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  • 201.
    Thyberg, Mikael
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Smärt och rehabiliteringscentrum.
    Arvidsson, Patrik
    Uppsala University/County Council of Gävleborg, Ga¨vle,Jönköping University, Jönköpng Sweden,.
    Thyberg, Ingrid
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för neuro- och inflammationsvetenskap. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Hjärt- och Medicincentrum, Reumatologiska kliniken i Östergötland.
    Nordenfelt, Lennart
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och hälsa, Hälsa och samhälle. Ersta Sköndal University Colege Stockholm .
    Simplified bipartite concepts of functioning and disability recommended for interdisciplinary use of the ICF.2015Inngår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 37, nr 19, s. 1783-1792Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    PURPOSE: To argue for and propose bipartite concepts of functioning and disability, to tally with the structure of the ICF classification list, concepts of social models and clinical needs.

    METHOD: The ICF concepts are discussed in relation to the history of ideas regarding disability concepts and the needs for such concepts in interdisciplinary rehabilitation.

    RESULTS: Bipartite concepts are presented; they refer to actual functioning, simply body functions/structures and participation, including functioning in standardized environments. Participation refers to actually performed "activities", with "activities" simply denoting things that people may do. Bipartite concepts are congruent with the ICF classification and the structure of social models of disability, suitable for clinical and interdisciplinary use and easy to understand. The issue of standardized environments represents a methodological issue rather than the conceptual issue of defining functioning and disability. An individual perspective on activity and activity limitations, i.e. the middle part of the tripartite ICF concept, is somewhat similar to concepts of traditional language that were regarded as too generalizing already in 1912, when the interactional concept of "disability in a social sense" was introduced in rehabilitation practices.

    CONCLUSION: Bipartite concepts of functioning and disability are recommended for interdisciplinary use of the ICF.

    IMPLICATIONS FOR REHABILITATION: The ICF classification is useful, but the ICF concept of activities in an individual perspective is confusing. We suggest a use of the term "activities" simply to denote things that people may do and "participation" to denote actually performed activities. Estimations of ability should be explicit about how they are related to environmental factors.

  • 202.
    Tinghög, Gustav
    Linköpings universitet, Institutionen för ekonomisk och industriell utveckling, Nationalekonomi. Linköpings universitet, Institutionen för medicin och hälsa, Hälsa och samhälle. Linköpings universitet, Tekniska högskolan.
    Are Individuals Luck Egalitarians? – An experiment on the influence of brute and option luck on social preferences2012Konferansepaper (Annet vitenskapelig)
    Abstract [en]

    Background / Objectives

    According to luck egalitarianism, inequalities should be deemed fair as long as they follow from individuals’ deliberate and fully informed choices, i.e. option luck – while inequalities should be deemed unfair if they follow from choices over which the individual has no control, i.e. brute luck. This study investigates if individuals’ fairness preferences correspond with the luck egalitarian fairness position. More specifically, in a laboratory experiment we test how individuals choose to redistribute gains and losses that stem from option luck compared to brute luck.

    Methods / Design

    A two-stage experimental design was employed. In total, 125 subjects were randomly assigned to either the brute luck or option luck treatment. Treatments were identical except for how monetary compensation for participation in the experiment was settled in stage one. In the option luck treatment, subjects were given the option to chose between a safe option (50 Sek) and a risky option (a 50/50 gamble between 0 SEK and 150 SEK) for how they would be compensated for participating in the experiment. In the brute luck treatment no such choice was given, instead  all subjects were compensated based on outcome of the risky option. In the second stage, before winners and losers of the gamble were revealed, subjects were asked to distribute additional endowments (100 SEK) in an anonymous dictator game using the strategy method, i.e. making decisions contingent on the recipient losing or wining in the gamble.

    Results / Findings

    The average redistribution rate to losers was significantly higher in the brute luck treatment (48% of own endowment) compared to the option luck treatment (38%), suggesting that individuals have stronger preferences for redistribution toward individuals who suffer bad brute luck compared to individuals who suffer from equally bad outcomes due to bad option luck.

    Conclusions / Implications

    We find strong support for people having a fairness preference not just for outcomes, but also for how those outcomes are reached. Our findings are potentially important for understanding the role citizens assign individual responsibility for life outcomes, i.e. health and wealth. 

  • 203.
    Tinghög, Gustav
    Linköpings universitet, Institutionen för ekonomisk och industriell utveckling, Nationalekonomi. Linköpings universitet, Institutionen för medicin och hälsa, Hälsa och samhälle. Linköpings universitet, Tekniska högskolan.
    Bör vi tillåta betalning för organ?2012Inngår i: Moderna läkare, ISSN 1403-5502, nr 2, s. 18-19Artikkel i tidsskrift (Annet (populærvitenskap, debatt, mm))
  • 204.
    Tinghög, Gustav
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för hälso- och sjukvårdsanalys. Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för ekonomisk och industriell utveckling, Nationalekonomi.
    Andersson, David
    Linköpings universitet, Institutionen för teknik och naturvetenskap. Linköpings universitet, Tekniska högskolan.
    Tinghög, Petter
    Linköpings universitet, Institutionen för medicin och hälsa, Hälsa och samhälle. Linköpings universitet, Filosofiska fakulteten.
    Lyttkens, Carl H.
    Department of Economics, Lund University.
    Horizontal Inequality in Rationing by Waiting Lists2014Inngår i: International Journal of Health Services, ISSN 0020-7314, E-ISSN 1541-4469, International Journal of Health Services, ISSN 0020-7314, Vol. 44, nr 1, s. 169-184Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The objective of this article was to investigate the existence of horizontal inequality in access to care for six categories of elective surgery in a publicly funded system, when care is rationed through waiting lists. Administrative waiting time data on all elective surgeries (n = 4,634) performed in Östergötland, Sweden, in 2007 were linked to national registers containing variables on socioeconomic indicators. Using multiple regression, we tested five hypotheses reflecting that more resourceful groups receive priority when rationing by waiting lists. Low disposable household income predicted longer waiting times for orthopedic surgery (27%, p < 0.01) and general surgery (34%,p < 0.05). However, no significant differences on the basis of ethnicity and gender were detected. A particularly noteworthy finding was that disposable household income appeared to be an increasingly influential factor when the waiting times were longer. Our findings reveal horizontal inequalities in access to elective surgeries, but only to a limited extent. Whether this is good or bad depends on one's moral inclination. From a policymaker's perspective, it is nevertheless important to recognize that horizontal inequalities arise even though care is not rationed through ability to pay.

  • 205.
    Tinghög, Gustav
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Utvärdering och hälsoekonomi. Linköpings universitet, Hälsouniversitetet.
    Andersson, David
    Linköpings universitet, Institutionen för medicin och hälsa, Utvärdering och hälsoekonomi. Linköpings universitet, Hälsouniversitetet.
    Tinghög, Petter
    Linköpings universitet, Filosofiska fakulteten. Linköpings universitet, Institutionen för medicin och hälsa, Hälsa och samhälle.
    Lyttkens, Carl Hampus
    Lunds universitet.
    Rationing in practice - inequalities in waiting times for elective surgery (poster)2010Konferansepaper (Fagfellevurdert)
  • 206.
    Tinghög, Petter
    Linköpings universitet, Institutionen för medicin och hälsa, Hälsa och samhälle. Linköpings universitet, Filosofiska fakulteten.
    Migration, Stress and Mental Ill Health: Post-migration Factors and Experiences in the Swedish Context2009Doktoravhandling, med artikler (Annet vitenskapelig)
    Abstract [en]

    This predominantly empirical dissertation deals with how socio-economic living conditions and immigrant-specific factors can be linked to immigrants’ mental ill health. It is also explored how cultural representations can affect stress and whether mental ill health is expressed differently among immigrants from Iraq and Iran than among individuals of Nordic origin. Moreover, a conceptual analysis is conducted, where a phenomenological conceptualisation of stress is outlined with a special focus on how this stress approach can be related to culture and migration.

    The empirical material consists of eleven in-depth interviews with Iraqi and Iranian immigrant women and two population-based surveys.

    The main findings of this thesis suggest as follows: 1) Mental ill health is more common among foreign-born than among native-born Swedes and can to a great extent be attributed to their poorer socio-economic living conditions. 2) Immigrants’ mental health is independently associated with different types of factors, such as traumatic episodes, socio-cultural adaptation level and socioeconomic living conditions. 3) The self-reporting mental health instruments, HSCL-25 and WHO (ten) Wellbeing Index, produce scores that are comparable between Scandinavians and immigrants of Middle Eastern descent. 4) Nonuniversal representations that can be found in Iraq and Iran can amplify, or even be necessary ingredients in certain types of stressful experiences among immigrant women from these countries. 5) The distinctions between universal and non-universal stress, and between immigrant/minority and non-immigrant/nonminority stress appear to be crucial for an adequate comprehension of immigrants’ stressful experiences.

    Delarbeid
    1. To what extent may the association between immigrant status and mental illness be explained by socioeconomic factors?
    Åpne denne publikasjonen i ny fane eller vindu >>To what extent may the association between immigrant status and mental illness be explained by socioeconomic factors?
    2007 (engelsk)Inngår i: Social Psychiatry and Psychiatric Epidemiology, ISSN 0933-7954, E-ISSN 1433-9285, Vol. 42, nr 12, s. 990-996Artikkel i tidsskrift (Fagfellevurdert) Published
    Abstract [en]

    Background Immigrants in Sweden have a higher rate of mental illness than the native Swedes. This study investigated to what extent the association between immigrant status and mental illness can be explained by a different distribution of known risk factors for impaired mental health between groups of immigrants and persons born in Sweden.

    Methods The study is based on data from the Swedish PART-study, designed to identify risk factors for, and social consequences of, mental illness. The study population consists of a random sample of 10,423 Swedish citizens, whereof 1,109 were immigrants. The data was collected in the year 2000. The immigrants were divided into three groups based on country of origin (Scandinavians born outside Sweden, Europeans born outside Scandinavia, non-Europeans). The occurrence of mental illness among immigrants and native Swedes were compared not adjusting and adjusting for indicators of socioeconomic advantage/disadvantage (education, income, labour market position, etc). Mental illness was approximated with the WHO (ten) wellbeing index scale and depressive symptoms were measured with the major depression inventory scale (MDI).

    Results Immigrants’ excess risk for low subjective wellbeing was completely accounted for by adjustment for known risk factors in all the immigrant groups. However, social-economic disadvantages could not account for the non-European immigrants’ higher prevalence of depression (MDI), although the increased relative risk found in univariate analyses was substantially reduced.

    Conclusions The findings in this study suggest that the association between immigrant status and mental illness appears above all to be an effect of a higher prevalence of social and economic disadvantage.

    sted, utgiver, år, opplag, sider
    Springer Link, 2007
    Emneord
    Immigrants, mental illness, prevalence, Sweden, risk factors
    HSV kategori
    Identifikatorer
    urn:nbn:se:liu:diva-18212 (URN)10.1007/s00127-007-0253-5 (DOI)
    Tilgjengelig fra: 2009-05-12 Laget: 2009-05-12 Sist oppdatert: 2018-01-13bibliografisk kontrollert
    2. Immigrant‐ and non‐immigrant‐specific factors’ association with mental ill health among immigrants in Sweden
    Åpne denne publikasjonen i ny fane eller vindu >>Immigrant‐ and non‐immigrant‐specific factors’ association with mental ill health among immigrants in Sweden
    2010 (engelsk)Inngår i: International Journal of Social Psychiatry, ISSN 0020-7640, E-ISSN 1741-2854, Vol. 56, nr 1, s. 74-93Artikkel i tidsskrift (Fagfellevurdert) Published
    Abstract [en]

    Background: It has often been shown that immigrants are particularly at risk for mental ill health. The aim of the study was to investigate the association of immigrant‐ and non‐immigrant‐specific factors with mental ill health, within a diverse immigrant population.

    Method: An extensive questionnaire was sent out to a stratified random sample of three immigrant populations from Finland, Iraq and Iran. The 720 respondents completed a Swedish, Arabic or Persian version of the questionnaire including the WHO (ten) wellbeing index and the HSCL‐25.

    Results: The results indicate that mental ill health among immigrants is independently associated with non‐immigrant‐specific factors (i.e. a high number of types of traumatic episodes, divorced or widow/widower, a poor social network, economic insecurity and being a woman) and immigrant‐specific factors (i.e. a low level of socio‐cultural adaptation). These results were obtained regardless of whether mental ill health was operationalised as low subjective wellbeing or a high symptom level of anxiety/depression.

    Conclusions: These findings support the notion that mental ill health among immigrants is a multi‐faceted phenomenon that needs to be tackled within a wide range of sectors − e.g. the health care system, the social service sector and of course the political arena.

    Emneord
    Migration, mental ill health, Sweden, risk factors, living conditions, trauma
    HSV kategori
    Identifikatorer
    urn:nbn:se:liu:diva-18213 (URN)10.1177/0020764008096163 (DOI)
    Tilgjengelig fra: 2009-05-12 Laget: 2009-05-12 Sist oppdatert: 2018-01-13bibliografisk kontrollert
    3. Cross‐cultural equivalence of HSCL‐25 and WHO (ten) Wellbeing Index: findings from a population‐based survey of immigrants and non‐immigrants in Sweden
    Åpne denne publikasjonen i ny fane eller vindu >>Cross‐cultural equivalence of HSCL‐25 and WHO (ten) Wellbeing Index: findings from a population‐based survey of immigrants and non‐immigrants in Sweden
    2010 (engelsk)Inngår i: Community mental health journal, ISSN 0010-3853, E-ISSN 1573-2789, Vol. 46, nr 1, s. 65-76Artikkel i tidsskrift (Fagfellevurdert) Published
    Abstract [en]

    The aim of this study was to investigate whether the Hopkins Symptom Checklist (HSCL‐25) and the WHO (ten) Wellbeing Index are cross‐culturally equivalent by comparing Scandinavians with Middle Eastern immigrants in Sweden. The study population consisted of a stratified random sample of nativeborn Swedes and immigrants from Finland, Iraq and Iran. Both instruments loaded on a single factor in the respective populations. A few of the items did however not discriminate or predict equally well in the groups, nonetheless it was found to only marginally influenced the instruments’ total scores in both groups. The analyses also revealed that the groups had similar intercept and slope when the exogenous factor traumatic episodes was used to predict the measurement scores, supporting scalar equivalency. In conclusion, the results support the use of these instruments in population‐based surveys within multicultural Western societies.

    sted, utgiver, år, opplag, sider
    Springer-Verlag New York, 2010
    Emneord
    Cross‐cultural equivalence, Immigrants, Hopkins Symptom Checklist (HSCL‐25), WHO Wellbeing Index, Population‐based
    HSV kategori
    Identifikatorer
    urn:nbn:se:liu:diva-18214 (URN)10.1007/s10597-009-9227-2 (DOI)000274399000008 ()
    Tilgjengelig fra: 2009-05-12 Laget: 2009-05-12 Sist oppdatert: 2018-01-13bibliografisk kontrollert
    4. A phenomenological approach to the study of stress among immigrants: the case of Iraqi and Iranian women in Sweden
    Åpne denne publikasjonen i ny fane eller vindu >>A phenomenological approach to the study of stress among immigrants: the case of Iraqi and Iranian women in Sweden
    (engelsk)Manuskript (Annet vitenskapelig)
    Abstract [en]

    This study begins with the outlining of a general phenomenological theory of stress, which subsequently is applied to eleven Iraqi and Iranian migrant women’s own accounts of life in Sweden. The analysis of the interviews suggested that domestic disputes and intergenerational conflicts may become particularly stressful in that they are often amplified by incompatible Western and Non‐Western representations. The detected stressful experiences are analysed and structured to elucidate their character. Finally, a typology of stressful experiences in the new environment based on the distinctions between immigrant/minority‐specific and non‐immigrant/‐ minority‐specific stress, as well as between culturogenic and non‐culturogenic stress, is presented and defended.

    Emneord
    Phenomenology, Stress, Immigrants, Women, Iraq, Iran
    HSV kategori
    Identifikatorer
    urn:nbn:se:liu:diva-18215 (URN)
    Tilgjengelig fra: 2009-05-12 Laget: 2009-05-12 Sist oppdatert: 2018-01-13bibliografisk kontrollert
  • 207.
    Tinghög, Petter
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Hälsa och samhälle. Linköpings universitet, Filosofiska fakulteten.
    Al‐Saffar, Suad
    Section of Psychiatry, Neurotec Institution, Karolinska Institute, Stockholm, Sweden.
    Carstensen, John
    Linköpings universitet, Institutionen för medicin och hälsa, Hälsa och samhälle. Linköpings universitet, Filosofiska fakulteten.
    Nordenfelt, Lennart
    Linköpings universitet, Institutionen för medicin och hälsa, Hälsa och samhälle. Linköpings universitet, Filosofiska fakulteten.
    Immigrant‐ and non‐immigrant‐specific factors’ association with mental ill health among immigrants in Sweden2010Inngår i: International Journal of Social Psychiatry, ISSN 0020-7640, E-ISSN 1741-2854, Vol. 56, nr 1, s. 74-93Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: It has often been shown that immigrants are particularly at risk for mental ill health. The aim of the study was to investigate the association of immigrant‐ and non‐immigrant‐specific factors with mental ill health, within a diverse immigrant population.

    Method: An extensive questionnaire was sent out to a stratified random sample of three immigrant populations from Finland, Iraq and Iran. The 720 respondents completed a Swedish, Arabic or Persian version of the questionnaire including the WHO (ten) wellbeing index and the HSCL‐25.

    Results: The results indicate that mental ill health among immigrants is independently associated with non‐immigrant‐specific factors (i.e. a high number of types of traumatic episodes, divorced or widow/widower, a poor social network, economic insecurity and being a woman) and immigrant‐specific factors (i.e. a low level of socio‐cultural adaptation). These results were obtained regardless of whether mental ill health was operationalised as low subjective wellbeing or a high symptom level of anxiety/depression.

    Conclusions: These findings support the notion that mental ill health among immigrants is a multi‐faceted phenomenon that needs to be tackled within a wide range of sectors − e.g. the health care system, the social service sector and of course the political arena.

  • 208.
    Tinghög, Petter
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Hälsa och samhälle. Linköpings universitet, Filosofiska fakulteten.
    Carstensen, John
    Linköpings universitet, Institutionen för medicin och hälsa, Hälsa och samhälle. Linköpings universitet, Filosofiska fakulteten.
    Cross‐cultural equivalence of HSCL‐25 and WHO (ten) Wellbeing Index: findings from a population‐based survey of immigrants and non‐immigrants in Sweden2010Inngår i: Community mental health journal, ISSN 0010-3853, E-ISSN 1573-2789, Vol. 46, nr 1, s. 65-76Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The aim of this study was to investigate whether the Hopkins Symptom Checklist (HSCL‐25) and the WHO (ten) Wellbeing Index are cross‐culturally equivalent by comparing Scandinavians with Middle Eastern immigrants in Sweden. The study population consisted of a stratified random sample of nativeborn Swedes and immigrants from Finland, Iraq and Iran. Both instruments loaded on a single factor in the respective populations. A few of the items did however not discriminate or predict equally well in the groups, nonetheless it was found to only marginally influenced the instruments’ total scores in both groups. The analyses also revealed that the groups had similar intercept and slope when the exogenous factor traumatic episodes was used to predict the measurement scores, supporting scalar equivalency. In conclusion, the results support the use of these instruments in population‐based surveys within multicultural Western societies.

  • 209.
    Tinghög, Petter
    et al.
    Linköpings universitet, Filosofiska fakulteten. Linköpings universitet, Institutionen för medicin och hälsa, Hälsa och samhälle.
    Carstensen, John
    Linköpings universitet, Filosofiska fakulteten. Linköpings universitet, Institutionen för medicin och hälsa, Hälsa och samhälle.
    Cross-cultural validity of two different types of mental ill-health instruments2008Inngår i: 2nd conference of Migrant Health in Europe,2008, Malmö: EUPHA , 2008, s. 40-Konferansepaper (Fagfellevurdert)
  • 210.
    Tinghög, Petter
    et al.
    Department of Bioscience and Nutrition, Karolinska Institutet, Novum, Huddinge.
    Carstensen, John
    Linköpings universitet, Institutionen för medicin och hälsa, Hälsa och samhälle. Linköpings universitet, Filosofiska fakulteten.
    Kaati, Gunnar
    Department of Bioscience and Nutrition, Karolinska Institutet, Novum, Huddinge.
    Edvinsson, Sören
    Demographic Database, Umeå University, Umeå.
    Sjöström, Michael
    Department of Bioscience and Nutrition, Karolinska Institutet, Novum, Huddinge.
    Bygren, Lars Olov
    Department of Bioscience and Nutrition, Karolinska Institutet, Novum, Huddinge.
    Migration and mortality trajectories: a study of individuals born in the rural community of Överkalix, Sweden2011Inngår i: Social Science & Medicine, ISSN 0277-9536, Vol. 73, nr 5, s. 744-751Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Migration may result in exposure to factors that are both beneficial and harmful for good health. How the act of migration is associated with mortality, or whether the socio-economic condition of migrants prior to migration influences their mortality trajectory, is not well understood. In the present study, a cohort of 413 randomly selected individuals born in the rural community of Överkalix, Sweden, between 1890 and 1935 were followed from birth to either death or old age. Around 50% of the study-population moved away from Överkalix at one time or another. To adjust for a potential bias resulting from self-selection among the migrants, the father’s occupational status was used together with parents’ and grandparents’ longevity. Overall, migration could not be shown to predict mortality when the backgrounds of the migrants were taken into account. Nonetheless, socio-economic background conditions appeared to moderate the association, decreasing the mortality rates for migrants with relatively good pre-migratory socio-economic conditions, while increasing it for migrants with poorer pre-migratory conditions. However, further scrutiny revealed that this effect modification mainly affected the female migrants’ mortality. In conclusion, the study suggests that there is no general association between migration and mortality, but that migrants with better socio-economic resources are more likely to improve their mortality trajectories than migrants with poorer resources. Better pre-migratory conditions hence appear to be important for avoiding health-adverse circumstances and gaining access to health beneficial living conditions when moving to foreign environments – especially for women.

  • 211.
    Tinghög, Petter
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Hälsa och samhälle. Linköpings universitet, Filosofiska fakulteten.
    Hemmingsson, Tomas
    National Institute for Working Life Stockholm, Sweden/Division of Occupational Health Dept. of Public Health Sciences Karolinska Institute Stockholm, Sweden.
    Lundberg, Ingvar
    National Institute for Working Life Stockholm, Sweden/Division of Occupational Health Dept. of Public Health Sciences Karolinska Institute Stockholm, Sweden.
    To what extent may the association between immigrant status and mental illness be explained by socioeconomic factors?2007Inngår i: Social Psychiatry and Psychiatric Epidemiology, ISSN 0933-7954, E-ISSN 1433-9285, Vol. 42, nr 12, s. 990-996Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background Immigrants in Sweden have a higher rate of mental illness than the native Swedes. This study investigated to what extent the association between immigrant status and mental illness can be explained by a different distribution of known risk factors for impaired mental health between groups of immigrants and persons born in Sweden.

    Methods The study is based on data from the Swedish PART-study, designed to identify risk factors for, and social consequences of, mental illness. The study population consists of a random sample of 10,423 Swedish citizens, whereof 1,109 were immigrants. The data was collected in the year 2000. The immigrants were divided into three groups based on country of origin (Scandinavians born outside Sweden, Europeans born outside Scandinavia, non-Europeans). The occurrence of mental illness among immigrants and native Swedes were compared not adjusting and adjusting for indicators of socioeconomic advantage/disadvantage (education, income, labour market position, etc). Mental illness was approximated with the WHO (ten) wellbeing index scale and depressive symptoms were measured with the major depression inventory scale (MDI).

    Results Immigrants’ excess risk for low subjective wellbeing was completely accounted for by adjustment for known risk factors in all the immigrant groups. However, social-economic disadvantages could not account for the non-European immigrants’ higher prevalence of depression (MDI), although the increased relative risk found in univariate analyses was substantially reduced.

    Conclusions The findings in this study suggest that the association between immigrant status and mental illness appears above all to be an effect of a higher prevalence of social and economic disadvantage.

  • 212.
    Tinghög, Petter
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Hälsa och samhälle. Linköpings universitet, Filosofiska fakulteten.
    Richt, Bengt
    Linköpings universitet, Institutionen för medicin och hälsa, Hälsa och samhälle. Linköpings universitet, Filosofiska fakulteten.
    Eriksson, Mimmi
    Centre for Social Research on Alcohol and Drugs (SoRAD), Stockholm University, Stockholm, Sweden.
    Nordenfelt, Lennart
    Linköpings universitet, Institutionen för medicin och hälsa, Hälsa och samhälle. Linköpings universitet, Filosofiska fakulteten.
    A phenomenological approach to the study of stress among immigrants: the case of Iraqi and Iranian women in SwedenManuskript (Annet vitenskapelig)
    Abstract [en]

    This study begins with the outlining of a general phenomenological theory of stress, which subsequently is applied to eleven Iraqi and Iranian migrant women’s own accounts of life in Sweden. The analysis of the interviews suggested that domestic disputes and intergenerational conflicts may become particularly stressful in that they are often amplified by incompatible Western and Non‐Western representations. The detected stressful experiences are analysed and structured to elucidate their character. Finally, a typology of stressful experiences in the new environment based on the distinctions between immigrant/minority‐specific and non‐immigrant/‐ minority‐specific stress, as well as between culturogenic and non‐culturogenic stress, is presented and defended.

  • 213.
    Tinhög, Gustav
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Utvärdering och hälsoekonomi. Linköpings universitet, Hälsouniversitetet.
    Andersson, David
    Linköpings universitet, Institutionen för medicin och hälsa, Utvärdering och hälsoekonomi. Linköpings universitet, Hälsouniversitetet.
    Tinghög, Petter
    Linköpings universitet, Filosofiska fakulteten. Linköpings universitet, Institutionen för medicin och hälsa, Hälsa och samhälle.
    Lyttkens, Carl Hampus
    Lunds universitet.
    Rationing in practice - inequalities in waiting times for elective surgery (poster)2010Konferansepaper (Fagfellevurdert)
  • 214.
    Tu, Jiong
    Linköpings universitet, Institutionen för medicin och hälsa, Hälsa och samhälle.
    Privatisation of Health Care in Transitional China: A Study of Private Clinics at the County Level2010Independent thesis Advanced level (degree of Master (Two Years)), 20 poäng / 30 hpOppgave
    Abstract [en]

    The thesis examines the privatisation of China's health care since the 1980s, focusingon the privatisation of primary health care at the county level. The research choosesprivate clinics as research objects, includes a brief historical description of privatehealth care evolution and the existing health care system in China; based on theempirical data collected in the field work, it provides a current picture of private clinicand its privatisation process in a Chinese city, discusses the problems in privatemedical practice and challenges private clinic faces, and the influence of privatisationon health sector performance.The thesis notes the privatisation of primary health care by private clinics supplies analternative way for health care services. It plays a significant role in compensatingpublic system and promotes more equal health access, although the radicalprivatisation of all health sectors undermines the accessibility and quality of healthservices in general. Currently the private health sector in China is still small and yet toform a mature market, and there are multiple challenges for its further development,but it can be expected that the private sector in the health care area will expand rapidly,and China could hopefully find a suitable way of public/private mix under the newhealth reform.

  • 215.
    Wegman Palmebäck, Pia
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Cellbiologi. Linköpings universitet, Hälsouniversitetet.
    Elingarami, Sauli
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Cellbiologi. Linköpings universitet, Hälsouniversitetet.
    Carstensen, John
    Linköpings universitet, Institutionen för medicin och hälsa, Hälsa och samhälle. Linköpings universitet, Filosofiska fakulteten.
    Stål, Olle
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Onkologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Kirurgi- och onkologicentrum, Onkologiska kliniken US.
    Nordenskjöld, Bo
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Onkologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Kirurgi- och onkologicentrum, Onkologiska kliniken US.
    Wingren, Sten
    Linköpings universitet, Institutionen för klinisk och experimentell medicin. Linköpings universitet, Hälsouniversitetet.
    Genetic variants of CYP3A5, CYP2D6, SULT1A1, UGT2B15 and tamoxifen response in postmenopausal breast cancer patients2007Inngår i: Breast Cancer Research, ISSN 1465-5411, Vol. 9, nr 1, s. R7-Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Introduction

    Tamoxifen therapy reduces the risk of recurrence and prolongs the survival of oestrogen-receptor-positive patients with breast cancer. Even if most patients benefit from tamoxifen, many breast tumours either fail to respond or become resistant. Because tamoxifen is extensively metabolised by polymorphic enzymes, one proposed mechanism underlying the resistance is altered metabolism. In the present study we investigated the prognostic and/or predictive value of functional polymorphisms in cytochrome P450 3A5 CYP3A5 (*3), CYP2D6 (*4), sulphotransferase 1A1 (SULT1A1; *2) and UDP-glucuronosyltransferase 2B15 (UGT2B15; *2) in tamoxifen-treated patients with breast cancer.

    Methods

    In all, 677 tamoxifen-treated postmenopausal patients with breast cancer, of whom 238 were randomised to either 2 or 5 years of tamoxifen, were genotyped by using PCR with restriction fragment length polymorphism or PCR with denaturing high-performance liquid chromatography.

    Results

    The prognostic evaluation performed in the total population revealed a significantly better disease-free survival in patients homozygous for CYP2D6*4. For CYP3A5, SULT1A1 and UGT2B15 no prognostic significance was observed. In the randomised group we found that for CYP3A5, homozygous carriers of the *3 allele tended to have an increased risk of recurrence when treated for 2 years with tamoxifen, although this was not statistically significant (hazard ratio (HR) = 2.84, 95% confidence interval (CI) = 0.68 to 11.99, P = 0.15). In the group randomised to 5 years' tamoxifen the survival pattern shifted towards a significantly improved recurrence-free survival (RFS) among CYP3A5*3-homozygous patients (HR = 0.20, 95% CI = 0.07 to 0.55, P = 0.002). No reliable differences could be seen between treatment duration and the genotypes of CYP2D6, SULT1A1 or UGT2B15. The significantly improved RFS with prolonged tamoxifen treatment in CYP3A5*3 homozygotes was also seen in a multivariate Cox model (HR = 0.13, CI = 0.02 to 0.86, P = 0.03), whereas no differences could be seen for CYP2D6, SULT1A1 and UGT2B15.

    Conclusion

    The metabolism of tamoxifen is complex and the mechanisms responsible for the resistance are unlikely to be explained by a single polymorphism; instead it is a combination of several mechanisms. However, the present data suggest that genetic variation in CYP3A5 may predict response to tamoxifen therapy.

  • 216.
    Welin, Stellan
    Linköpings universitet, Institutionen för medicin och hälsa, Hälsa och samhälle. Linköpings universitet, Filosofiska fakulteten.
    A more secure existence: Rethinking the myth of individual origin2013Inngår i: Johanssonian Investigations: Essays in honour of Ingvar Johansson on his seventieth birthday / [ed] Christer Svennerlid, Jan Almäng, Rögnvaldur Ingthorsson, Frankfurt am Main: Ontos Verlag, 2013, s. 717-727Kapittel i bok, del av antologi (Annet vitenskapelig)
    Abstract [en]

    During the last decades, Ingvar Johansson has made a formidable contribution to the development of philosophy in general and perhaps especially to the development of metaphysics. This volume consists of original papers written by 50 philosophers from all over the world in honour of Ingvar Johansson to celebrate his 70th birthday. The papers cover traditional issues in metaphysics and the philosophy of mind, applied ethics and applied metaphysics, the nature of human rights, the philosophy of economics and sports. Some of the papers study the philosophy of Ingvar Johansson.All of them studies subjects which he has shown an interest in. The variety of subjects covered, testifies to the extraordinary wide range of issues his thought has had a bearing on.

  • 217.
    Welin, Stellan
    Linköpings universitet, Filosofiska fakulteten. Linköpings universitet, Institutionen för medicin och hälsa, Hälsa och samhälle.
    Ethical issues in tissue engineering2008Inngår i: Tissue Engineering / [ed] Ulrich Meyer, Jörg Handschel, Hans Peter Wiesmann, Thomas Meyer, London: Academic Press , 2008, s. 685-703Kapittel i bok, del av antologi (Annet vitenskapelig)
    Abstract [en]

    Tissue Engineering (or regenerative medicine) is a rapidly developing field of research pursued by very different branches of medicine. The most results are published by orthopedists [28] and cardiologists, but meanwhile, there is nearly no special subject that does not investigate in this area. Furthermore, there is a multitude of methods and techniques that are involved in tissue engineering. Therefore, it is difficult to define or to describe the scope of “tissue engineering” in one sentence.

  • 218.
    Welin, Stellan
    Linköpings universitet, Filosofiska fakulteten. Linköpings universitet, Institutionen för medicin och hälsa, Hälsa och samhälle.
    Governance and Ethics in Biosciences and Biotechnology2008Inngår i: Bioethics, Politics and Business, Köpenhamn: Nordic Council of Ministers , 2008, s. 55-64Kapittel i bok, del av antologi (Annet vitenskapelig)
    Abstract [en]

    In the decision-making involving biosciences and biotechnology, both politicians and the general public have come to increasingly rely on different kinds of experts and specialised bodies. Interest groups such as industry, religious authorities and consumer organisations also try to influence political decision-making, and the role of the media has not always been - it is claimed - as neutral as the public perceives it to be. At the same time, according to the democratic ideal, ultimate power should rest with the parliamentarians and with the people. Who has the power in decision-making in biotechnology? Can there be legitimate expertise in bioethics? How can we improve the power balance? These are some of the questions this book seeks to answer.

    The book is divided into three parts. The first part presents articles dealing with the role of biopolitics and the expert bodies in relation to the democratic ideal. The second part looks at the special role of the media in relation to decision-making in bioethics and biopolitics. The third part of the book looks at the links between the biotechnology industry and bioethical decision-making.

  • 219.
    Welin, Stellan
    Linköpings universitet, Institutionen för medicin och hälsa, Hälsa och samhälle. Linköpings universitet, Filosofiska fakulteten.
    In vitro meat - some moral issues2009Inngår i: Ethical futures: bioscience and food horizons / [ed] Millar, K, Hobson West, P & Nerlich, B, 2009, s. 170-174Konferansepaper (Fagfellevurdert)
  • 220.
    Welin, Stellan
    Linköpings universitet, Institutionen för medicin och hälsa, Hälsa och samhälle. Linköpings universitet, Filosofiska fakulteten.
    Introducing the new meat. Problems and prospects2013Inngår i: Etikk i praksis, ISSN 1890-3991, E-ISSN 1890-4009, Vol. 7, nr 1, s. 24-37Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Cultured meat, or in vitro meat, is one of the ideas that are being proposed to help solve the problems associated with the ever-growing global meat consumption. The prospect may bring benefit for the environment, climate, and animal ethics, but has also generated doubts and criticism. A discussion of the possible environmental benefit and of animal ethics issues in relation to cultured meat production will be given. A perceived ’unnaturalness’ of cultured meat may be one of the strongest barriers for public acceptance. This will be discussed and rejected. As to our relations with nature and animals, it is plausible that cultured meat will lead to improvement rather than to deterioration. The issue of public acceptance and some of the problems of introducing this new product on the market will also be discussed. 

  • 221.
    Welin, Stellan
    et al.
    Linköpings universitet, Filosofiska fakulteten. Linköpings universitet, Institutionen för medicin och hälsa, Hälsa och samhälle.
    Berlin, Johanna
    Sik, Göteborg.
    Gold, Julie
    Chalmers, Göteborg.
    Köttproduktion utan djur2008Inngår i: Klimatfrågan på bordet / [ed] Birgitta Johansson, Stockholm: Formas , 2008, 1, s. 261-271Kapittel i bok, del av antologi (Annet vitenskapelig)
    Abstract [sv]

    Mat åt nio miljarder - klimatet är en joker, Johan Kuylenstierna Vi måste minska sårbarheten i ordlingssystemen, Jakob Lundberg och Fredrik Moberg Euoropas mat i nytt klimat, Thomas OhlssonKött och klimat - kunskap som funnits länge, Annika Carlsson-KanyamaAlla matens utsläpp borde synas i klimatrapporteringen. Christel CederbergMatval för klimatets skull - svenska äpplen och mindre pizzor, Charlotte Lagerberg FogelbergVärms jordklotet upp av fisken på din tallrik, Friederike ZieglerVälfyllda lastrum ger klimateffektiva transporter, Gunilla JönssonMaten i soptunnan - vem täljer trägubbar för att elda upp dem, Karin Östergren coh Ulf SonessonKlimatmärkning av mat - vad kan det ge och när ska det ske, Oksana Mont och Katsiarna PaulavetsAha - klimatmärkt mat, Helena Shanahan och Helene WåhlanderHoppfull oro - en medelväg för klimatvänlig matkonsumtion, Maria OjalaSvensk växtodling i nytt klimat, Herik Eckersten, Håkan Fogelfors och Roland SigvaldMat och klimat - ett växtgenetiskt perspektiv, Christina DixeliusNya krav på djurhållning, Ann Albihn och Ulf MagnussonMindre metan från högavkastande kor, Jan Bertilsson och Gunnar BörjessonKöttproduktion utan djur, Stellan Welin, Johanna Berlin och Julie GoldJordbruk med naturen som modell, Johanna BjörklundÄr ekomat bättre eller sämre för klimatet, Niels Andresen, Ann-Marie Dock Gustavsson och Johan WahlanderEkologiskt jordbruk ger mera koldioxid i atmosfären, Olof Andrén och Holger KirchmannKlimatvänligt jordbruk - hur kan det se ut, Göte Bertilsson

  • 222.
    Welin, Stellan
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Hälsa och samhälle. Linköpings universitet, Filosofiska fakulteten.
    Gold, Julie
    Chalmers tekniska högskola, Göteborg, Sweden.
    Köd uden dyr?: Kan ny teknik göre problemer med dyreetik og miljö til historie?2012Inngår i: Köd: En antologi / [ed] Mickey Gjerris, Kristian Bjørkdahl, Köbenhavn: Tiderne Skifter , 2012, s. 285-294Kapittel i bok, del av antologi (Annet vitenskapelig)
  • 223.
    Welin, Stellan
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Hälsa och samhälle. Linköpings universitet, Filosofiska fakulteten.
    Gold, Julie
    Chalmers tekniska högskola, Göteborg, Sweden.
    Berlin, Johanna
    SIK.
    In vitro meat. What are the moral issues?2012Inngår i: The Philosophy of Food / [ed] David Kaplan, Berkeley, California: University of California Press, 2012, s. 292-304Kapittel i bok, del av antologi (Annet vitenskapelig)
  • 224.
    Welin, Stellan
    et al.
    Linköpings universitet, Filosofiska fakulteten. Linköpings universitet, Institutionen för medicin och hälsa, Hälsa och samhälle.
    Sandrin, Mauro S.
    Some ethical problems in xenotransplantation: introductory remarks at Ethics Workshop2006Annet (Annet vitenskapelig)
  • 225.
    Welin, Stellan
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Hälsa och samhälle. Linköpings universitet, Filosofiska fakulteten.
    Var der Weele, Cor
    LEI, Wageningen UR, the Netherlands.
    Cultured Meat: will it separate us from nature?2012Inngår i: Climate Change and Sustainable Development: Ethical perspectives on land use and food production / [ed] Thomas Potthast and Simon Meish, Wageningen: Wageningen Academic Publishers, 2012, s. 348-351Kapittel i bok, del av antologi (Annet vitenskapelig)
    Abstract [en]

    In vitro meat, or cultured meat, is one of the ideas that are being proposed to help solve the problems associated with the ever growing global meat consumption. The prospect is a source or great moral hope, but also generates doubts and criticism. In this paper, we focus on worries about (1) the alleged unnaturalness of in vitro meat; and (2) the possible deterioration of our relations with nature and animals. We will argue that arguments about (un)naturalness take us to any conclusion we want. As to our relations with nature and animals, we think it more plausible that cultured meat will lead to improvement than to deterioration.

  • 226.
    Wennerholm, Carina
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Omvårdnad. Linköpings universitet, Hälsouniversitetet.
    Grip, Björn
    Linköpings universitet, Institutionen för studier av samhällsutveckling och kultur. Linköpings universitet, Filosofiska fakulteten.
    Johansson, AnnaKarin
    Linköpings universitet, Institutionen för medicin och hälsa, Omvårdnad. Linköpings universitet, Hälsouniversitetet.
    Nilsson, Hans
    Linköpings universitet, Institutionen för studier av samhällsutveckling och kultur, Centrum för lokalhistoria. Linköpings universitet, Filosofiska fakulteten.
    Honkasalo, Marja-Liisa
    Linköpings universitet, Institutionen för medicin och hälsa, Hälsa och samhälle. Linköpings universitet, Hälsouniversitetet.
    Faresjö, Tomas
    Linköpings universitet, Institutionen för medicin och hälsa, Allmänmedicin. Linköpings universitet, Hälsouniversitetet.
    Cardiovascular disease occurrence in two close but different social environments2011Inngår i: INTERNATIONAL JOURNAL OF HEALTH GEOGRAPHICS, ISSN 1476-072X, Vol. 10, nr 5Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Cardiovascular diseases estimate to be the leading cause of death and loss of disability-adjusted life years globally. Conventional risk factors for cardiovascular diseases only partly account for the social gradient. The purpose of this study was to compare the occurrence of the most frequent cardiovascular diseases and cardiovascular mortality in two close cities, the Twin cities. Methods: We focused on the total population in two neighbour and equally sized cities with a population of around 135 000 inhabitants each. These twin cities represent two different social environments in the same Swedish county. According to their social history they could be labelled a "blue-collar" and a "white-collar" city. Morbidity data for the two cities was derived from an administrative health care register based on medical records assigned by the physicians at both hospitals and primary care. The morbidity data presented are cumulative incidence rates and the data on mortality for ischemic heart diseases is based on official Swedish statistics. Results: The cumulative incidence of different cardiovascular diagnoses for younger and also elderly men and women revealed significantly differences for studied cardiovascular diagnoses. The occurrence rates were in all aspects highest in the population of the "blue-collar" twin city for both sexes. Conclusions: This study revealed that there are significant differences in risk for cardiovascular morbidity and mortality between the populations in the studied different social environments. These differences seem to be profound and stable over time and thereby give implication for public health policy to initiate a community intervention program in the "blue-collar" twin city.

  • 227.
    Wennerholm, Carina
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Omvårdnad. Linköpings universitet, Hälsouniversitetet.
    Jern, Michaela
    Linköpings universitet, Hälsouniversitetet, Hälsouniversitetets läkarutbildning.
    Honkasalo, Marja-Liisa
    Linköpings universitet, Institutionen för medicin och hälsa, Hälsa och samhälle. Linköpings universitet, Hälsouniversitetet.
    Faresjö, Tomas
    Linköpings universitet, Institutionen för medicin och hälsa, Allmänmedicin. Linköpings universitet, Hälsouniversitetet.
    Young Women After MI - A Qualitative Study of Social Context and Lay Perceptions of the Disease.2011Konferansepaper (Annet vitenskapelig)
    Abstract [en]

    Background: A recently published study by us shows interesting incidence numbers of myocardial infarction (MI) in two close cities. One of the cities has the highest incidence of MI in Sweden. Conventional risk factors for cardiovascular diseases only partly account for the social gradient. MI among women of working age is a relatively rare event. It can be an indicator of the current health situation in a city. The purpose of this study was to analyze lay perceptions and believes regarding the disease among affected women in their social context. Knowledge about this can give us a better understanding about how they think, act and choose in life.

    Methods: We focused on younger women under 65 years of age affected by MI. Qualitative interviews was made with 12 women in the defined region.

    Results: The majority of the women mentioned inner stress as a cause for, and specific life events adjacent to the MI. All women in the study point out conventional risk factors (smoking, obesity, lack of exercise, diet, and heredity) as an explanation for their MI. Finally, most of these women had high demands on themselves, put other people's needs above their own and some testified about very traumatic life experiences.

    Conclusions: Knowledge about young women affected by MI and their lay perceptions is an important prerequisite for preventive measures for this special group.

  • 228.
    Wickström, Anette
    Linköpings universitet, Institutionen för medicin och hälsa, Hälsa och samhälle. Linköpings universitet, Filosofiska fakulteten.
    Kärlek i virusets tid: att hantera relationer och hälsa i Zululand2008Doktoravhandling, monografi (Annet vitenskapelig)
    Abstract [sv]

    Huvudsyftet med avhandlingen är att förstå hur människor tänker om och hanterar kärlek, sexualitet och hälsa i sina vardagliga liv på landsbygden i nordöstra KwaZulu Natal i Sydafrika. Målet är att förstå vad kärlek innebär för dem, men också hur större samhälleliga processer påverkar erfarenheter av kärlek, hälsa och relationer.

    Studien baserar sig på sex månaders etnografiska fältstudier bland framförallt åtta familjer. Data samlades in genom deltagande observationer och öppna intervjuer. Vid sidan om familjerna intervjuades tio örtdoktorer. Materialet består av 60 bandade intervjuer och cirka 340 sidor fältanteckningar.

    Analysen visar att man talar mer om kärlek i termer av respektfulla handlingar och en social ordning än om kärlek som en känsla. Kärleken är visserligen känslofull, men talet om respektfulla handlingar som kännetecknet på kärlek visar att invånarna ser sig som djupt beroende av varandra. Individen definieras av en väv av relationer där även förfäderna, både levande och döda, ingår. Kärlek mellan två individer hänger därför intimt samman med släkten och relationer i närsamhället, vilket skapar tillhörighet men också utsatthet. Kärleksmediciner tillverkade av örter utgör en möjlig väg att stärka ett förhållande eller att vinna någons kärlek. Berättelser om kärleksmediciner visar emellertid vad människor drabbas av och vad som anses vara ett omoraliskt agerande, vilket ger förklaring och lindring i svåra situationer men också lyfter fram att strukturella omständigheter under vilka människor lever behöver förändras.

    Kolonisation, apartheid och under senare år demokratisering har inneburit radikala förändringar för kärleks- och familjerelationer. Män, och fler och fler kvinnor, försörjer sig som migrantarbetare, vilket har lett till en uppsplittring av familjen mellan stad och landsbygd och skapat nya slags försörjningsnätverk. Förändringarna har lett till svårigheter med att visa kärlek i handling och till efterfrågan på nya sorters handlingar som bevis på kärlek.

    Arbetslöshet och sjukdomar utgör dock det allvarligaste hotet mot kärleken. I brist på effektiva åtgärder mot aids åberopar människor en tydligare moralisk ordning och försöker finna alternativa vägar att skydda sig. För att lyfta fram både det individuella och det gemensamma ansvaret för sexuella relationer och för att stärka flickors position har invånarna skapat en ritual för att kontrollera flickors oskuld, som en preventiv snarare än en diagnostisk åtgärd. En välkänd historisk ritual som lyfter fram oskuldens och kollektivets betydelse används i en modern strategi för att försöka hejda spridningen av aids och göra kärleken möjlig.

    Studien lyfter fram hur både inomstatliga och västerländska projekt som syftar till att förbättra zulufolkets situation grundar sig i perspektiv och föreställningar som är främmande för dem, och ibland krockar med deras sätt att uppfatta kärlek, relationer och sexualitet. Invånarna ser ömsom nya möjligheter, ömsom försöker de bevara sin tidigare moraliska ordning, men framförallt transformerar de sin specifika förståelse av hur samlevnad fungerar till dagens behov och villkor.

  • 229.
    Wickström, Anette
    Linköpings universitet, Filosofiska fakulteten. Linköpings universitet, Institutionen för medicin och hälsa, Hälsa och samhälle.
    Love as action; managing relationships, sickness and medicine in a Zulu society2008Inngår i: Medische antropologie, ISSN 0925-4374, Vol. 20, s. 47-68Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

      

  • 230.
    Willner , Sam
    Linköpings universitet, Institutionen för medicin och hälsa, Hälsa och samhälle. Linköpings universitet, Filosofiska fakulteten.
    Public health and municipal policy making: Britain and Sweden, 1900-19402009Inngår i: MEDICAL HISTORY, ISSN 0025-7273 , Vol. 53, nr 2, s. 307-308Artikkel, omtale (Annet (populærvitenskap, debatt, mm))
  • 231.
    Willner, Sam
    Linköpings universitet, Filosofiska fakulteten. Linköpings universitet, Institutionen för medicin och hälsa, Hälsa och samhälle.
    Kontinuitet och förändring i det urbana dödlighetsmönstret ur ett genusperspektiv: Sverige 1750-20002008Inngår i: Se människan: demografi, rätt och hälsa - en vänbok till Jan Sundin / [ed] Annika Sandén, Jan Sundin, Linköping: Linköpings universitet , 2008, s. 183-193Kapittel i bok, del av antologi (Annet vitenskapelig)
  • 232.
    Willner, Sam
    Linköpings universitet, Filosofiska fakulteten. Linköpings universitet, Institutionen för medicin och hälsa, Hälsa och samhälle.
    Spatial inequality in socioeconomic conditions and health: experiences from 20th century Sweden2008Inngår i: The Price of Life: Welfare Systems, Social Nets and Economic Growth / [ed] Laurinda Abreu & Patrice Bourdelais,, Évora: CIDEHUS/UE, PhoenixTN , 2008, s. 109-125Kapittel i bok, del av antologi (Annet vitenskapelig)
  • 233.
    Willner, Sam
    Linköpings universitet, Filosofiska fakulteten. Linköpings universitet, Institutionen för medicin och hälsa, Hälsa och samhälle.
    The History of Social Determinants and Health in Europe: a Swedish example2009Inngår i: The Price of Life: Welfare Systems, Social Nets and Economic Growth, Hyderabad: Orient Blackswan Private Limited , 2009, 1, s. 78-110Kapittel i bok, del av antologi (Annet vitenskapelig)
    Abstract [en]

    Every subject has its history, including the Social Determinants of Health. It is a subject that investigates differences in human health that occur because of social life, from income and class to family life and neighbourhood. Social determinants can have very large effects on longevity, just as do other determinants, such as the provision of medical care or clean drinking water. A Commission to study the social determinants of health and to propose ways of improving health based upon their analysis was therefore established under the auspices of the World Health Organization and chaired by Professor Sir Michael Marmot. In support of the work of the Commission, therefore, a large international meeting was organised in London in order to bring together some of the members of the Commission and several eminent historians to discuss the historical experience of people from around the globe. Because historians are among those who have tried to assess how social relationships have affected health, they can point to some determinants of health that others might miss, while historical investigations can in turn benefit from knowing what other analysts consider to be the most important social determinants of health. The result produced knowledge of importance to us all. Many of the arguments and evidence are therefore brought together here in one book, so that the work of the Commission and some of the debates it has prompted can be better known. This is the first volume of its kind to bring historical studies to the investigation of the social determinants of health from a global perspective. It brings together eminent historians of international health to explore an important and topical subject. The contributors summarise a large body of recent historical literature in order to make it useful for policy analysts. It includes a wide range of international examples. It also includes two chapters on different methods of taking oral histories, which is a central concern for anyone who is interested in examining the recent past.

  • 234.
    Wiréhn, Ann-Britt
    Linköpings universitet, Institutionen för medicin och hälsa, Hälsa och samhälle. Linköpings universitet, Hälsouniversitetet.
    A Data-Rich World: Population‐based registers in healthcare research2007Doktoravhandling, med artikler (Annet vitenskapelig)
    Abstract [en]

    Advances and integration of information and communication technologies into healthcare systems offer new opportunities to improve public health worldwide. In Sweden, there are already unique possibilities for epidemiological research from registers because of a long tradition of centralized data collection into population-based registers and their allowance for linkage. The growing efficiency of automated digital storage provides growing volumes of archived data that increases the potential of analyses further.

    The purpose of this thesis can be divided into two parallel themes: illustrations and discussions of the use and usefulness of population-based registers on the one hand, and specific research questions in epidemiology and healthcare research on the other. The research questions are addressed in separate papers.

    From the Swedish Cancer Registry, 25 years of incidence data on testicular cancer was extracted for a large cohort. Record linkage to survey data on serum cholesterol showed a highly significant positive association, suggesting that elevated serum cholesterol concentration is a risk factor for testicular cancer. Since the finding is the first of its kind and because of wide confidence intervals further studies are needed to confirm the association.

    Östergötland County council’s administra-tive database (the Care Data Warehouse in Östergötland (CDWÖ)) provided data for preva-lence estimations of four common chronic diseases.

    The prevalence rate agreed very well with previous estimates for diabetes and fairly well with those for asthma. For hypertension and chronic obstructive pulmonary disease, the observed rates were lower than previous prevalence estimates. Data on several consecutive years covering all healthcare levels are needed to achieve valid prevalence estimates.

    CDWÖ data was also used to analyse the impact of diabetes on the prevalence of ischemic heart disease. Women had higher diabetes/non-diabetes prevalence rate ratios across all ages. The relative gender difference remained up to the age of 65 years and thereafter decreased considerably.

    The age-specific direct healthcare cost of diabetes was explored using data from the CDWÖ, the county council’s Cost Per Patient database and the Swedish Prescribed Drug Register. The cost per patient and the relative magnitude of different cost components varied considerably by age, which is important to consider in the future planning of diabetes management.

    The Cancer Registry was established mainly as a basis for epidemiological surveillance and research, exemplified in this thesis by a study on testicular cancer. In contrast, the newly established and planned healthcare databases in different Swedish counties are mainly for managerial purposes. As is shown in this thesis, these new databases may also be used to address problems in epidemiology and healthcare research.

    Delarbeid
    1. Serum cholesterol and testicular cancer incidence in 45 000 men followed for 25 years
    Åpne denne publikasjonen i ny fane eller vindu >>Serum cholesterol and testicular cancer incidence in 45 000 men followed for 25 years
    2005 (engelsk)Inngår i: British Journal of Cancer, ISSN 0007-0920, Vol. 92, nr 9, s. 1785-1786Artikkel i tidsskrift (Fagfellevurdert) Published
    Abstract [en]

    In a 25-year follow-up study of 44 864 men with measured serum cholesterol levels, the testicular cancer hazard ratios for the serum cholesterol categories 5.7–6.9 and ≥7.0 mmol l-1 vs the reference category (<5.7 mmol l-1) were 1.3 and 4.5, respectively; P-value for trend=0.005. This highly significant association suggests that high-serum cholesterol is a risk factor for testicular cancer.

    Emneord
    epidemiology, testicular neoplasm, cholesterol
    HSV kategori
    Identifikatorer
    urn:nbn:se:liu:diva-12757 (URN)10.1038/sj.bjc.6602539 (DOI)
    Tilgjengelig fra: 2007-11-06 Laget: 2007-11-06 Sist oppdatert: 2011-02-03
    2. Estimating disease prevalence using a population-based administrative healthcare database
    Åpne denne publikasjonen i ny fane eller vindu >>Estimating disease prevalence using a population-based administrative healthcare database
    2007 (engelsk)Inngår i: Scandinavian Journal of Public Health, ISSN 1403-4948, Vol. 35, nr 4, s. 424-431Artikkel i tidsskrift (Fagfellevurdert) Published
    Abstract [en]

    Aims: In Östergötland County, Sweden, all data on hospital care and primary healthcare (PHC) have been entered in a diagnosis-related administrative database since 1999. This database was used to estimate the prevalence of four chronic diseases and to examine the capture of data in PHC, outpatient hospital care, and inpatient hospital care, considered in different time frames.

    Methods: A case-finding algorithm identified patients with at least one healthcare contact involving a diagnosis of diabetes, hypertension, asthma, or chronic obstructive pulmonary disease (COPD) in 1999—2003. Prevalence rates were calculated as the ratio of the number of identified patients alive to the total number of inhabitants on 31 December 2003 (n~415,000).

    Results: Prevalence rates were 4.4% for diabetes, 10.3% for hypertension, 4.5% for asthma, and 1.2% for COPD. For all four diagnoses, the proportions of patients identified on only one healthcare level were greatest for PHC, reaching rates of 23%, 68%, 53%, and 48%, respectively. The cases identified solely in PHC comprised larger proportions of women and patients over the age of 65 years. Considering the proportion of patients identified in 2003 in relation to the total five-year period gave values of 71%, 50%, 38%, and 58%, respectively, for the four diagnoses.

    Conclusions: The administrative healthcare databases in Sweden today can be important tools in epidemiological research. However, data on several consecutive years and both PHC and hospital data are needed to achieve valid prevalence estimates.

    Emneord
    Asthma, COPD, diabetes mellitus, epidemiology, healthcare, hypertension, inpatients, prevalence, primary outpatients, registries
    HSV kategori
    Identifikatorer
    urn:nbn:se:liu:diva-12758 (URN)10.1080/14034940701195230 (DOI)
    Tilgjengelig fra: 2007-11-06 Laget: 2007-11-06 Sist oppdatert: 2009-05-19
    3. Age and Gender Differences in the Impact of Diabetes on the Prevalence of Ischemic Heart Disease: a Population-Based Register Study
    Åpne denne publikasjonen i ny fane eller vindu >>Age and Gender Differences in the Impact of Diabetes on the Prevalence of Ischemic Heart Disease: a Population-Based Register Study
    2008 (engelsk)Inngår i: Diabetes Research and Clinical Practice, ISSN 0168-8227, E-ISSN 1872-8227, Vol. 79, nr 3, s. 497-502Artikkel i tidsskrift (Fagfellevurdert) Published
    Abstract [en]

    Objective: To explore age and gender differences in the impact of diabetes on the prevalence of ischemic heart disease (IHD) in a defined population.

    Methods: Data were obtained from an administrative health care register covering a population of about 415 000. The study included all patients aged 45-74 years diagnosed between 1999-2003 with IHD (n=11 311) and diabetes (n=10 364) by physicians at all primary health care centres (PHCs) and out- and inpatient clinics at all hospitals in the county of Östergötland, Sweden.

    Results: In the 45-54 year-old age group, diabetes was associated with an increase in IHD prevalence equivalent to ageing about 20 years in women and 10 years in men. The diabetes/nondiabetes IHD prevalence rate ratio (IPR) decreased with age in both men and women (trend p-values < 0.001). The IPR was higher among women than men in each age group, though the female relative excess decreased from 75% higher in the 45-54 year-old age group to 33% higher in the 65-74 year-old age group (trend p-value = 0.018).

    Conclusions: The relative gender difference in the impact of diabetes on IHD in younger middle-aged patients remained up to the age of 65 years, decreasing considerably thereafter.

    sted, utgiver, år, opplag, sider
    Institutionen för medicin och hälsa, 2008
    Emneord
    aging, coronary disease, diabetes mellitus, prevalence, sex differences
    HSV kategori
    Identifikatorer
    urn:nbn:se:liu:diva-11241 (URN)10.1016/j.diabres.2007.10.009 (DOI)
    Merknad
    Original publication: Ann-Britt E. Wiréhn, Carl Johan Östgren and John M. Carstensen, Age and Gender Differences in the Impact of Diabetes on the Prevalence of Ischemic Heart Disease: a Population-Based Register Study, 2008, Diabetes Research and Clinical Practice, (79), 3, 497-502. http://dx.doi.org/10.1016/j.diabres.2007.10.009. Copyright: Elsevier B.V., http://www.elsevier.com/Tilgjengelig fra: 2008-03-12 Laget: 2008-03-12 Sist oppdatert: 2017-12-13
    4. Age-specific direct health care costs attributable to diabetesin a Swedish population: a register-based analysis
    Åpne denne publikasjonen i ny fane eller vindu >>Age-specific direct health care costs attributable to diabetesin a Swedish population: a register-based analysis
    2008 (engelsk)Inngår i: Diabetic Medicine, ISSN 0742-3071, E-ISSN 1464-5491, Vol. 25, nr 6, s. 732-737Artikkel i tidsskrift (Fagfellevurdert) Published
    Abstract [en]

    Aims: The aim of this population-based study was to explore the age-specific additional direct healthcare cost for patients with diabetes compared with the non-diabetic population.

    Methods: In 1999-2005, patients with diabetes in the Swedish county of Östergötland (n = 20 876) were identified from an administrative database. Cost data on the healthcare expenditure in primary healthcare, out-patient hospital care and in-patient care for the entire county population (n = ∼415 000) in 2005 were extracted from a cost per patient (CPP) database, which includes information on all utilized healthcare resources in the county. Data on drug sales were obtained from the Swedish Prescribed Drug Register.

    Results: The cost per person was 1.8 times higher in patients with diabetes than in the non-diabetic population, 7.7 times higher in children and 1.3 times higher in subjects aged > 75 years. The additional cost per person for diabetes was €1971; €3930 and €1367, respectively, for children and subjects aged > 75 years. The proportion of total additional diabetes costs attributable to in-patient care increased with age from 25 to 50%; in-patient care was the most expensive component at all ages except in children, for whom visiting a specialist was most expensive. The diabetes-related segment of the total healthcare cost was 6.6%, increasing from 2.0% in children to 10.3% in the age group 65-74 years, declining to 6.2% in the oldest age group.

    Conclusions: The direct medical cost of diabetes varies considerably by age. Knowledge about the influence of age on healthcare costs to society will be important in future planning of diabetes management.

    Emneord
    Diabetes, Economics, Healthcare delivery, Prevalence, Registers
    HSV kategori
    Identifikatorer
    urn:nbn:se:liu:diva-12760 (URN)10.1111/j.1464-5491.2008.02444.x (DOI)
    Tilgjengelig fra: 2007-11-06 Laget: 2007-11-06 Sist oppdatert: 2017-12-14
  • 235.
    Wiréhn, Ann-Britt
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Hälsa och samhälle. Linköpings universitet, Filosofiska fakulteten.
    Andersson, Agneta
    Linköpings universitet, Institutionen för medicin och hälsa, Socialmedicin och folkhälsovetenskap. Linköpings universitet, Hälsouniversitetet.
    Östgren, Carl Johan
    Linköpings universitet, Institutionen för medicin och hälsa, Allmänmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Närsjukvården i västra Östergötland, Vårdcentraler.
    Carstensen, John
    Linköpings universitet, Institutionen för medicin och hälsa, Hälsa och samhälle. Linköpings universitet, Filosofiska fakulteten.
    Age-specific direct health care costs attributable to diabetesin a Swedish population: a register-based analysis2008Inngår i: Diabetic Medicine, ISSN 0742-3071, E-ISSN 1464-5491, Vol. 25, nr 6, s. 732-737Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aims: The aim of this population-based study was to explore the age-specific additional direct healthcare cost for patients with diabetes compared with the non-diabetic population.

    Methods: In 1999-2005, patients with diabetes in the Swedish county of Östergötland (n = 20 876) were identified from an administrative database. Cost data on the healthcare expenditure in primary healthcare, out-patient hospital care and in-patient care for the entire county population (n = ∼415 000) in 2005 were extracted from a cost per patient (CPP) database, which includes information on all utilized healthcare resources in the county. Data on drug sales were obtained from the Swedish Prescribed Drug Register.

    Results: The cost per person was 1.8 times higher in patients with diabetes than in the non-diabetic population, 7.7 times higher in children and 1.3 times higher in subjects aged > 75 years. The additional cost per person for diabetes was €1971; €3930 and €1367, respectively, for children and subjects aged > 75 years. The proportion of total additional diabetes costs attributable to in-patient care increased with age from 25 to 50%; in-patient care was the most expensive component at all ages except in children, for whom visiting a specialist was most expensive. The diabetes-related segment of the total healthcare cost was 6.6%, increasing from 2.0% in children to 10.3% in the age group 65-74 years, declining to 6.2% in the oldest age group.

    Conclusions: The direct medical cost of diabetes varies considerably by age. Knowledge about the influence of age on healthcare costs to society will be important in future planning of diabetes management.

  • 236.
    Wiréhn, Ann-Britt E.
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Hälsa och samhälle. Linköpings universitet, Filosofiska fakulteten.
    Östgren, Carl Johan
    Linköpings universitet, Institutionen för medicin och hälsa, Allmänmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Närsjukvården i västra Östergötland, Vårdcentraler.
    Carstensen, John M.
    Linköpings universitet, Filosofiska fakulteten. Linköpings universitet, Institutionen för medicin och hälsa, Hälsa och samhälle.
    Age and Gender Differences in the Impact of Diabetes on the Prevalence of Ischemic Heart Disease: a Population-Based Register Study2008Inngår i: Diabetes Research and Clinical Practice, ISSN 0168-8227, E-ISSN 1872-8227, Vol. 79, nr 3, s. 497-502Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: To explore age and gender differences in the impact of diabetes on the prevalence of ischemic heart disease (IHD) in a defined population.

    Methods: Data were obtained from an administrative health care register covering a population of about 415 000. The study included all patients aged 45-74 years diagnosed between 1999-2003 with IHD (n=11 311) and diabetes (n=10 364) by physicians at all primary health care centres (PHCs) and out- and inpatient clinics at all hospitals in the county of Östergötland, Sweden.

    Results: In the 45-54 year-old age group, diabetes was associated with an increase in IHD prevalence equivalent to ageing about 20 years in women and 10 years in men. The diabetes/nondiabetes IHD prevalence rate ratio (IPR) decreased with age in both men and women (trend p-values < 0.001). The IPR was higher among women than men in each age group, though the female relative excess decreased from 75% higher in the 45-54 year-old age group to 33% higher in the 65-74 year-old age group (trend p-value = 0.018).

    Conclusions: The relative gender difference in the impact of diabetes on IHD in younger middle-aged patients remained up to the age of 65 years, decreasing considerably thereafter.

  • 237.
    Wiréhn, Ann-Britt
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Hälsa och samhälle. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Närsjukvården i västra Östergötland, Forsknings- och utvecklingsenheten för Närsjukvården i Östergötland.
    Foldemo, Anniqa
    Linköpings universitet, Institutionen för medicin och hälsa, Omvårdnad. Linköpings universitet, Hälsouniversitetet.
    Josefsson, Ann
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Obstetrik och gynekologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Barn- och kvinnocentrum, Kvinnokliniken i Linköping.
    Lindberg, Malou
    Linköpings universitet, Institutionen för medicin och hälsa, Allmänmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Närsjukvården i västra Östergötland, Forsknings- och utvecklingsenheten för Närsjukvården i Östergötland.
    Use of hormonal contraceptives in relation to antidepressant therapy: A nationwide population-based study2010Inngår i: European journal of contraception & reproductive health care, ISSN 1362-5187, E-ISSN 1473-0782, Vol. 15, nr 1, s. 41-47Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVES: The relation between the use of different hormonal contraceptives and antidepressant therapy was investigated. METHODS: In a nationwide cross-sectional study among all women in Sweden aged 16-31, drug expenditure data on hormonal contraceptives and antidepressants were obtained from the Swedish Prescribed Drug Register. Odds ratios (ORs) for antidepressant use were calculated by logistic regression for progestin-only users versus non-users as well as for combined hormonal contraceptive (CHC) users versus non-users. RESULTS: In the study population (N = 917,993), 58.9% were hormonal contraceptive users, and 8.5% were antidepressant users. The age-pattern for antidepressant ORs differed between the two types of users of contraceptives; progestin-only users had significant ORs above 1 in all age groups whereas among CHC users the OR was above 1 solely in those aged 16-19. The largest difference between types of users was seen in the age group 16-19 in which women resorting to a progestin-only contraceptive had a 67% (95% confidence interval: 57- 78%) higher antidepressant use than women treated with a CHC. CONCLUSION: Progestin-only contraceptive users resorted to antidepressants more than users of CHCs. This phenomenon is particularly pronounced among teenagers. Therefore, special attention should be given to young women's mental history when prescribing hormonal contraceptives and vice versa: the contraceptive history should be taken into account when prescribing antidepressants.

  • 238.
    Wiréhn, Ann-Britt
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Hälsa och samhälle. Linköpings universitet, Filosofiska fakulteten.
    Karlsson, H. Mikael
    Östergötland County Council, Sweden.
    Carstensen, John
    Linköpings universitet, Institutionen för medicin och hälsa, Hälsa och samhälle. Linköpings universitet, Filosofiska fakulteten.
    Estimating disease prevalence using a population-based administrative healthcare database2007Inngår i: Scandinavian Journal of Public Health, ISSN 1403-4948, Vol. 35, nr 4, s. 424-431Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aims: In Östergötland County, Sweden, all data on hospital care and primary healthcare (PHC) have been entered in a diagnosis-related administrative database since 1999. This database was used to estimate the prevalence of four chronic diseases and to examine the capture of data in PHC, outpatient hospital care, and inpatient hospital care, considered in different time frames.

    Methods: A case-finding algorithm identified patients with at least one healthcare contact involving a diagnosis of diabetes, hypertension, asthma, or chronic obstructive pulmonary disease (COPD) in 1999—2003. Prevalence rates were calculated as the ratio of the number of identified patients alive to the total number of inhabitants on 31 December 2003 (n~415,000).

    Results: Prevalence rates were 4.4% for diabetes, 10.3% for hypertension, 4.5% for asthma, and 1.2% for COPD. For all four diagnoses, the proportions of patients identified on only one healthcare level were greatest for PHC, reaching rates of 23%, 68%, 53%, and 48%, respectively. The cases identified solely in PHC comprised larger proportions of women and patients over the age of 65 years. Considering the proportion of patients identified in 2003 in relation to the total five-year period gave values of 71%, 50%, 38%, and 58%, respectively, for the four diagnoses.

    Conclusions: The administrative healthcare databases in Sweden today can be important tools in epidemiological research. However, data on several consecutive years and both PHC and hospital data are needed to achieve valid prevalence estimates.

  • 239.
    Wiréhn, Ann-Britt
    et al.
    Linköpings universitet, Filosofiska fakulteten. Linköpings universitet, Institutionen för medicin och hälsa, Hälsa och samhälle.
    Törnberg, Sven
    Cancer Screening Unit, Oncologic Centre, Karolinska University Hospital, Stockholm, Sweden.
    Carstensen, John
    Linköpings universitet, Filosofiska fakulteten. Linköpings universitet, Institutionen för medicin och hälsa, Hälsa och samhälle.
    Serum cholesterol and testicular cancer incidence in 45 000 men followed for 25 years2005Inngår i: British Journal of Cancer, ISSN 0007-0920, Vol. 92, nr 9, s. 1785-1786Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    In a 25-year follow-up study of 44 864 men with measured serum cholesterol levels, the testicular cancer hazard ratios for the serum cholesterol categories 5.7–6.9 and ≥7.0 mmol l-1 vs the reference category (<5.7 mmol l-1) were 1.3 and 4.5, respectively; P-value for trend=0.005. This highly significant association suggests that high-serum cholesterol is a risk factor for testicular cancer.

  • 240.
    Woolhead, G.
    et al.
    MRC Health Services Research Collaboration, Department of Social Medicine, University of Bristol, Canynge Hall, Whiteladies Road, Bristol, BS8 2PR, United Kingdom.
    Tadd, W.
    Academic Department of Geriatric Medicine, Wales College of Medicine, Cardiff University, Academic Centre, Cardiff CF64 2XX, United Kingdom.
    Boix-Ferrer, J.A.
    Fundacio Hospital Asil de Granollers (FHAG), Department of Geriatric Medicine, Avenida Fransisco Ribas s/n, 08400 Granollers, Spain.
    Krajcik, S.
    Slovak Health University (SHU), Krajinska 91-101, 82556 Bratislava, Slovakia.
    Schmid-Pfahler, B.
    Aquitaine Organisation of Research, Information and Co-ordination on Older people (OAREIL), Universite Victor Segalen, 33076 Bordeaux Cedex, France.
    Spjuth, Barbro
    Linköpings universitet, Filosofiska fakulteten. Linköpings universitet, Institutionen för medicin och hälsa, Hälsa och samhälle.
    Stratton, D.
    Age Action Ireland Ltd, Dublin, 2, Ireland.
    Dieppe, P.
    MRC Health Services Research Collaboration, Department of Social Medicine, University of Bristol, Canynge Hall, Whiteladies Road, Bristol, BS8 2PR, United Kingdom.
    "Tu" or "Vous?". A European qualitative study of dignity and communication with older people in health and social care settings2006Inngår i: Patient Education and Counseling, ISSN 0738-3991, E-ISSN 1873-5134, Vol. 61, nr 3, s. 363-371Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: To examine the experiences of communication between older people and health and social care providers in six European countries. Methods: Focus groups were carried out with groups of older people (91 focus groups, 391 participants), and health and social care professionals (85 focus groups, 424 participants), in order to gain insights into concepts of good communications. Data collection and analysis continued concurrently according to the method of constant comparison. Results: Different styles of communication between professionals and older people were found to be capable of enhancing or jeopardising dignity. The use of appropriate forms of address, listening, giving people choice, including them, respecting their need for privacy and politeness, and making them feel valued emerged as significant ways to maintain older peoples' sense of self-worth and dignity. Despite being aware of good communication practices, health and social care professionals often failed to implement them. Lack of time, staff, resource scarcity, regulation and bureaucracy were cited as barriers, as was a lack of awareness and effort. Conclusions and practice implications: The findings have important implications for health and social care professionals when they engage with older people. © 2005 Elsevier Ireland Ltd. All rights reserved.

  • 241.
    Zbikowski, Ancke
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Genus och medicin. Linköpings universitet, Hälsouniversitetet.
    Brüggemann, Adrianus Jelmer
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Genus och medicin. Linköpings universitet, Hälsouniversitetet.
    Wijma, Barbro
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Genus och medicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Barn- och kvinnocentrum, Kvinnokliniken i Linköping.
    Zeiler, Kristin
    Linköpings universitet, Institutionen för medicin och hälsa, Hälsa och samhälle. Linköpings universitet, Filosofiska fakulteten.
    Swahnberg, Katarina
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Genus och medicin. Linköpings universitet, Hälsouniversitetet.
    Ethical guidelines and the prevention of abuse in healthcare2012Inngår i: European Journal of Obstetrics, Gynecology, and Reproductive Biology, ISSN 0301-2115, E-ISSN 1872-7654, Vol. 165, nr 1, s. 18-28Artikkel, forskningsoversikt (Fagfellevurdert)
    Abstract [en]

    Objective

    In obstetrical and gynaecological healthcare, patients often find themselves in a vulnerable position. Sensitive issues such as sexual and reproductive health are addressed and certain procedures can be experienced as abusive. According to research a lifetime prevalence of abuse in healthcare (AHC) can be assumed for 13–28% of female patients in the Nordic countries. In the present study we analyse the content of ethical documents for healthcare professionals within obstetrics and gynaecology in Sweden, in order to find out to what extent ethicalguidelines consider issues that have shown to be related to the occurrence of AHC.

    Study design

    We searched the literature to find empirical data on AHC. Guidelines for nurses, midwives and physicians were selected. After developing an analytical framework based on the empirical data the content of the ethicalguidelines was analysed.

    Results

    The various ethicalguidelines for staff working within obstetrics and gynaecology differ distinctively from each other regarding their content of issues that are related to AHC. Issues that were mostly disregarded were: considering the patient's perspective and the patients’ possible experience of violence, considering power imbalances within healthcare, sexual misconduct, how to deal with other professional's ethical misconduct and how professionals relate to each other. We found the ethicalguidelines of the International Federation of Gynecology and Obstetrics (FIGO) and of the International Confederation of Midwives to be those which contained most of the issues that have empirically shown to be important in regard to AHC.

    Conclusion

    While staff members from different professions may share responsibility for the same patient, their ethicalguidelines vary considerably. To become a possible resource for prevention of AHC, we suggest that ethicalguidelines in healthcare should be revised following empirical research on ethical conduct. As ethicalguidelines cannot be effective by their existence only, we would like to initiate a discussion on the function and use of ethicalguidelines in general and regarding AHC in particular. Being aware that ethicalguidelines are only a part of ethics in healthcare, however, we envision a broader approach to the aim of preventing AHC, where research is encouraged on how a virtue ethics approach could be applied.

  • 242.
    Zeiler, Kristin
    Linköpings universitet, Institutionen för medicin och hälsa, Hälsa och samhälle. Linköpings universitet, Filosofiska fakulteten.
    A phenomenological analysis of bodily self-awareness in the experience of pain and pleasure: on dys-appearance and eu-appearance2010Inngår i: MEDICINE HEALTH CARE AND PHILOSOPHY, ISSN 1386-7423, Vol. 13, nr 4, s. 333-342Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The aim of this article is to explore nuances within the field of bodily self-awareness. My starting-point is phenomenological. I focus on how the subject experiences her or his body, i.e. how the body stands forth to the subject. I build on the phenomenologist Drew Leders distinction between bodily dis-appearance and dys-appearance. In bodily dis-appearance, I am only prereflectively aware of my body. My body is not a thematic object of my experience. Bodily dys-appearance takes place when the body appears to me as "ill" or "bad." This is often the case when I experience pain or illness. Here, I will examine three versions of bodily dys-appearance. Whereas many phenomenological studies have explored cases of bodily dys-appearance, few studies have focused on the opposite of bodily dys-appearance, i.e. on bodily modes of being where the body appears to the subject as something good, easy or well. This is done in this article. When the body stands forth as good, easy or well to the subject, I suggest that the body eu-appears to this person. The analysis of eu-appearance shows that the subject can attend to her or his body as something positive and that this attention need not result in discomfort or alienation. Eu-appearance can take place in physical exercise, in sexual pleasure and in some cases of wanted pregnancies. I also discuss, briefly, the case of masochism.

  • 243.
    Zeiler, Kristin
    Linköpings universitet, Institutionen för medicin och hälsa, Hälsa och samhälle. Linköpings universitet, Filosofiska fakulteten.
    Bringing the lived body to medical ethics education: Learning to See the Suffering Other2012Inngår i: Reconceiving Medical Ethics / [ed] Christopher Cowley, London: Continuum, 2012, s. 44-55Kapittel i bok, del av antologi (Annet vitenskapelig)
    Abstract [en]

    This volume of original work comprises a modest challenge, sometimes direct, sometimes implicit, to the mainstream Anglo-American conception of the discipline of medical ethics.  It does so not by trying to fill the gaps with exotic minority interest topics, but by re-examining some of the fundamental assumptions of the familiar philosophical arguments, and some of the basic situations that generate the issues. The most important such situation is the encounter between the doctor and the suffering patient, which forms one of the themes of the book. The authors show that concepts such as the body, suffering and consent - and the role such concepts play within patients' lives - are much more complicated than the Anglo-American mainstream appreciates. Some of these concepts have been discussed with subtlety by Continental philosophers (like Heidegger, Ricoeur), and a secondary purpose of the volume is to apply their ideas to medical ethics. Designed for upper-level undergraduates and graduate students with some philosophical background in ethics, Reconceiving Medical Ethics opens up new avenues for discussion in this ever-developing field.   

  • 244.
    Zeiler, Kristin
    Linköpings universitet, Filosofiska fakulteten. Linköpings universitet, Institutionen för medicin och hälsa, Hälsa och samhälle.
    Case. Parental living kidney donation2010Inngår i: Teaching Ethics in Organ Transplantation and Tissue Donation - Cases and Movies / [ed] Eds. S. Schicktanz, C. Wieseman, S. Wöhlke, in cooperation with A Carmi UNESCO Chair in Bioethics, Göttingen: Göttingen University Press , 2010, s. 19-21Kapittel i bok, del av antologi (Annet (populærvitenskap, debatt, mm))
  • 245.
    Zeiler, Kristin
    Linköpings universitet, Institutionen för medicin och hälsa, Hälsa och samhälle. Linköpings universitet, Filosofiska fakulteten.
    Chosen Children?: An empirical study and a philosophical analysis of moral aspects of pre-implantation genetic diagnosis and germ-line gene therapy2005Doktoravhandling, monografi (Annet vitenskapelig)
    Abstract [en]

    With pre-implantation genetic diagnosis (PGD), genetic testing and selective transfer of embryos is possible. In the future, germ-line gene therapy (GLGT) applied to embryos before implantation, in order to introduce missing genes or replace mutant ones, may be possible. The objective of this dissertation is to analyse moral aspects of these technologies, as described by eighteen British, Italian and Swedish gynaecologists and geneticists. The objective is systematised into three parts: research interviews and qualitative analysis, philosophical analysis, and elaboration of a framework that supports the combination of analytic methods.

    PGD was described as positive since it enabled some couples at risk for a genetic disease to have a child without the disease. PGD was described as in different senses ‘better’ than methods for prenatal diagnosis and selective termination of pregnancy. It was also described as positive since it provided couples at risk with one more option, even if it did not result in the birth of a healthy child. However, interviewees were concerned about the difficulty of defining and evaluating genetic disease. They were also concerned about patients’ choices, and about exaggerated use or misuse. Whereas PGD gave rise to ambivalence in terms of how to understand, describe and evaluate it, GLGT was often described as unrealistic or undesirable.

    The results of the qualitative analysis are used in a philosophical analysis of the concepts of choice, autonomous choice, ambivalence, trust and ambivalence in trust relations. A set of distinct characteristics of each concept are elaborated. The results of the philosophical analysis are used in the discussion of the results of the qualitative analysis.

    The study shows that the technologies imply both ‘new’ ways to perform ‘old’ medical practices and ‘new’ practices. Old moral questions are reformulated. New moral questions are added. Against the background of this, the concept of genetic identity is discussed.

    Key words: empirical ethics, pre-implantation genetic diagnosis, germ-line gene therapy, qualitative research, philosophical analysis, medical progress, genetic disease, choice, autonomous choice, ambivalence, trust, genetic identity.

  • 246.
    Zeiler, Kristin
    Linköpings universitet, Institutionen för medicin och hälsa, Hälsa och samhälle. Linköpings universitet, Filosofiska fakulteten.
    Deadly Pluralism? Why Death-Concept, Death-Definition, Death-Criterion and Death-Test Pluralism Should Be Allowed, Even Though It Creates Some Problems2009Inngår i: BIOETHICS, ISSN 0269-9702, Vol. 23, nr 8, s. 450-459Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Death concept, death definition, death criterion and death test pluralism has been described by some as a problematic approach. Others have claimed it to be a promising way forward within modern pluralistic societies. This article describes the New Jersey Death Definition Law and the Japanese Transplantation Law. Both of these laws allow for more than one death concept within a single legal system. The article discusses a philosophical basis for these laws starting from John Rawls understanding of comprehensive doctrines, reasonable pluralism and overlapping consensus. It argues for the view that a certain legal pluralism in areas of disputed metaphysical, philosophical and/or religious questions should be allowed, as long as the disputed questions concern the individual and the resulting policy, law or acts based on the policy/law, do not harm the lives of other individuals to an intolerable extent. However, while this death concept, death definition, death criterion and death test pluralism solves some problems, it creates others.

  • 247.
    Zeiler, Kristin
    Linköpings universitet, Institutionen för medicin och hälsa, Hälsa och samhälle. Linköpings universitet, Filosofiska fakulteten.
    Ethics and Organ Transfer: A Merleau-Pontean Perspective2009Inngår i: HEALTH CARE ANALYSIS, ISSN 1065-3058, Vol. 17, nr 2, s. 110-122Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The articles aim is to explore human hand allograft recipients postoperative experience of disownership and their gradual experience of their new hand as theirs, with the aid of the work of the French phenomenologist Maurice Merleau-Ponty. Many have used a Merleau-Pontinian perspective in the analysis of embodiment. Far fewer have used it in medico-ethical analysis. Drew Leders phenomenologically based ethics of organ donation and organ sale is an exception to this tendency. The articles second aim is to examine Leders phenomenologically based ethics of organ donation and organ sale. Though I find parts of Leders approach promising, I also elaborate a line of reasoning that draws on Merleau-Ponty, that does allow us to argue for certain kinds of organ donation and against organ sale-and that avoids some of the problems with Leders approach. This alternative route builds on the concept of the integrity of the body-subject.

  • 248.
    Zeiler, Kristin
    Linköpings universitet, Filosofiska fakulteten. Linköpings universitet, Institutionen för medicin och hälsa, Hälsa och samhälle.
    Gender and medical technologies: the case of living organ donation2007Inngår i: Dynamics of health and welfare: texts and contexts, Lisboa: Edicoes Colibri , 2007, s. 159-162Kapittel i bok, del av antologi (Annet vitenskapelig)
    Abstract [en]

    This part briefly reviews the most important contributions made to the wide issue of Gender and Health in Europe and Latin America over the past 12 years. Particular attention is paid to historiographic production focused on the contemporary world, identifying the main research lines and taking account of the constant interactions and exchanges among different disciplines, notably sociology, anthropology and history. Relevant non-European literature in the English language has been included when new topics are developed, theoretical contributions are advanced or European and/or Latin American realities are addressed. The following types of studies are reviewed: those that incorporate feminist perspectives, specifically a gender approach, to the study of health, medicine and healthcare practices; those that study the ways in which medicine and science have explained the feminine body and the sexual difference; those that make women the subject of investigation, addressing their health, work and role in social-cultural systems of health; and those that investigate the part played by male- -female relationships in healthcare organization and in the production of ideas, norms and values related to health and disease. First, we summarize the concepts of gender and androcentrism and their interest for the history of medicine and health, proposing some methodological points for a gender approach. Second, we outline the main contributions and research lines on these issues. Finally, the results of research into gender and health are illustrated by 15 collaborations that gather documentary sources and case studies.

  • 249.
    Zeiler, Kristin
    Linköpings universitet, Institutionen för medicin och hälsa, Hälsa och samhälle. Linköpings universitet, Filosofiska fakulteten.
    Just love in live organ donation2009Inngår i: Medicine, Health care and Philosophy, ISSN 1386-7423, E-ISSN 1572-8633, Vol. 12, nr 3, s. 323-331Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Emotionally-related live organ donation is different from almost all other medical treatments in that a family member or, in some countries, a friend contributes with an organ or parts of an organ to the recipient. Furthermore, there is a long-acknowledged but not well-understood gender-imbalance in emotionally-related live kidney donation. This article argues for the benefit of the concept of just love as an analytic tool in the analysis of emotionally-related live organ donation where the potential donor(s) and the recipient are engaged in a love relation. The concept of just love is helpful in the analysis of these live organ donations even if no statistical gender-imbalance prevails. It is particularly helpful, however, in the analysis of the gender-imbalance in live kidney donations if these donations are seen as a specific kind of care-work, if care-work is experienced as a labour one should perform out of love and if women still experience stronger pressures to engage in care-work than do men. The aim of the article is to present arguments for the need of just love as an analytic tool in the analysis of emotionally-related live organ donation where the potential donor(s) and the recipient are engaged in a love relation. The aim is also to elaborate two criteria that need to be met in order for love to qualify as just and to highlight certain clinical implications.

  • 250.
    Zeiler, Kristin
    Linköpings universitet, Institutionen för medicin och hälsa, Hälsa och samhälle. Linköpings universitet, Filosofiska fakulteten.
    Levinas och det kroppsliga givandets etik2011Inngår i: Människan sedd: genom olika vetenskapliga prismor / [ed] Matz Hammarström, Elisabeth Gerle och Peter Gärdenfors, Nora: Bokförlaget Nya Doxa, 2011, s. 153-172Kapittel i bok, del av antologi (Annet vitenskapelig)
    Abstract [sv]

    Hur ser vetenskapen på människan 150 år efter Darwins Om arternas ursprung?Är hon fortfarande skapelsens krona, eller bara ett djur som styrs av själviska gener?Och hur är det med hennes förnuft? Är det dags att nedgradera dess betydelse?Slår evolutionsläran undan benen för all form av gudstro eller finns det en möjlighet till fredlig samexistens mellan religion och darwinism? Kan idén om det "naturliga urvalet" hjälpa oss att förstå förändringsprocesser i samhället lika väl som i naturen? Går det att förena en humanistisk och en biologistisk syn på människan?I boken, som är en del i det samtal mellan olika positioner som blir allt viktigare, hävdas att evolutionsläran åtminstone är glasklar på enpunkt: den ger inget utrymme för rasistiska spekulationer om olika etniska gruppers olika värde.Möt den mångfasetterade människan, sedd genom ett antal olika vetenskapliga prismor.Människan sedd genom olika vetenskapliga prismor

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