes in public Primary Health Care Centres (PHCCs) under the Ministry of Health (MOH) in Oman, including the various challenges associated with diabetes management and the most preferable Human Resources for Health (HRH) management mechanism, and to examine how this could be optimized from provider and patient perspectives.Materials and methods: The entire project was conducted in Muscat Governorate and was based on one quantitative and three qualitative studies. In the quantitative study, 26 public PHCCs were approached through cross-sectional study. The core diabetes management team recommended by the MOH for PHCCs in Oman was explored in terms of their competencies, values, skills, and resources related to the team-based approach to diabetes management. For the qualitative studies, five public purposely-selected PHCCs were approached. The diabetes consultations conducted by the core members and other supportive members involved in diabetes management were observed and later the Primary Health Care Providers (PHCPs) were interviewed. The different approaches explored challenges related to diabetes management and the most preferable HRH mechanism by PHCPs. Seven type 2 diabetes patients with different gender, employment status, and education were consequently interviewed to explore their perceptions towards the current diabetes management service and their opinions towards nurse-led clinics.Results: The survey provided significant and diverse perceptions of PHCPs towards their competencies, values, skills, and resources related to diabetes management. Physicians considered themselves to have better competencies than nurses and dieticians. Physicians also scored higher on team-related skills and values compared with health educators. In terms of team-related skills, the difference between physicians and nurses was statistically significant and showed that physicians perceived themselves to have better skills than nurses. Confusion about the leadership concept among PHCPs with a lack of pharmacological, technical, and human resources was also reported. The observations and interviews with PHCPs disclosed three different models of service delivery at diabetes management clinics. The challenges explored involved PHCCs’ infrastructure, nurses’ knowledge, skills, and non-availability of technical and pharmaceutical support. Other challenges that evolved into the community were cultural beliefs, traditions, health awareness, and public transportation. Complete implementation of task-sharing mechanisms within the team-based approach was selected by all PHCPs as the most preferable HRH mechanism. The selection was discussed in the context of positive outcomes, worries, and future requirements. The physicians stated that nurses’ weak contribution to the team within the selected mechanism could be the most significant aspect. Other members supported the task-sharing mechanism between physicians and nurses. However, type 2 diabetes patients’ non-acceptance of a service provided by the nurses created worries for the nurses. The interviews with type 2 diabetes patients disclosed positive perceptions towards the current diabetes management visits; however, opinions towards nurse-led clinics varied among the patients.Conclusions and recommendations: The team-based approach at diabetes management clinics in public PHCCs in Oman requires thoughtful attention. Diverse presence of the team members can form challenges during service delivery. Clear roles for team members must be outlined through a solid HRH management mechanism in the context of a sharp leadership concept. Nurse-led clinics are an important concept within the team; however, their implementation requires further investigation. The concept must involve clear understandings of independence and interdependence by the team members, who must be educated to provide a strong gain for team-based service delivery.
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| 19. |
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| 20. |
- Al-Alawi, Kamila, et al.
(author)
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“Yes to discuss different models of care between primary care physicians and diabetes-practice nurses, but not to complete implementation yet”: Explorative qualitative study at diabetes clinics in primary health care centres in Muscat, Oman
- 2020
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In: International Journal of Healthcare. - : Sciedu Press. - 2377-7338 .- 2377-7346. ; 6:1, s. 72-80
-
Journal article (peer-reviewed)abstract
- Background: Globally, many models of care through which the way health services are delivered have been adopted withinteam-based primary health care. Although these models have aimed to solve some of the health care challenges related tophysician’s shortages in clinics and further acceptance of non-physician-led clinics, their application is usually determined by arange of factors, such as preparedness of the health care providers, preparedness of patients and support from higher authorities.Objective: The study was designed to explore health care providers’ perceptions for changes in models of care in diabetes clinicsat primary health care in Muscat, Oman.Methods: A total of 27 semi-structured interviews were conducted with health care providers involved in diabetes clinics atfive purposively selected primary health care centres in Muscat. The interviewees included the core members of the diabetesmanagement team and other supportive members available at the centres, and were of mixed genders, nationalities and professions.Qualitative thematic analysis was applied.Results: The analysis resulted in one main theme, which captured positive responses towards task-sharing model, but revealedworries and requirements for complete implementation. Nurses’ competences and diabetic patients’ acceptance were among themain concerns. Health care providers revealed that for complete implementation of the model, nurses’ involvement in the teamcould be improved through updating their knowledge and through the provision of support from higher authorities, while diabeticpatients’ acceptance could be improved through understanding of their perceived knowledge towards the model which couldpromote nurse-led clinics.Conclusion: Task-sharing within the discussed possibilities could provide many positive outcomes and a rewarding future fordiabetes clinics at primary health care centres. Omani culture could play a role in its implementation; therefore, if successfulimplementation is desired, carefully considered steps must be applied by the government and the community
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| 21. |
- Andersson, Elin M., et al.
(author)
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Cognitive and emotional reactions to pictorial-based risk communication on subclinical atherosclerosis : a qualitative study within the VIPVIZA trial
- 2023
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In: Scandinavian Journal of Primary Health Care. - : Taylor & Francis. - 0281-3432 .- 1502-7724. ; 41:1, s. 69-80
-
Journal article (peer-reviewed)abstract
- Objectives, setting and subjects: Atherosclerosis screening with ultrasound is non-invasive and can be used as part of risk communication. The potential of personalised and pictorial-based risk communication is assessed in VIPVIZA, a population-based randomised controlled trial that aims at optimising cardiovascular disease (CVD) prevention by investigating the impact of visualisation of subclinical atherosclerosis. The present aim was to explore cognitive and emotional reactions evoked by the intervention as well as attitudes to any implemented life style changes in VIPVIZA participants in the intervention group with improved health status and furthermore to study possible interactions between these factors. Understanding mechanisms of action was central since non-adherence to preventive guidelines are often faced in clinical practice. Design: In-depth interviews with 14 individuals were analysed with qualitative content analysis. Results: Cognitive and emotional processes were highly interlinked and described by the main theme Cognitive and emotional reactions in strong interplay for orchestration of health oriented behavioural change. The informants’ descriptions revealed two distinctly different psychological processes which constituted the two subthemes, Problem-focused coping and Encouragement-driven process. Conclusions: The results highlight that an interaction between emotional reactions and efficacy beliefs is important in facilitating behavioural change. Furthermore, the results underscore the importance of the risk message being perceived as clear, accurate, reliable and also emotionally engaging and thereby show why atherosclerosis screening and pictorial-based risk communication have the potential to contribute to effective CVD prevention strategies and shared decision making in primary care.
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| 22. |
- Andersson, Elin M., et al.
(author)
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From risk communication about asymptomatic atherosclerosis to cognitive and emotional reactions and lifestyle modification
- 2023
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In: BMC Psychology. - : BioMed Central (BMC). - 2050-7283. ; 12:1
-
Journal article (peer-reviewed)abstract
- Background: Non-adherence in the general population to preventive guidelines on cardiovascular disease calls for an interdisciplinary approach acknowledging psychological factors of relevance for risk communication and lifestyle modification. Evidence is building up regarding the advantage of sharing arterial imaging evidence of subclinical atherosclerosis with asymptomatic individuals, but there is limited understanding of how this relates to mechanisms of importance for behavioural change. Longitudinal studies on associations between patients’ reactions and lifestyle modification are missing. The population-based randomized controlled trial VIPVIZA investigates the impact of pictorial information about subclinical atherosclerosis, added to traditional risk factor-based communication. The intervention includes a personalized, colour-coded and age-related risk communication strategy and a motivational conversation, and has been shown to reduce cardiovascular disease risk. Methods: In the present study we assessed cognitive and emotional reactions to the intervention, and how these reactions are associated to lifestyle modification. The participants’ evaluation of the risk communication was assessed in the intervention group (n=1749). Lifestyle modification was assessed with a lifestyle index based on physical activity, diet, smoking and alcohol consumption at baseline and after 3 years. Associations between cognitive and emotional response and lifestyle modification were tested with analyses of covariance in a subset of participants (n=714-857).Results: The intervention increased understanding of personal CVD risk, the possibility to influence the risk, and how to influence the risk. Severity of atherosclerosis was associated with emotional reactions, but emotions of strong negative valence were uncommon. Cognitive response and emotional arousal evoked by the intervention were positively associated with lifestyle modification, whereas negative emotions in isolation were not. High level of cognitive response in combination with high level of emotional arousal was found to be most beneficial for lifestyle modification.Conclusions: The results demonstrate the potential of communicating asymptomatic atherosclerosis with a pictorial, colour-coded and age-related strategy, also including a motivational conversation. Furthermore, the results show the importance of CVD risk communication evoking engagement, and that an interaction between cognitive and emotional reactions might be central for sustained lifestyle modification. Our results also indicate that, in an asymptomatic population, atherosclerosis screening may strengthen disease prevention and health promotion.
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| 23. |
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| 24. |
- Andersson, Helene, 1983, et al.
(author)
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Extensional flow, viscoelasticity and baking performance of gluten-free zein-starch doughs supplemented with hydrocolloids
- 2011
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In: Food Hydrocolloids. - : Elsevier BV. - 0268-005X .- 1873-7137. ; 25:6, s. 1587-1595
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Journal article (peer-reviewed)abstract
- Viscoelastic doughs of zein and starch were prepared at 40 degrees C, above the glass transition temperature of zein. The effects of hydrocolloid supplementation with hydroxypropyl methylcellulose (HPMC) or oat bran with a high content of beta-glucan (28%) were investigated by dynamic measurements in shear, confocal laser scanning microscopy (CLSM) and Hyperbolic Contraction Flow. Zein-starch dough without hydrocolloids exhibited rapid age-related stiffening, believed to be caused by cross-links between peptide chains. A prolonged softness was attributed to doughs containing hydrocolloids, with the oat bran exhibiting the most pronounced reduction in age-related stiffening. Moreover, CLSM-images of dough microstructure revealed that a finer fibre network may be formed by increased shearing through an addition of viscosity-increasing hydrocolloids, a reduction in water content in the dough or the use of appropriate mixing equipment. The Hyperbolic Contraction Flow measurements showed that doughs containing hydrocolloids had high extensional viscosities and strain hardening, suggesting appropriate rheological properties for bread making. Zein-starch dough without hydrocolloids showed poor bread making performance while hydrocolloid additions significantly improved bread volume and height. Although the hydrocolloid supplemented doughs had similar extensional rheological properties and microstructures, a fine crumb structure was attributed only to bread containing HPMC, marking the importance of surface active components in the liquid-gas interface of dough bubble walls. Zein could not mimic the properties of gluten on its own, but hydrocolloids did positively affect the structural and rheological properties of zein, which yielded dough similar to wheat dough and bread with increased volume.
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| 25. |
- Andersson, Helene
(author)
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MRSA and other resistant bacteria : prevalence, patient and staff experiences, wounds and infection control
- 2012
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Doctoral thesis (other academic/artistic)abstract
- Antibiotic resistance has become a major and serious global problem in healthcare. Limited treatment options for infections caused by these organisms can lead to increased morbidity and mortality. Sweden has a low prevalence of antibiotic resistance compared to most other countries but this presents an increasing problem for society and healthcare even in Sweden. The overall aim of this thesis was to illuminate potential problems related to antibiotic resistance from different perspectives: assessing the prevalence of resistant bacteria methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE) or other resistant bacteria, and associated wound types, patient and health staff experiences when confronted with resistant bacteria infection, and the occurrence of such infections in the nursing home environment. In the first study a total of 2172 patients admitted to hospital or as out-patient visit at a University hospital during one day were examined with the purpose to identify all wounds, wound types and wound characteristics, and to identify bacteria in all wounds, particularly MRSA, VRE and multi-resistant Gramnegative rods. Four hundred and eight (19%) patients had a total of 668 wounds. Of these, 248 wounds, from 216 patients were cultured. Two unknown MRSA-patients were identified. No patient with VRE was found and there was a low prevalence of other multi-resistant bacteria. In the second study fifteen patients with MRSA infected wounds were interviewed. The aim was to ascertain and describe patients’ knowledge, perceptions and experiences of being MRSA-positive. The interviews were analyzed according to qualitative content analysis. From the analysis three categories and one overall theme were identified. Results showed that information about the MRSA diagnosis often caused a shock-like reaction. The patients’ perception of being MRSA-positive was that it was stigmatizing like the plague or leprosy; they felt dirty and a severe threat to their environment. Fears of infecting someone else and being rejected were commonly expressed. Knowledge and empathy from staff involved in their care was crucial to optimise patients’ experiences. Staff’s needs of education to meet patients’ demands for information, and to prevent spread of antibiotic contamination was essential. In the third study eight nurses and seven assistant nurses from different hospital wards and nursing homes were interviewed regarding their experiences of caring for MRSA-positive patients. Qualitative content analysis was carried out when analysing the data and three themes were identified during the process. Stress and too high workload were factors which were described to cause concerns in the caring situation. A major concern was that nurses felt at risk of becoming infected themselves and then transmitting the infection to other patients and to family members. Knowledge and ignorance about MRSA affected the nurses’ caring; ignorance made them afraid and insecure while knowledge and understanding shaped confidence in their role as caregivers. In the fourth study 560 residents in a total of 67 wards, in nine nursing homes were investigated for prevalence of MRSA, VRE and extended-spectrum β-lactamase (ESBL) - producing Enterobacteriaceae and if carriage of resistant bacteria was related to antibiotic treatment, other risk factors and/or staff´s adherence to guidelines for infection control. In all 296 staff members were interviewed and observed. No resident was positive for MRSA or VRE. Fifteen residents were found to be ESBL-positive. Usage of antibiotics was higher in wards where ESBL-positive residents were detected and there was an indication that there was transmission of ESBL between residents. Staff´s adherence to infection control guidelines sometimes revealed shortcomings but no significant difference regarding adherence to the guidelines could be found. In conclusion: Prevalence of MRSA appears low in both hospitalized patients, out-patients and nursing home residents. Adherence to infection control guidelines among healthcare staff, however, needs further improvement. MRSA colonized patients experienced psychological pressure and stigmatization. Knowledge and empathy from staff involved in their care is crucial to optimise patients’ experiences. Staff education to meet patients' demands for information and the prevention of contamination is essential
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| 26. |
- Bajinskis, Ainars, et al.
(author)
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Low-Dose/Dose-Rate gamma Radiation Depresses Neural Differentiation and Alters Protein Expression Profiles in Neuroblastoma SH-SY5Y Cells and C17.2 Neural Stem Cells
- 2011
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In: Radiation Research. - 0033-7587 .- 1938-5404. ; 175:2, s. 185-192
-
Journal article (peer-reviewed)abstract
- The effects of low doses of ionizing radiation on cellular development in the nervous system are presently unclear. The focus of the present study was to examine low-dose gamma-radiation-induced effects on the differentiation of neuronal cells and on the development of neural stem cells to glial cells. Human neuroblastoma SH-SY5Y cells were exposed to (137)Cs gamma rays at different stages of retinoic acid-induced neuronal differentiation, and neurite formation was determined 6 days after exposure. When SH-SY5Y cells were exposed to low-dose-rate gamma rays at the onset of differentiation, the number of neurites formed per cell was significantly less after exposure to either 10, 30 or 100 mGy compared to control cells. Exposure to 10 and 30 mGy attenuated differentiation of immature C17.2 mouse-derived neural stem cells to glial cells, as verified by the diminished expression of glial fibrillary acidic protein. Proteomic analysis of the neuroblastoma cells by 2D-PAGE after 30 mGy irradiation showed that proteins involved in neuronal development were downregulated. Proteins involved in cell cycle and proliferation were altered in both cell lines after exposure to 30 mGy; however, the rate of cell proliferation was not affected in the low-dose range. The radiation-induced attenuation of differentiation and the persistent changes in protein expression is indicative of an epigenetic rather than a cytotoxic mechanism. (C) 2011 by Radiation Research Society
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| 27. |
- Bentham, James, et al.
(author)
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A century of trends in adult human height
- 2016
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In: eLIFE. - 2050-084X. ; 5
-
Journal article (peer-reviewed)abstract
- Being taller is associated with enhanced longevity, and higher education and earnings. We reanalysed 1472 population-based studies, with measurement of height on more than 18.6 million participants to estimate mean height for people born between 1896 and 1996 in 200 countries. The largest gain in adult height over the past century has occurred in South Korean women and Iranian men, who became 20.2 cm (95% credible interval 17.522.7) and 16.5 cm (13.319.7) taller, respectively. In contrast, there was little change in adult height in some sub-Saharan African countries and in South Asia over the century of analysis. The tallest people over these 100 years are men born in the Netherlands in the last quarter of 20th century, whose average heights surpassed 182.5 cm, and the shortest were women born in Guatemala in 1896 (140.3 cm; 135.8144.8). The height differential between the tallest and shortest populations was 19-20 cm a century ago, and has remained the same for women and increased for men a century later despite substantial changes in the ranking of countries.
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| 28. |
- Bentham, James, et al.
(author)
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A century of trends in adult human height
- 2016
-
In: eLIFE. - : eLife Sciences Publications Ltd. - 2050-084X. ; 5
-
Journal article (peer-reviewed)abstract
- Being taller is associated with enhanced longevity, and higher education and earnings. We reanalysed 1472 population-based studies, with measurement of height on more than 18.6 million participants to estimate mean height for people born between 1896 and 1996 in 200 countries. The largest gain in adult height over the past century has occurred in South Korean women and Iranian men, who became 20.2 cm (95% credible interval 17.5–22.7) and 16.5 cm (13.3– 19.7) taller, respectively. In contrast, there was little change in adult height in some sub-Saharan African countries and in South Asia over the century of analysis. The tallest people over these 100 years are men born in the Netherlands in the last quarter of 20th century, whose average heights surpassed 182.5 cm, and the shortest were women born in Guatemala in 1896 (140.3 cm; 135.8– 144.8). The height differential between the tallest and shortest populations was 19-20 cm a century ago, and has remained the same for women and increased for men a century later despite substantial changes in the ranking of countries.
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| 29. |
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| 30. |
- Björkman Lundberg, Kerstin, et al.
(author)
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Compliance to National Guidelines for Pharmaceutical Treatment of Sleeping Disorders among Elderly Incident Patients in Sweden in PHARMACOEPIDEMIOLOGY AND DRUG SAFETY, vol 20, issue , pp S203-S203
- 2011
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In: PHARMACOEPIDEMIOLOGY AND DRUG SAFETY. - : John Wiley and Sons. ; , s. S203-S203
-
Conference paper (peer-reviewed)abstract
- Background:National guidelines for pharmaceutical treatmentof sleeping disorders among elderly state that zopicloneshould be the first choice and that other hypnotics,such as long acting benzodiazepines and propiomazine,should be avoided. According to aggregated data describingprevalent users compliance to guidelines is fairly high. Objectives:The objective of this study was to investigatechoice and volume (DDD) of substance among incidentusers 75 years and older (75+) of hypnotics (N05C) in Swedenand compare between different county councils andwith incident users below 75 years of age. Methods:Data from the Swedish Prescribed Drug registercovering all dispensed prescriptions in Sweden was analyzedfor incident users of hypnotics (15–44, 45–64, 65–74 and 75+ years of age). Incident users were defined aspeople who filled a prescription (index date) of a hypnotic(N05C) during the period December 2009 - November2010 and had not filled any prescription for a hypnotic duringa wash-out period of 24 months before the index date. Results:Among incident patients 75+ (n= 38,620) zopiclone(52.9%), zolpidem (25.4%), and propiomazine(10.4%) were the most frequently used hypnotics. Therewere however differences between different county councilsin Sweden, with zopiclone ranging from 30 % to 68 %. Theincidence for recommended and appropriate hypnoticsincreased with increasing age, whereas the incidence ofinappropriate hypnotics did not. The prescribed volume ofinappropriate hypnotics was generally larger than the prescribedvolume of recommended hypnotics. Conclusions:The compliance to current guidelines onchoice of hypnotics for the elderly is fairly good, althoughthere is considerable variation between county councils.There are tendencies towards larger mean volumes of inappropriatehypnotics, although further studies are needed toconfirm these findings. Another aspect of quality in treatmentwith sleeping agents is to which extent incident userscontinue their treatment and for how long. This is an issuefor further research.
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| 31. |
- Bracht Jörgensen, Helene, et al.
(author)
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Selective foraging of fungi by collembolans in soil
- 2005
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In: Biology letters. - : The Royal Society. - 1744-9561 .- 1744-957X. ; 1:2, s. 243-246
-
Journal article (peer-reviewed)abstract
- Soils contain highly diverse communities of microorganisms and invertebrates. The trophic interactions between these species are largely unknown. Collembolans form an abundant part of the invertebrate community in soils. A prevailing view is that soil collembolans are generalist feeders on fungi, lichens, fragmented litter and bacteria. However, in laboratory food choice experiments, it has been shown that collembolans preferentially select certain taxa of fungi. To examine this apparent contradiction, we developed a molecular technique based on the analysis of 18S ribosomal DNA (rDNA) sequences to explore the diversity of fungi in soils and in the guts of collembolans. We report that the diversity of fungi found in the natural soil was 33 times higher than that in the guts of the collembolan Protaphorura armata. The data support the view that collembolan species can be highly selective when foraging on fungi in soils.
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| 32. |
- Brembeck, Helene, 1952, et al.
(author)
-
Barn som medforskare av matlandskap. Del 1: Medforskning
- 2010
-
Reports (other academic/artistic)abstract
- Att ta med barn i forskningsprocessen är undantag snarare än regel i barndomsforskning. Det är även mycket ovanligt när det gäller forskning inom fältet mat och hälsa som domineras av kvantitativa studier. De flesta av dessa studier har folkhälsovetenskapliga eller kostvetenskapliga utgångspunkter där man försöker följa, mäta effekterna av och utvärdera olika interventioner riktade mot barn. Forskarna i BAMM ville inte forska om barn utan med dem. Deras utgångspunkt var barnen och deras intressefokus och frågeställningar. Vad är intressant för dem? Vad har de för kunskaper och vad är de nyfikna på att få veta mer om? Hur tar de reda på mer om det de är intresserade av? Hur sammanställer och presenterar de sin forskning? Hur föreslår och visualiserar de förändringar? Kan barns forskning göra skillnad? För dem? För samhället? Detta metodiska angreppssätt innebar också med nödvändighet en kritik av gängse uppifrån-och-ner-modeller för interventioner riktade mot barn. Fältarbetet bedrevs i två fjärdeklasser med totalt 45 barn på en skola i en av Göteborgs kranskommuner. Medforskarna arbetade i grupper på 7-8, med en eller två av forskarna som handledare. Forskarnas ambition som handledare var att uppmärksamma medforskarnas intressen och önskemål och låta dem leda forskarna runt i sina matlandskap. Det var inte bestämt i detalj hur medforskandet skulle gå till utan forskningssamarbetet fick växa fram tillsammans med barnen. Genom BAMM fick forskarna uppslag för hur barns matmiljöer kan bli mer hälsofrämjande. Det behövs insatser på såväl individ, som skol- och kommunnivå. Utgångspunkten är att barn ska bemötas som individer med resurser att tillföra i ett hälsofrämjande arbete. Det innebär att ta vara på barns erfarenheter och kunskaper och att ge dem möjligheter, både i och utanför skolan, att ta reda på mer om det de är intresserade av. Det är också viktigt att ta matglädje och sinnlighet på allvar och inte minst att ge barn reell möjlighet att vara delaktiga i beslut som fattas rörande deras matlandskap.
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| 33. |
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| 34. |
- Brembeck, Helene, 1952, et al.
(author)
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Exploring Children’s foodscapes
- 2010
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In: Proceedings from the 4th International Conference on Multidisciplinary Perspectives on Child and Teen Consumption. June 21-23 2010, Campus Norrköping, Sweden.
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Conference paper (peer-reviewed)
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| 35. |
- Brembeck, Helene, 1952, et al.
(author)
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Exploring children's foodscapes
- 2013
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In: Children's Geographies. - : Informa UK Limited. - 1473-3285 .- 1473-3277. ; 11:1, s. 74-88
-
Journal article (peer-reviewed)abstract
- In this article, we discuss children’s becoming as food consumers in the intersection of various foodscapes. We draw from a project, Children as co-researchers of foodscapes, where we have been working with children as co-researchers, using basically ethnographic methods, and as co-designers in a collaborative design effort. This article focuses on the findings from a theoretically inspired perspective, using the concept of foodscapes. These are food-related structures of different kinds, which evolve as the child explores them and where children as food consumers are generated. In this article, we highlight the scapes of taste, routines, people, things, commerce, child (as opposed to adult) and health and give brief accounts of the way the children related to them. Finally, we turn to the benefits of working with foodscapes for a better understanding of children’s becoming as food consumers in the intersection of various foodscapes. This article is based on data gathered by the children, but also on our fieldwork notes and observations following the children in their foodscapes.
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| 36. |
- Brembeck, Helene, 1952, et al.
(author)
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Foodscapes and Children’s Bodies
- 2010
-
In: Cultural Unbound. Journal of Current Cultural Research. - 2000-1525. ; 2:Article 42, s. 797-818
-
Journal article (peer-reviewed)abstract
- This article addresses children, food and body, and introduces a Deleuzian and Childhood Studies-inspired use of the concept of foodscape. The data draws on a transdisciplinary project on children as co-researchers of foodscapes. In this arti-cle we do not discuss the method or the children’s research results, which we have done elsewhere. Instead, our aim is to present a theoretically inspired analysis of our own fieldwork observations during this project in order to discuss the per-formance of children’s bodies, food and eating. Departing from the concept of foodscape, we present an analysis of some food events that illustrate the complex-ity of children’s foodscapes concerning the interaction between spaces, bodies, foodstuffs, values and rules. In encountering food and eating at various places, different child becomings emerge. We distinguish three powerful performances of what Stuart Aitken (2008) calls “I-dos”: First, the seemingly obedient pupil, who pretends to do what he or she is told, but who more or less imperceptibly escapes from adult supervi-sion. Second, the child who makes use of the stereotyped and possibly cute “food monster” designation, and turns it into a threatening subject, who disturbs the or-der and challenges adults’ power. Third, the knowledgeable scientist who, with the help of a research project, adult experts, nutritional calculation programs and ingredients, seizes the definition of the body as a site for growing stronger, health-ier and more capable. The foodscapes we met held many “striated spaces” (Deleuze & Guattari 1987), where the children had few alternatives to adhering to the adults’ designated “I-ams”. But we also entered smooth spots where children had the opportunity to experiment with “I-dos” that would not have occurred to us had we not followed them, and there are certainly many more that appear in the children’s everyday encounters with food.
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| 37. |
- Brembeck, Helene, 1952, et al.
(author)
-
Matlandskap och barns kroppar
- 2011
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In: Skjønnhet og helse - det ytre og indre, (ed) Roos, Gun & Rysst, Mari. - Oslo : Statens Institutt for forbruksforskning. ; , s. 35-42
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Book chapter (other academic/artistic)
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| 38. |
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| 39. |
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| 40. |
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| 41. |
- Ding, Ming, et al.
(author)
-
Dairy consumption, systolic blood pressure, and risk of hypertension : Mendelian randomization study
- 2017
-
In: The BMJ. - : BMJ Publishing Group Ltd. - 1756-1833 .- 0959-8138. ; 356
-
Journal article (peer-reviewed)abstract
- OBJECTIVE To examine whether previous observed inverse associations of dairy intake with systolic blood pressure and risk of hypertension were causal. DESIGN Mendelian randomization study using the single nucleotide polymorphism rs4988235 related to lactase persistence as an instrumental variable. SETTING CHARGE (Cohorts for Heart and Aging Research in Genomic Epidemiology) Consortium. PARTICIPANTS Data from 22 studies with 171 213 participants, and an additional 10 published prospective studies with 26 119 participants included in the observational analysis. MAIN OUTCOME MEASURES The instrumental variable estimation was conducted using the ratio of coefficients approach. Using metaanalysis, an additional eight published randomized clinical trials on the association of dairy consumption with systolic blood pressure were summarized. RESULTS Compared with the CC genotype (CC is associated with complete lactase deficiency), the CT/TT genotype (TT is associated with lactose persistence, and CT is associated with certain lactase deficiency) of LCT-13910 (lactase persistence gene) rs4988235 was associated with higher dairy consumption (0.23 (about 55 g/day), 95% confidence interval 0.17 to 0.29) serving/day; P<0.001) and was not associated with systolic blood pressure (0.31, 95% confidence interval -0.05 to 0.68 mm Hg; P=0.09) or risk of hypertension (odds ratio 1.01, 95% confidence interval 0.97 to 1.05; P=0.27). Using LCT-13910 rs4988235 as the instrumental variable, genetically determined dairy consumption was not associated with systolic blood pressure (beta=1.35, 95% confidence interval -0.28 to 2.97 mm Hg for each serving/day) or risk of hypertension (odds ratio 1.04, 0.88 to 1.24). Moreover, meta-analysis of the published clinical trials showed that higher dairy intake has no significant effect on change in systolic blood pressure for interventions over one month to 12 months (intervention compared with control groups: beta=-0.21, 95% confidence interval -0.98 to 0.57 mm Hg). In observational analysis, each serving/day increase in dairy consumption was associated with -0.11 (95% confidence interval -0.20 to -0.02 mm Hg; P=0.02) lower systolic blood pressure but not risk of hypertension (odds ratio 0.98, 0.97 to 1.00; P=0.11). CONCLUSION The weak inverse association between dairy intake and systolic blood pressure in observational studies was not supported by a comprehensive instrumental variable analysis and systematic review of existing clinical trials.
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| 42. |
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| 43. |
- Fogelstrand, Linda, 1974, et al.
(author)
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Prognostic Implications of Mutations in NOTCH1 and FBXW7 in Childhood T-ALL Treated According to the NOPHO ALL-1992 and ALL-2000 Protocols
- 2014
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In: Pediatric Blood & Cancer. - : Wiley-Blackwell. - 1545-5009 .- 1545-5017. ; 61:3, s. 424-430
-
Journal article (peer-reviewed)abstract
- Background In children, T-cell acute lymphoblastic leukemia (T-ALL) has inferior prognosis compared with B-cell precursor ALL. In order to improve survival, individualized treatment strategies and thus risk stratification algorithms are warranted, ideally already at the time of diagnosis.Procedure We analyzed the frequency and prognostic implication of mutations in NOTCH1 and FBXW7 in 79 cases of Swedish childhood T-ALL treated according to the Nordic Society of Pediatric Hematology and Oncology (NOPHO) ALL-1992 and ALL-2000 protocols. In a subgroup of patients, we also investigated the functional relevance of NOTCH1 mutations measured as expression of the HES1, MYB, and MYC genes.Results Forty-seven of the cases (59%) displayed mutations in NOTCH1 and/or FBXW7. There was no difference in overall (P=0.14) or event-free survival (EFS) (P=0.10) in patients with T-ALL with mutation(s) in NOTCH1/FBXW7 compared with patients with T-ALL without mutations in any of these genes. T-ALL carrying NOTCH1 mutations had increased HES1 and MYB mRNA expression (HES1 9.21.9 (mean +/- SEM), MYB 8.7 +/- 0.8 (mean +/- SEM)) compared to T-ALL with wild-type NOTCH1 (HES1 1.8 +/- 0.7, MYB 5.1 +/- 1.2, P=0.02 and 0.008, respectively). In cases of T-ALL with high HES1 expression, improved overall (P=0.02) and EFS (P=0.028) was seen.Conclusions Increased NOTCH activity, reflected by increased HES1 expression, is associated with improved outcome in pediatric T-ALL, but its role as a diagnostic tool or a therapeutic target in future clinical treatment protocols remains to be elucidated. Pediatr Blood Cancer 2014;61:424-430. (c) 2013 Wiley Periodicals, Inc.
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| 44. |
- Franco, Irene, et al.
(author)
-
Somatic mutagenesis in satellite cells associates with human skeletal muscle aging
- 2018
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In: Nature Communications. - : Springer Science and Business Media LLC. - 2041-1723. ; 9
-
Journal article (peer-reviewed)abstract
- Human aging is associated with a decline in skeletal muscle (SkM) function and a reduction in the number and activity of satellite cells (SCs), the resident stem cells. To study the connection between SC aging and muscle impairment, we analyze the whole genome of single SC clones of the leg muscle vastus lateralis from healthy individuals of different ages (21-78 years). We find an accumulation rate of 13 somatic mutations per genome per year, consistent with proliferation of SCs in the healthy adult muscle. SkM-expressed genes are protected from mutations, but aging results in an increase in mutations in exons and promoters, targeting genes involved in SC activity and muscle function. In agreement with SC mutations affecting the whole tissue, we detect a missense mutation in a SC propagating to the muscle. Our results suggest somatic mutagenesis in SCs as a driving force in the age-related decline of SkM function.
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| 45. |
- Gothilander, Jennifer, et al.
(author)
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School nurses’ experiences and challenges of working with childhood obesity in northern Sweden : a qualitative descriptive study
- 2023
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In: Nordic journal of nursing research. - : Sage Publications. - 2057-1585 .- 2057-1593. ; 43:1
-
Journal article (peer-reviewed)abstract
- Childhood obesity is increasing in Sweden. All children are offered regularly spread health visits to a school nurse. As health visits include a measure of height and weight and a health dialogue, school nurses can discover, disclose, and treat a child's weight gain. The aim of this study was to describe school nurses’ experiences and challenges in working with childhood obesity. This qualitative study collected data through focus-group discussion and semi-structured interviews with ten female school nurses from six municipalities. Data were analysed inductively using manifest qualitative content analysis. The study was reported using the COREQ guidelines. Stigmatization and lack of resources are major challenges for school nurses working with childhood obesity, and they experience frustration, powerlessness and feel that they provide unequal treatment. The present study concludes that obesity stigmatization is a widespread challenge for school nurses. They cannot alone generate all the resources needed or conquer all challenges. Evidence-based guidelines, increased knowledge, time for reflections and peer support could potentially empower school nurses, reduce frustration, and improve the quality of and equality in childhood obesity treatment.
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| 46. |
- Gustafsson Nyckel, Jan, 1960-, et al.
(author)
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Travelling and Recontextualization of Discourses on Quality in Early Childhood Education and Care : A Meta-Ethnographic Investigation
- 2023
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In: Oxford Ethnography and Education Conference 2023. ; , s. 1-1
-
Conference paper (other academic/artistic)abstract
- This article is a response to the need for comparative and critical studies of preschool as a local practice and examines the recontextualization of quality in Early childhood education and care. The aim of this meta-ethnographic study is to investigate how neoliberal policy discourses on quality are recontextualized and embedded in local early childhood and care institutional practices. A central concept in the analysis is recontextualization, and our pre-understanding of how neoliberal policy discourses are travelling and transformed from official to local policy that is embedded in the preschools’ work with quality as an institutional practice.The findings show how neoliberal policy discourses on quality is recontextualized, transformed and embedded in local institutional practices with different results and responses. The analysis uncovers three strategic, institutional responses as Enacting through acquiescence response, Defiance response as resistance and obfuscation of class, gender, and post-colonial perspective.
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| 47. |
- Harryson, Lisa, et al.
(author)
-
Örat mot marken, blicken mot horisonten : Västerbottensmodell för samordning avregionalt och lokalt folkhälsoarbete
- 2021
-
Reports (other academic/artistic)abstract
- Uppdrag: I denna rapport sammanfattas det regeringsuppdrag som Länsstyrelsen Västerbotten haft under åren 2019–2021. Syftet med uppdraget var att utveckla metoder och arbetssätt för samordning av ett regionalt arbete för en god och jämlik hälsa utifrån bestämningsfaktorerna i de åtta målområdena, med målet att skapa bättre förutsättningar för det lokala främjande och förebyggande folkhälsoarbetet i länet. Genomförande: Uppdraget har genomförts i nära samarbete mellan Länsstyrelsen Västerbotten, Region Västerbotten och Umeå Universitet. Tillsammans har dessa tre aktörer genomfört en omfattande och noggrann inventering av förutsättningarna för lokalt och regionalt folkhälsoarbetet i länet, vilken har legat till grund för aktiviteter som genomförts och processer som startats under pilotprojektets tid. Detta innefattar i huvudsak kommunbesök, dialoger, samverkanskonferenser, utbildning i folkhälsa och folkhälsoarbete, studiebesök till Bodö samt förankring och framtagande av en avsiktsförklaring för en god, jämlik och jämställd hälsa.Resultat: Pilotprojektet har bidragit till goda förutsättning för att etablera en samordningsstruktur som stimulerar och förtydligar det gemensamma regionala folkhälsoarbetet, vilket i sin tur stärker det lokala folkhälsoarbetet. Arbetet med pilotprojektet har lett till ökad kunskap hos beslutsfattare och andra aktörer om betydelsen av och förutsättningarna för att bedriva ett folkhälsoarbete med fokus på jämlikhet. Pilotprojektet har även bidragit till att utveckla relationer, kunskaper, drivkrafter, engagemang och motivation hos länets folkhälsoaktörer. Med utgångspunkt i de lokala behoven har pilotprojektet utvecklat arbetssätt för samordning av lokalt och regionalt folkhälsoarbete. Detta arbetssätt kan sammanfattas i en modell som möjliggör för aktörer att bidra till, få hjälp med och samarbeta efter de egna förutsättningarna i syfte att stärka både det lokala och regionala folkhälsoarbetet. Västerbottensmodellen består av följande komponenter:Lyssna – ett behovsorienterat förhållningssätt: Lokala perspektiv och behov styr hur samverkan fungerar och utvecklas för att olika aktörer tillsammans ska kunna bidra till ett gott folkhälsoarbete utifrån sina förutsättningar.Lita på varandra – en tillitsbaserad arbetsprocess: Det behovsorienterade förhållningssättet karakteriserar såväl de externa som det interna arbetsprocesserna med en kontinuerlig dialog mellan lokala och regionala aktörer.Göra – strukturerade metoder: Gemensamt utformade och väl förankrade metoder ger goda förutsättningar för att kunna etablera en samordningsstruktur för lokalt och regionalt folkhälsoarbete.När pilotprojektet tar slut behövs en samordnade funktion som tar vid helheten av det pilotprojektet stått för, varför pilotprojektet tog initiativ till att bilda Forum för folkhälsa i Västerbotten. Intentionen är att Forum för folkhälsa i Västerbotten ska förvalta och utveckla de metoder och arbetssätt för regional samordning som pilotprojektet arbetat fram, vilka inkluderar: kunskapshöjande insatser, dialoger, överenskommelser, samverkanskonferenser och informationsspridning. Förhoppningen är att Forum för folkhälsa i Västerbotten kommer utgöra ett nav för samverkan som både främjar och stödjer dialog, informations- och erfarenhetsutbyte, utveckling och utbildning och bidrar till uppföljning av folkhälsoarbetet i länet.
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| 48. |
- Hedegaard, Joel, et al.
(author)
-
Gendered communicative construction of patients in consultation settings
- 2014
-
In: Women & health. - : Informa UK Limited. - 0363-0242 .- 1541-0331. ; 54:6, s. 513-529
-
Journal article (peer-reviewed)abstract
- This study aimed to explore the communication in consultations between patients and health care staff from a gender perspective. We used 23 tape-recorded consultations between patients with Atrial Fibrillation and 5 nurses and 5 physicians at cardiac outpatient clinics at 6 different hospitals in southern Sweden during autumn 2009 to explore the verbal gendered constructions of patients. Through critical discourse analysis, we revealed that the male patients tended to describe their ailments with performance-oriented statements, whereas the female patients usually used emotional-oriented statements. The staff downplayed the male patients' questions and statements, while they acknowledged concern toward the female patients. Both the patients and the staff made conclusions according to a mutual construction. Male patients were constructed as competent, and female patients as fragile through gender-stereotypical communication. Open-ended statements and questions enabled consultations to be less limited by gender stereotypes.
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| 49. |
- Hedegaard, Joel
(author)
-
The production and maintenance of inequalities in health care : A communicative perspective
- 2014
-
Doctoral thesis (other academic/artistic)abstract
- The Swedish health care system does not offer care on equal terms for all its end-users. Discrimination toward patients can take the form substandard communication toward women or foreign born patients. Discrimination is also embedded in the organizational context. Health care is under pressure to increase efficiency and quality of care at the same time. There is a risk that demands for equality will be pushed aside. This thesis aims to contribute to our understanding of how discrimination is expressed in interpersonal- and organizational communication within health care, and highlight educational implications for health care practices. This thesis is comprised of three empirical studies and one conceptual study. In the first study, critical discourse analysis (CDA) is used to categorize gender patterns in communication between health care workers and patients, and finds that both patients and health care workers reproduced the gender order. Open questions created a setting less prone to be limited by gender stereotypes. In the second study, CDA is used and complemented with Linell’s dialogic perspective in order to explore whether patients who were native speakers of Swedish were constructed differently than those who were not, in patient-physician consultations. Findings indicated that the non-native speakers actually were model, participative patients according to patient-centered care. Notwithstanding this they were met by argumentation, whereas the more amenable native patients were met by accommodating responses. In the third study, qualitative content analysis is used to analyze how health care workers talked about patients in their absence. The results revealed that communication about patients who were perceived as not acting according to socially accepted gender norms contained negative and disparaging statements. The final study focused on Clinical Microsystems, a New Public Management-based model for multi-professional collaboration and improvement of health care delivery. Drawing on theories of New Public Management, gender, and organizational control, this study argues that the construction of innovative and flexible health care workers risks reproducing the gender order. The thesis concludes that gender and ethnic stereotypes are reproduced in health care communication, and that an efficiency-inspired organizational and institutional discourse may be an impediment to equal care. This calls for focus on learning about communication for prospective and existing health care workers in a multicultural health care context.
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| 50. |
- Heid, Iris M, et al.
(author)
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Meta-analysis identifies 13 new loci associated with waist-hip ratio and reveals sexual dimorphism in the genetic basis of fat distribution
- 2010
-
In: Nature Genetics. - : Springer Science and Business Media LLC. - 1061-4036 .- 1546-1718. ; 42:11, s. 949-960
-
Journal article (peer-reviewed)abstract
- Waist-hip ratio (WHR) is a measure of body fat distribution and a predictor of metabolic consequences independent of overall adiposity. WHR is heritable, but few genetic variants influencing this trait have been identified. We conducted a meta-analysis of 32 genome-wide association studies for WHR adjusted for body mass index (comprising up to 77,167 participants), following up 16 loci in an additional 29 studies (comprising up to 113,636 subjects). We identified 13 new loci in or near RSPO3, VEGFA, TBX15-WARS2, NFE2L3, GRB14, DNM3-PIGC, ITPR2-SSPN, LY86, HOXC13, ADAMTS9, ZNRF3-KREMEN1, NISCH-STAB1 and CPEB4 (P = 1.9 × 10⁻⁹ to P = 1.8 × 10⁻⁴⁰) and the known signal at LYPLAL1. Seven of these loci exhibited marked sexual dimorphism, all with a stronger effect on WHR in women than men (P for sex difference = 1.9 × 10⁻³ to P = 1.2 × 10⁻¹³). These findings provide evidence for multiple loci that modulate body fat distribution independent of overall adiposity and reveal strong gene-by-sex interactions.
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