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Biomedical subjects

B Mattsson

Publications and source records attributed to B Mattsson.

At least 37 records · Page 2Linked to original sources
PubMed1998

A phenomenological analysis of doctor-patient interaction: a case study.

The fact that the biomedical model has been very successful in practice does not preclude that some health issues can be understood by way of other health care perspectives. Acquiring skills in meeting patients requires theories that structure other fields of knowledge than the biomedical sciences. An old man, who experiences himself as deeply misunderstood by the medical profession, is interviewed, his personal life-story is gone into and his case records and other available data are analysed. A phenomenological method is used, i.e. disciplined and rigorous reflection upon available data, remaining close to the particular pieces of the patient's narrative as they stand forth in their contextual relationships. The study shows that the doctors involved did not relate to the patient but to a biomedical image of him. His efforts to make himself understood were converted into instrumentally manageable disorders. Finally, dialogue medicine is briefly introduced as a model for counselling patients, especially when they need assistance to abandon the notion that they have been afflicted with a disease, a perception that might serve the purpose of keeping a threatening self-image out of consciousness.

Aged↗
PubMed1998

Loyalty conflicts in medical practice. A comparative study of general practitioners', paediatricians' and gynaecologists' assessments of three cases.

OBJECTIVE: To shed light on attitudes towards loyalty conflicts among general practitioners (GPs) compared with related specialists such as gynaecologists and paediatricians. DESIGN: A postal questionnaire containing three case histories with arguments for and against different ways of acting in loyalty conflicts. The medical problems of the clinical cases varied, but the ethical ones were in principle similar. SETTING: A random sample of all Swedish GPs, gynaecologists, and paediatricians. SUBJECTS: GPs (n = 313), paediatricians (n = 197), and gynaecologists (n = 236). RESULTS: On average 71% of the doctors replied. The gynaecologists differed from the other groups by being markedly loyal to the individual patient especially in one case. The paediatricians tended to reply most consistently and they seemed to favour the family perspective, compared with the other doctors. The GPs' response pattern fell in between the other two groups. CONCLUSIONS: The study indicates that ethical reasoning depends on the doctors' different medical background with regard to specialty. This study should be followed by others in order to give further explanation of the findings.

Adult↗
PubMed1998

Doctors' attitudes to fibromyalgia: a phenomenological study.

Besides specific technical skills, successful encounters with patients require an understanding of the many ways in which patients may express themselves. This qualitative study reports on the clinical experiences of doctors when meeting patients with fibromyalgia (FM). Ten strategically chosen rheumatologists and 10 GPs in central Sweden were interviewed. The interviews were taped, transcribed and analysed in accordance with the empirical, phenomenological, psychological method. The analyses indicate that doctors try to comply with the wishes and demands of patients, and at the same time avoid perceptions of personal frustration. They are inclined to be objective and to act instrumentally, apparently in order to keep in touch with what gave biomedical meaning to an otherwise incomprehensible phenomenon. The meaning structures revealed by doctors' descriptions of FM and of relating to FM patients were characterized mainly by the way in which the doctors were (i) managing their clinical uncertainty, (ii) adhering to the biomedical paradigm, (iii) prioritizing diagnostics, (iv) establishing an instrumental relationship, and (v) avoiding recognizing FM as a possible biomedical anomaly.

Adult↗
PubMed1997

The importance of the time factor in fire and rescue service operations in Sweden.

The aim of the paper is to measure the benefits and costs for the society if the fire and rescue service is delayed by 5 and 10 min respectively. A 5 min longer turn-out time is often the difference between a full-time and a voluntary crew. A 10 min difference may represent what happens if a voluntary crew on the outskirts of the municipality is closed down and their services are taken over by the centrally located full-time staff. In Sweden a full-time staff costs USD 180,000 more per year and man on duty. When it comes to the costs of a longer turn-out time three items dominates: fires in buildings; road transport accidents; and drowning cases. These three account for 38% of the alarms but 97% of the damage increase if the rescue operation is delayed, whether it is for 5 or 10 min. For all these three items we have carried out calculations based on our own empirical material. To be allowed to fight fires using breathing apparatus Swedish legislation requires a minimum crew of five. For a municipality in Sweden with the average number and distribution of alarms a full time crew of five is not economically justifiable until it reaches a population of 30,000.

Accidents↗
PubMed1997

Neural grafting to experimental neocortical infarcts improves behavioral outcome and reduces thalamic atrophy in rats housed in enriched but not in standard environments.

BACKGROUND AND PURPOSE: The purpose of this study was to evaluate whether grafting of fetal neocortical tissue 1 week after focal brain ischemia improved behavioral outcome and reduced secondary thalamic atrophy. METHODS: One week after distal ligation of the right middle cerebral artery in spontaneously hypertensive male rats, blocks of fetal neocortex (embryonic day 17) were homografted to rats housed in standard or enriched environments. Control infarcted nongrafted rats were housed in the enriched environment. Behavioral outcome was repeatedly tested until the rats were killed 20 weeks after the ligation. Ten days earlier, a mixture of 2% Fluoro-Gold and 10% biotinylated dextran amine was injected into the transplants for retrograde and anterograde tracing of graft-host connections. RESULTS: Grafted and nongrafted rats with enriched housing performed significantly better than grafted rats with standard housing on a rotating pole and a prehensile traction test. Grafted "enriched" rats were moreover significantly better than grafted "standard" rats and nongrafted enriched rats in a rotation test and a postural and locomotor tail position test. In the latter test, nongrafted enriched rats performed significantly better than grafted standard rats. The lesion-induced atrophy in posterior thalamus with its major sensorimotor cortex relay nuclei was significantly reduced in grafted enriched rats compared with nongrafted enriched rats. Afferent and efferent graft-host connections were identified in both grafted groups. Graft volumes did not differ. CONCLUSIONS: Neural grafting enhanced functional outcome and reduced thalamic atrophy only when combined with housing in enriched environments.

Animals↗
PubMed1995

Influence of an enriched environment and cortical grafting on functional outcome in brain infarcts of adult rats.

The purpose of this work was to study if enriched housing conditions and fetal neocortical transplantation could enhance the functional outcome after focal brain ischemia in adult rats. The right middle cerebral artery (MCA) was ligated in 34 inbred, spontaneously hypertensive male rats, which were then randomly divided into three groups. Groups A and B were transferred to an enriched environment, i.e., a large cage with opportunities for various activities but not forcing the rats to do any particular tasks; group C was kept in standard laboratory cages. Three weeks after the MCA occlusion blocks of fetal neocortical tissue (Embryonic Day 17) were transplanted to the infarct cavity in groups B and C. Rats in group A (n = 11) and group B (n = 11) performed equally well and significantly better than rats in group C (n = 10) when placed on an inclined plane and when traversing a rotating pole 6 and 9 weeks after the MCA occlusion and in a leg placement test at 9, but not 6 and 12 weeks. Skilled forelimb function did not differ between the groups. Infarct size and thalamic atrophy did not differ between the groups and graft size was similar in group B and C. There was no correlation between infarct size and motor function in any of the tests in rats housed in an enriched environment. Since the environment can significantly alter functional outcome without reducing infarct size we suggest that more attention should be given to the role of the laboratory environment and to long term behavioral outcome in experimental stroke.

Animals↗
PubMed1995

Patients with dementia in group living: experiences 4 years after admission.

Sixteen patients with dementia were studied 4 years after admission to group-living (GL) units, an intermediate level of dementia care. Of eight patients who were still alive, four lived in the GL units and four had been institutionalized. The eight patients who had died had spent 89% of their survival time in GL. Aggression was the most frequent cause of institutionalization.

Activities of Daily Living↗
PubMed1995

Patients frequently consulting general practitioners at a primary health care centre in Sweden--a comparative study.

The purpose of this study was to describe the sociodemographic patterns, consultations and the nature of problems of frequent attenders (FAs) at general practitioners at a primary health care centre. The design was a comparative study of FAs (> or = 5 consultations during 1991) (n = 179) and a contrast group of patients (CPs) matched by age and sex (1-4 consultations during 1991, n = 179). Data from medical records, appointment system, mortality and marital status were recorded. FAs comprised 1.7% of the inhabitants. Boys, middle-aged females, retired males and females and especially very old females were more frequent among FAs than their sections of the population would imply. FAs accounted for 15% and CPs for 4% of the consultations, 6.3 and 1.7 consultations on average, respectively. The average booked time for consultations during 1991 was 140 minutes for FAs and 35 minutes for CPs. Continuity was higher among older than younger FAs. Contacts other than medical consultations comprised a substantial part of the work with FAs, especially among middle-aged and elderly FAs. Problems arising from the musculoskeletal system, psychological and social problems were most common among FAs, often in combination, while chronic diseases such as cardiovascular diseases and diabetes were not crucial for frequent attending. Few FAs consulted as frequently in the preceding years and the following year, as in 1991, but still they accounted for more consultations than CPs during these years. More female FAs than males and CPs were divorced. The study indicates that FAs require a long-term strategy where continuity and accessibility are often important. They might also have profited by more time. However, FAs were a heterogeneous group of patients and follow-up studies and individual studies of FAs would be of interest.

Adolescent↗