| 1. |
- Westerståhl, Anna, 1948, et al.
(author)
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Gender in medical curricula: course organizer views of a gender-issues perspective in medicine in Sweden.
- 2003
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In: Women & health. - 0363-0242. ; 37:4, s. 35-47
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Journal article (peer-reviewed)abstract
- While there is growing awareness of the importance of gender issues in medicine, with new knowledge and new perspectives intensely debated, reports on the implementation of gender issues into medical curricula are scarce. In 1996, the Medical Faculty of Göteborg University, Sweden, determined that a gender-issues perspective be included in medical education. In 1999, course organizers from preclinical and clinical departments of the faculty were interviewed to determine whether they felt that a gender-issues perspective had contributed to their scientific field and, if so, how they implemented it in their teaching. The interviews revealed varied opinions on the relevance of this perspective in medicine. These variations followed gender division rather than that of preclinicians/clinicians. Thus, female gender was overwhelming for inspiring and introducing a gender-issues perspective both scientifically and practically. Positivism is firmly established in medicine and this must be taken into consideration when introducing a more culturally- and socially-based understanding of sex/gender issues. Female gender is important in this process, but successful implementation requires thorough faculty support and participation of male colleagues and students.
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| 2. |
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| 3. |
- Risberg, Gunilla, et al.
(author)
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Attitudes toward and experiences of gender issues among physician teachers : a survey study conducted at a university teaching hospital in Sweden
- 2008
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In: BMC Medical Education. - : BioMed Central. - 1472-6920. ; 8
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Journal article (peer-reviewed)abstract
- BACKGROUND: Gender issues are important to address during medical education, however research about the implementation of gender in medical curricula reports that there are obstacles. The aim of this study was to explore physician teachers' attitudes to gender issues.METHODS: As part of a questionnaire, physician teachers at Umeå University in Sweden were given open-ended questions about explanations for and asked to write examples why they found gender important or not. The 1 469 comments from the 243 respondents (78 women, 165 men) were analyzed by way of content analysis. The proportion of comments made by men and women in each category was compared.RESULTS: We found three themes in our analysis: Understandings of gender, problems connected with gender and approaches to gender. Gender was associated with differences between women and men regarding behaviour and disease, as well as with inequality of life conditions. Problems connected with gender included: delicate situations involving investigations of intimate body parts or sexual attraction, different expectations on male and female physicians and students, and difficulty fully understanding the experience of people of the opposite sex. The three approaches to gender that appeared in the comments were: 1) avoidance, implying that the importance of gender in professional relationships was recognized but minimized by comparing gender with aspects, such as personality and neutrality; 2) simplification, implying that gender related problems were easy to address, or already solved; and 3) awareness, implying that the respondent was interested in gender issues or had some insights in research about gender. Only a few individuals described gender as an area of competence and knowledge. There were comments from men and women in all categories, but there were differences in the relative weight for some categories. For example, recognizing gender inequities was more pronounced in the comments from women and avoidance more common in comments from men.CONCLUSION: The surveyed physician teachers gave many examples of gender-related problems in medical work and education, but comments describing gender as an area of competence and knowledge were few. Approaches to gender characterized by avoidance and simplification suggest that faculty development programs on gender need to address and reflect on attitudes as well as knowledge.
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| 4. |
- Westerståhl, Anna, 1948, et al.
(author)
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Integration of information about cardiovascular risk factors: how do highly motivated women in a lifestyle intervention programme act and react?
- 2002
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In: Scandinavian journal of primary health care. - 0281-3432. ; 20:1, s. 22-7
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Journal article (peer-reviewed)abstract
- OBJECTIVE: To understand the experience of being at risk and of participating in health interventions. How is information about risk factors handled on an individual level with respect to feeling, thinking and doing? DESIGN: Tape-recorded, open interviews, written out and analysed using a descriptive/analytical method. SETTING: Selected women who had participated in a lifestyle intervention programme aimed at reducing risk factors for cardiovascular disease in Strømstad, a community of 10 000 inhabitants on the west coast of Sweden. SUBJECTS: Eight women in the most active group who had had some contact with the project during the whole period 1985-94. MAIN OUTCOME MEASURES: The creation of core concepts as a result of close text reading through codes and categories. RESULTS: Three core concepts in relation to the handling of risk factors were identified: there is no one but yourself to rely on, resisting invasion, and living with incompatibility, based respectively on the subjects' self-efficacy and self-awareness, their ways of maintaining a good life and their trying to understand the risk-factor concept. CONCLUSION: Risk-factor-oriented health interventions focus on disease and create uncertainty as to the relationship between the concepts of risk and disease. The powerful health resources demonstrated by the women in this study to counterbalance the risk pre-occupation suggest changing to health-oriented interventions that focus on individual health resources.
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| 5. |
- Olofsson, P. S., et al.
(author)
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Genetic variants of TNFSF4 and risk for carotid artery disease and stroke
- 2009
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In: Journal of Molecular Medicine. - New York : Springer. - 0946-2716 .- 1432-1440. ; 87:4, s. 337-346
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Journal article (peer-reviewed)abstract
- In two independent human cohorts, the minor allele of SNP rs3850641 in TNFSF4 was significantly more frequent in individuals with myocardial infarction than in controls. In mice, Tnfsf4 expression is associated with increased atherosclerosis. The expression of TNFSF4 in human atherosclerosis and the association between genotype and cerebrovascular disease have not yet been investigated. TNFSF4 messenger RNA (mRNA) levels were significantly higher in human atherosclerotic lesions compared with controls (730∈±∈30 vs 330∈±∈65 arbitrary units, p∈<∈0.01). TNFSF4 was mainly expressed by macrophages in atherosclerotic lesions. In cell culture, endothelial cells upregulated TNFSF4 in response to tumor necrosis factor alpha (TNF-α; 460∈±∈110 vs 133∈±∈8 arbitrary units, p∈<∈0.001 after 6 h of stimulation). We analyzed the TNFSF4 gene in 239 patients who had undergone carotid endarterectomy and 138 matching controls from The Biobank of Karolinska Carotid Endarterectomies and Stockholm Heart Epidemiology Program cohorts and 929 patients and 1,382 matching controls from the Sahlgrenska Academy Study on Ischemic Stroke and Case Control Study of Stroke cohorts, limiting inclusion to patients with ischemic stroke. Participants were genotyped for the rs3850641 SNP in TNFSF4. Genotype associations were neither found with TNFSF4 mRNA levels nor with atherosclerosis associated systemic factors or risk for stroke. This study shows that TNFSF4 is expressed on antigen-presenting cells in human carotid atherosclerotic lesions but provides no evidence for an association of TNFSF4 gene variation with the risk for ischemic stroke.
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| 6. |
- Tegelberg, Åke, et al.
(author)
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General practice dentists' knowledge of temporomandibular disorders in children and adolescents.
- 2007
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In: European journal of dental education : official journal of the Association for Dental Education in Europe. - : Wiley. - 1396-5883 .- 1600-0579. ; 11:4, s. 216-21
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Journal article (peer-reviewed)abstract
- Aim: The aim of the study was to map general practice dentists' (GPDs) knowledge of temporomandibular disorders (TMD) in children and adolescents. Materials and methods: A questionnaire was mailed to 286 Swedish dentists in the Public Dental Service and 17 TMD specialists with documented research experience. The questionnaire contained 37 statements on aetiology, diagnostics, classification, chronic pain and pain behaviour, treatment, and prognosis. Each statement was judged on a 0-10 point scale with the endpoint definitions agree or disagree. Results: The overall response rate to the questionnaire was 87%. In 28 of all 37 statements, the TMD specialists endorsed a consensus, i.e. >75% of the specialists had the same opinion about the statement. TMD specialists differed most in opinion in the domain diagnostics and classification. In 65% of the statements, differences in knowledge between GPDs and TMD specialists were non-significant. The greatest number of significant between-group differences was found in the domain treatment and prognosis. Most of these statements were related to morphological factors. Conclusion: There is a high degree of consensus in TMD knowledge amongst the TMD specialists and a high degree of agreement in knowledge between GPDs and TMD specialists. In some areas, however, TMD specialists still need to reach a consensus which is founded on evidence-based TMD knowledge in children and adolescents and that can be used in undergraduate teaching. It is therefore important to develop and strengthen the undergraduate dental teaching in TMD and orofacial pain.
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| 8. |
- Björkelund, Cecilia, 1948, et al.
(author)
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Secular trends in cardiovascular risk factors with a 36-year perspective: observations from 38- and 50-year-olds in the Population Study of women in Gothenburg
- 2008
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In: Scandinavian Journal of Primary Health Care. - : Informa UK Limited. - 1502-7724 .- 0281-3432. ; 26:3, s. 140-6
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Journal article (peer-reviewed)abstract
- Department of Public Health and Community Medicine/Primary Health Care, The Sahlgrenska Academy, University of Gothenburg, Sweden. cecilia.bjorkelund@allmed.gu.se OBJECTIVES: To study secular trends in cardiovascular risk factors in four different cohorts of women examined in 1968-1969, 1980-1981, 1992-1993 and 2004-2005. DESIGN: Comparison of four representative cohorts of 38- and 50-year-old women over a period of 36 years. SETTING: Gothenburg, Sweden with approximately 450,000 inhabitants. SUBJECTS: Four representative samples of 38- and 50-year-old women were invited to free health examinations (participation rate 59-90%, n =1901). MAIN OUTCOME MEASURES: Body mass index (BMI), systolic and diastolic blood pressure (SBP, DBP), leisure time exercise, use of antihypertensive medication, smoking, levels of haemoglobin, b-glucose, s-cholesterol, s-triglycerides and HDL-cholesterol. RESULTS: There was no significant difference in mean BMI from 1968-1969 versus 2004-2005. Mean leisure time exercise was significantly higher in later born cohorts; in 1968, around 15% were physically active compared with 40% in 2004. SBP and DBP, mean s-cholesterol and s-triglyceride levels were significantly lower in both 38- and 50-year-old cohorts in 2004-2005 versus 1968-1969. HDL-cholesterol (not measured until 1992-1993), showed a significantly higher mean level in 2004-2005. Reduction of risk factors was apparent in women with a high as well as low level of physical activity. Smoking declined most in women with high levels of physical activity. CONCLUSIONS: Several cardiovascular risk factors related to lifestyle have improved in middle-aged women from the 1960s until today. Most of the positive trends are observed in women with both low and high physical activity.
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| 9. |
- Westerståhl, Anna, 1948, et al.
(author)
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GPs and lesbian women in the consultation: issues of awareness and knowledge.
- 2002
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In: Scandinavian journal of primary health care. - 0281-3432. ; 20:4, s. 203-7
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Journal article (peer-reviewed)abstract
- OBJECTIVE: To study awareness of having lesbian women in the consultation among general practitioners (GPs) and their knowledge of lesbian health-related issues. DESIGN: A mailed questionnaire study using closed and open-ended questions, with an analysis using both quantitative and qualitative methods. SETTING: The city of Göteborg, Sweden. SUBJECTS: GPs working in the city of Göteborg. MAIN OUTCOME MEASURES: Frequencies are presented for closed questions. Open-ended questions are categorised and illustrated by citations. RESULTS: The response rate was 52%, but only 37% were aware of having had any lesbian patients despite many years in practice. Five per cent had ever asked their patients about sexual identity, and most questions concerning social network were put in terms of the heterosexual, nuclear family. Eleven per cent knew of any health issues relevant to lesbian women, but half of all informants declared an interest in learning more. CONCLUSION: Unreflected assumptions of heterosexuality and use of heterosexist concepts may work together in keeping the lesbian patient invisible to health care. Medical education needs to include issues of gender and sexual identity/orientation in the curriculum, and to address the health effects of marginalisation.
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| 10. |
- Sundvall, Pär-Daniel, et al.
(author)
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Evaluation of dipstick analysis among elderly residents to detect bacteriuria: a cross-sectional study in 32 nursing homes.
- 2009
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In: BMC geriatrics. - : Springer Science and Business Media LLC. - 1471-2318. ; 9
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Journal article (peer-reviewed)abstract
- BACKGROUND: Few studies have evaluated dipstick urinalysis for elderly and practically none present confidence intervals. Furthermore, most previous studies combine all bacteria species in a "positive culture". Thus, their evaluation may be inappropriate due to Yule-Simpson's paradox. The aim of this study was to evaluate diagnostic accuracy of dipstick urinalysis for the elderly in nursing homes. METHODS: In this cross-sectional study voided urine specimens were collected from 651 elderly individuals in nursing homes. Dipstick urinalysis for nitrite, leukocyte esterase and urine culture were performed. Sensitivity, specificity, positive and negative predictive values with 95% confidence intervals were calculated. Visual readings were compared to readings with a urine chemistry analyzer. RESULTS: 207/651 (32%) of urine cultures showed growth of a potentially pathogenic bacterium. Combining the two dipsticks improved test characteristics slightly compared to using only one of the dipsticks. When both dipsticks are negative, presence of potentially pathogenic bacteria can be ruled out with a negative predictive value of 88 (84-92)%. Visual and analyzer readings had acceptable agreement. CONCLUSION: When investigating for bacteriuria in elderly people at nursing homes we suggest nitrite and leukocyte esterase dipstick be combined. There are no clinically relevant differences between visual and analyzer dipstick readings. When dipstick urinalysis for nitrite and leukocyte esterase are both negative it is unlikely that the urine culture will show growth of potentially pathogenic bacteria and in a patient with an uncomplicated illness further testing is unnecessary.
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