| 1. |
- Carling, Malin S, et al.
(author)
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Preoperative Fibrinogen Plasma Concentration Is Associated With Perioperative Bleeding and Transfusion Requirements in Scoliosis Surgery.
- 2011
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In: Spine. - 1528-1159. ; 36:7, s. 549-55
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Journal article (peer-reviewed)abstract
- STUDY DESIGN.: Prospective observational study. OBJECTIVE.: To investigate the potential association between fibrinogen, bleeding, and transfusion requirements after scoliosis surgery. SUMMARY OF BACKGROUND DATA.: Bleeding complications during and after orthopedic surgery are associated with increased morbidity and mortality. Early identification of patients with increased risk of excessive bleeding offers the possibility to initiate countermeasures. Fibrinogen is a key protein in the coagulation cascade, and thus a potential biomarker for bleeding risk. METHODS.: A total of 82 otherwise healthy patients (mean age: 15 ± 3 years, 85% girls) undergoing surgery for adolescent idiopathic scoliosis were included in the study. Patient variables (age, gender, operation time, and thrombosis prophylaxis), preoperative laboratory variables (hemoglobin, platelet count, activated partial thromboplastin time [aPTT], prothrombin time [PT], and fibrinogen), peroperative and postoperative bleeding volume, and transfusions were registered. Correlations between laboratory variables and bleeding volume were calculated with Pearson test. Patient variables and laboratory variables were compared with Student t test between patients with bleeding volume in the upper quartile ("bleeders") and the remaining patients, and between patients with extensive transfusion (defined as >2 U of packed red cells) and no or limited transfusions (≤2 U). RESULTS.: Mean fibrinogen concentration was 3.0 ± 0.7 g/L (range, 1.3-4.9). Mean total perioperative bleeding volume was 1552 ± 1019 mL (range, 100-5800 mL). Total bleeding volume correlated significantly with preoperative fibrinogen concentration (r = -0.31, P = 0.005) but neither with platelet count, aPTT, nor PT (P = 0.61, 0.46, and 0.57, respectively). Bleeders had significantly lower preoperative fibrinogen plasma concentration (2.6 ± 0.6 vs. 3.1 ± 0.6 g/L, P = 0.002). Of total, 16% (13/82) of the patients were transfused with >2 U of packed red cells.Patients with extensive transfusions had significantly lower preoperative fibrinogen plasma concentration (2.5 ± 0.7 vs. 3.1 ± 0.6 g/L, P = 0.002), while preoperative platelet count, aPTT, and PT did not differ. CONCLUSION.: The results indicate that preoperative fibrinogen concentration is a limiting factor for postoperative hemostasis during and after scoliosis surgery. Preoperative measurement of fibrinogen concentration provides more information about bleeding volume and transfusion requirements than standard screening tests.
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| 2. |
- Dahl, Emmy, et al.
(author)
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Genusdimensioner i svensk kommunal planering och krishantering : en forskningsöversikt
- 2010
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Reports (other academic/artistic)abstract
- The purpose of this research review of gender dimensions within research of municipal planning is to learn from previous studies as a new field of research is being established, namely gender and climate mitigation and adaptation. The research review has shown that women are often depicted as a homogenous group with common interests within the different areas that are included in the study: housing, civil rights to participate and influence political decisions, safety. planning and planning practices, risk and crisis management. The result from the research review encourages further research that broadens the picture of both the multiple lives of women and men and likewise illustrates multiple family forms. This research can challenge the notion of men and women as homogeneous groups. Studies of the construction and reconstruction of gender as a social and cultural category may further develop this field. An intersectional perspective on urban planning may also visualize how gender, ethnicity, family, sexuality, age and class intersect and contribute to various forms of exclusion.
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| 3. |
- Dahl, Emmy, et al.
(author)
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Konstruktioner av maskulinitet i samtal om kollektivtrafik
- 2012
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In: Norma. - : Universitetsforlaget. - 1890-2138 .- 1890-2146. ; 7:2, s. 160-181
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Journal article (peer-reviewed)abstract
- This article highlights how environmental issues influence transport planning, and how they make transport planners rethink previous categorizations of user groups. The introduction of an environmental discourse leads to a questioning of men’s travel activities, i.e. car driving. However, the critique against men’s travelling does not address all men. Instead, two types of masculinities are constructed in the local planning discourse: the first one is a ‘problematic’ obsolete old driver. The second one is a young ‘quality conscious’ man who opts for new technological solutions. The relationship between these two constructions of masculinities is hierarchical.The transport planners interpret it as their responsibility to make sure that public transport is regarded as attractive to younger men and their imagined ‘needs’. The elderly men however, are made scapegoats and are blamed for their unsustainable travelling. These rather stereotypical constructions of men also include a negative perception of elderly men. The analysis is based on discussions in eight focus groups, accomplished in 2009 with 36 transport planners and politicians (24 men and 12 women) working with the planning of the future public transport system in Malmö city in the south of Sweden.
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| 4. |
- Henriksson, Malin
(author)
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Att resa rätt är stort, att resa fritt är större : Kommunala planerares föreställningar om hållbara resor
- 2014
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Doctoral thesis (other academic/artistic)abstract
- Minskning av transporters negativa miljöpåverkan, eller en ökning av hållbara resor, har blivit en allt viktigare fråga för lokala aktörer. Genom samhälls- och trafikplanering ska dagens ohållbara transportsystem bli mer hållbart. Det gör hur planerare i Helsingborg planerar för hållbara resor intressant att studera. Avhandlingen undersöker hur planerare föreställer sig vad hållbart resande är, vilka resenärer det är som bör resa mer hållbart samt hur en hållbar stad kan se ut. Teoretiskt kombinerar avhandlingen ett intersektionellt ramverk med feministisk planeringsteori samt teorier från STS (teknik- och vetenskapsstudier). Det empiriska materialet består av djupintervjuer med sexton planerare, en fokusgruppsintervju samt bildanalys av de planeringsdokument som Helsingborgs stad använder sig av i planeringen för hållbara resor. Framförallt visar avhandlingen att planerare inte betraktar resors negativa miljöpåverkan som ett argument som kan få människor att resa mer hållbart. Istället är det möjligheten att framställa hållbara resor som roliga, hälsosamma, lustfyllda och praktiska som planerare tror kan få helsingborgarna att cykla eller åka mer buss. Men det är bara vissa resenärer som antas kunna ta del av de hållbara resornas positiva värden. Planerarnas föreställningar om bland annat kön, etnicitet och klass är avgörande för hur de förstår hållbara resor. Planerarna menar sammanfattningsvis att det är stort att resa rätt av miljöskäl, men större att fritt välja det mest attraktiva färdsättet.
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| 5. |
- Henriksson, Malin, 1981-, et al.
(author)
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Genusdimensioner i svensk kommunal planering och krishantering : En forskningsöversikt
- 2010
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Reports (peer-reviewed)abstract
- Syftet med denna forskningsöversikt är att genom en litteraturstudie av hur genusteori och genusperspektiv hanterats i forskning om kommunal planering dra lärdomar inför etableringen av ett nytt forskningsfält: genus och klimatanpassning. Den forskning om genus och samhällsplanering som har bedrivits under närmare 40 år kan delas in i fyra olika teman: boende, medborgarinflytande, trygghet, planering och planerings-praktiker. Ett femte tema, kris- och riskhantering, introduceras på grund av dess relevans för forskningsfältet genus och klimatanpassning. Forskningen om boendefrågor har berört olika sätt att organisera bostaden för att svara mot kvinnors behov, men också ifrågasatt kärnfamiljens isolering i samhället. Kvinnors erfarenheter har setts som centrala att utforska, medan mäns erfarenheter osynliggjorts. Gällande medborgarinflytande så sysselsätter forskningen sig med frågan om ifall kvinnors medverkan i planeringsprocesser leder till en annorlunda eller ”bättre” planering. Genom kvinnors medverkan blir planeringen bredare vad gäller perspektiv. Typiska frågor som kvinnor är tänkta att bidra med är barns behov och vikten av att hushållsarbete är praktiskt och enkelt. Kvinnor framställs bitvis som en homogen grupp. Trygghet är ett forskningsområde som har fått stor genomslagskraft i den praktiska samhällsplaneringen. Samtidigt lyfts kritik mot att när trygghet diskuteras så konstrueras kvinnor ofta som rädda. Hur kvinnors rädsla kan synliggöras men samtidigt inte leda till schablonbilder av kvinnlighet är därför en fråga som har uppehållit forskarna inom detta forskningsområde. Ett intresse för hur män hanterar rädsla saknas dock. Forskningen om planering och planeringspraktiker är omfattande. Resultaten pekar emellertid på en ambivalens kring hur mäns och kvinnors erfarenheter av livet i samhället ska betraktas. Finns det en grundläggande skillnad mellan könen eller beror skillnaderna på mäns och kvinnors olika erfarenheter? Tanken om två biologiskt olika kön har historiskt lett till att samhället blir ojämlikt eftersom könen tilldelas olika värden och rättigheter. Att negligera könets betydelse för hur fysiska rum upplevs kan dock innebära att planeringen blir könsblind. Forskningen i sig kan även reproducera bilden av män och kvinnor som olika vilket leder till att planeringen fortsätter att reproducera ojämlikhet. I forskningen om krishantering, risk och kön har genus som social och kulturell konstruktion uppmärksammats. Genus ses som inflytelserikt över hur individer, praktiker och organisationer hanterar och påverkas av kriser och risker. Forskningen är dock inte särskilt omfattande. Mer kunskap om genusaspekter av hur män och kvinnor drabbas av kriser, hur organisationer med ansvar för krishantering präglas och hur risker definieras och värderas efterfrågas. Forskningsöversikten ger överlag anledning att uppmuntra analyser som kan ge en bredare bild av både kvinnors och mäns liv och av olika familjeformer för att på så sätt bryta föreställningen om män respektive kvinnor som homogena grupper. Studier av hur genus skapas och återskapas som en social och kulturell konstruktion kan vidareutveckla fältet. Ett intersektionellt perspektiv kan dessutom synliggöra hur normer för genus, etnicitet, familj, sexualitet, ålder och klass samverkar och bidrar till olika former av exkluderingar och kategoriseringar i samhällsplaneringen.
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| 6. |
- Levin, Lena, et al.
(author)
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Bilagedelen : Genusperspektiv på utveckling av kollektivtrafik: hållbar jämställdhet vid planering av framtidens kollektivtrafik i Malmö
- 2011
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Reports (other academic/artistic)abstract
- Består av 1) Hållbar jämställdhet i framtidens kollektivtrafik. Lägesrapport 1a: Rapportering från fokusgrupperna, av Lena Levin, Emmy Dahl och Malin Henriksson. 2) Hållbar jämställdhet i framtidens kollektivtrafik. Lägesrapport 1b: Resultat av innehålls- och bildanalys, av Charlotta Faith-Ell och Susanna Nilsson. 3) Hållbar jämställdhet i framtidens kollektivtrafik. Dokumentation från workshop 11 februari 2010, av Susanna Nilsson, Lena Levin, Charlotta Faith-Ell, Emmy Dahl och Malin Henriksson.4) Hållbar jämställdhet i framtidens kollektivtrafik. Observationer och utvärdering av dialogmöten i Malmö stad, av Jonna Nyberg, Elina Engelbrektsson, Susanna Gustafsson, Lena Levin och Charlotta Faith-Ell. 5) Jämställd stadsplanering i Malmö - hur gör vi nu då? slutseminarium & workshop 26 november 2010, dokumentation: Lena Levin, Elina Engelbrektsson, Charlotta Faith-Ell och Lennart Skoglund.
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| 7. |
- Pettersson, S, et al.
(author)
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An exploration of patient-reported symptoms in systemic lupus erythematosus and the relationship to health-related quality of life.
- 2012
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In: Scandinavian Journal of Rheumatology. - : Taylor & Francis. - 0300-9742 .- 1502-7732. ; 41:5, s. 383-390
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Journal article (peer-reviewed)abstract
- OBJECTIVE: The aim of this study was to explore the most distressing symptoms of systemic lupus erythematosus (SLE) and determine how these relate to health-related quality of life (HRQoL), anxiety/depression, patient demographics, and disease characteristics (duration, activity, organ damage).METHODS: In a cross-sectional study, patients with SLE (n = 324, age 18-84 years) gave written responses regarding which SLE-related symptoms they experienced as most difficult. Their responses were categorized. Within each category, patients reporting a specific symptom were compared with non-reporters and analysed for patient demographics, disease duration, and results from the following questionnaires: the Medical Outcomes Study 36-item Short Form Health Survey (SF-36), the Hospital Anxiety and Depression Scale (HADS), the Systemic Lupus Activity Measure (SLAM), the SLE Disease Activity Index (SLEDAI), and the Systemic Lupus International Collaboration Clinics/American College of Rheumatology (SLICC/ACR) damage index.RESULTS: Twenty-three symptom categories were identified. Fatigue (51%), pain (50%), and musculoskeletal distress (46%) were most frequently reported. Compared with non-reporters, only patients reporting fatigue showed a statistically significant impact on both mental and physical components of HRQoL. Patients with no present symptoms (10%) had higher HRQoL (p < 0.001) and lower levels of depression (p < 0.001), anxiety (p < 0.01), and disease activity (SLAM) (p < 0.001).CONCLUSION: Fatigue, pain, or musculoskeletal distress dominated the reported symptoms in approximately half of the patients. Only patients reporting fatigue scored lower on both mental and physical aspects of HRQoL. Our results emphasize the need for further support and interventions to ease the symptom load and improve HRQoL in patients with SLE. Our findings further indicate that this need is particularly urgent for patients with symptoms of pain or fatigue.
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| 8. |
- Pettersson, Susanne, et al.
(author)
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Symptom distress related to systemic lupus erythematosus, analysis of patient account and comparison to standardised assessment
- 2010
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In: The European league against rheumatism. - Rom, Italien.
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Conference paper (other academic/artistic)abstract
- Background: Systemic lupus erythematosus (SLE) is a heterogenic disease with individual variation of both organ involvement and symptom perception. Despite this broad spectrum of symptoms clinical assessment often focus on predefined aspects of the disease, where patients are asked to rate or assess according to standards. An open approach to different aspects of the disease where the question of which SLE symptom patients perceive as most distressing need more specific attention. This abstract has focus on the most troublesome SLE related symptoms as reported by the patients themselves. Objectives: To explore patient reported SLE symptoms in relation to age and disease duration, and comparison with instruments assessing disease activity and health related quality of life. Methods: Patients with SLE (=4 ACR criteria)(n=309 women 91,3%, mean-age 47,3yrs, mean disease-duration 15,2yrs) recruited to a cross-sectional cohort study answered the written question "What SLE related symptoms have you experienced as most difficult during your disease?" followed by "What symptoms do you presently perceive as most difficult?" together with a questionnaire assessing health-related quality of life (EQ5D). The inclusion also included an assessment by a rheumatologist regarding disease activity and disease damage. Results: The respondent's answers included a broad spectrum of symptoms. A list of codes was validated and used to sort each patient's statements. Twenty categories with statements from more than ten respondents were identified. The three most frequent categories were distress of fatigue and distress of pain (statements from 51% respondents each) and distress from musculoskeletal structures (46,3%). Each category was compared according to respondent's age and disease duration. Patients with distress related to kidney function (mean 41,7yrs p=0,018) or swelling (mean 41,6yrs p=0,041) were younger. Respondents reporting distress from eyes or mouth were older (mean 53,1 yrs, p= 0,007). Patients (10%) perceiving no present symptom at inclusion had lower disease activity (SLAM, p<0,001) and SLE disease damage (SLICC, p=0,013) and higher self-rated health-related quality of life (EQ5D, p<0,001) than those reporting any kind of symptom distress. Conclusion: The symptoms most frequent reported by patients with SLE were fatigue, pain and musculoskeletal distress and these were described independent of age or disease duration. The disease activity score SLAM covered most patient-reported SLE related distress. When EQ5D were added to the comparison, distress related to perceived physical ability was also identified. Neither SLAM nor EQ5D mentions distress related to treatment, assessment or examination, and healthcare-givers should have this in mind when meeting these patients. Other categories not covered by SLAM combined by EQ5D were swelling and infections. These symptoms were reported by few patients and can be described to have the character of general discomfort. The study indicates that a combination of standardised instruments might well discover patient's perception of SLE, but are unlikely to point out each patient's whole experience of disease related discomfort. This should be taken into account by care-givers in the clinic to enable acknowledgement of the individual person's experience of the disease.
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| 9. |
- Regardt, Malin, et al.
(author)
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Hand exercise intervention in patients with polymyositis and dermatomyositis : a pilot study
- 2014
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In: Musculoskeletal Care. - : John Wiley & Sons. - 1478-2189 .- 1557-0681. ; 12:3, s. 160-172
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Journal article (peer-reviewed)abstract
- OBJECTIVE: The aim of the present study was to develop a 12-week hand exercise intervention for patients with polymyositis (PM) and dermatomyositis (DM) and evaluate adherence, patients' opinions of the programme design and overall feasibility, and the effect on hand function and activity limitation after the intervention.METHOD: A pilot hand exercise intervention was conducted on a convenience sample of 15 patients with reduced handgrip strength and established, inactive PM and DM. Acceptable adherence was set at 75%. The programme was evaluated based on patients' opinions regarding exertion, the movements involved and overall feasibility. Hand- and pinch-grip strength, grip ability, dexterity and activity limitation were assessed.RESULTS: Eleven of 15 patients completed the intervention, with acceptable adherence of 78-100%. Measures of handgrip strength, dexterity and activity limitation were reduced at baseline compared with normative data from the literature. Throughout the intervention, rates of perceived exertion were scored between 'moderate' and 'fairly strong'. Finger abduction and adduction were excluded from the hand exercise programme because they were not feasible to perform. Repetitions of the exercise increased gradually to a maximum of 30 per movement. Patients regarded this as too time-consuming and suggested ten repetitions daily or 10-20 repetitions 2-4 times per week. There were some individual, clinically meaningful improvements in hand function and activity limitation. A comparison between baseline and after the intervention showed that the three-jaw (tripod) pinch-grip strength (left hand) had increased (p < 0.007; z = -2.7).CONCLUSION: A hand exercise programme was found to be feasible to perform by patients with established PM or DM. The effect was limited, with few individual improvements in hand function and activity limitation, indicating a need to increase the resistance in the movements and to limit the duration of each exercise session.
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| 10. |
- Regardt, Malin, et al.
(author)
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Patients with polymyositis or dermatomyositis have reduced grip force and health-related quality of life in comparison with reference values : an observational study
- 2011
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In: Rheumatology. - : Oxford University Press. - 1462-0324 .- 1462-0332. ; 50:3, s. 578-585
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Journal article (peer-reviewed)abstract
- OBJECTIVES: The aims of this study were to investigate hand function in PM and DM patients and compare this with reference values in healthy individuals and also to investigate if hand function correlated with activity performance and health-related quality of life.METHODS: An observational cross-sectional study was performed in 18 women and 13 men with PM or DM with established disease. Grip force and hand mobility were assessed by Grippit and Escola Paulista de Medicina-Range of Motion scale. Activity performance was measured with myositis activities profile and health-related quality of life by short form-36 (SF-36).RESULTS: Women and men with PM and DM with mean disease duration of 6.8 (5.5) years had a significantly lower grip force than gender- and age-matched healthy individuals (women 71% and men 60%). They also had significantly lower mean values in all dimensions of the health-related quality of life instrument SF-36 compared with the Swedish population. In patients with PM and DM, the grip force correlated significantly with the ability to perform domestic activities. In women with PM and DM, the grip force correlated significantly with the health-related quality of life dimensions vitality and mental health. There were no significant differences between patients with PM and DM regarding grip force, hand mobility, activity performance or health-related quality of life.CONCLUSIONS: Patients with PM or DM have reduced grip force that could influence activity performance and health-related quality of life.
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