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Biomedical subjects

L Jacobsson

Publications and source records attributed to L Jacobsson.

At least 73 records · Page 4Linked to original sources

The male partner involved in legal abortion.

This study comprises 75 men who have been involved in legal abortion. The men answered a questionnaire concerning living conditions and attitudes about pregnancy and abortion. Most men were found to be in stable relationships with good finances. More than half clearly stated that they wanted the woman to have an abortion while 20 stressed that they submitted themselves to their partner's decision. Only one man wanted the woman to complete the pregnancy. Apart from wanting children within functioning family units, the motivation for abortion revealed that the desire to have children depended on the ability to provide qualitatively good parenting. More than half the men had discussed with their partner what to do in event of pregnancy and half had decided to have an abortion if a pregnancy occurred. More than half expressed ambivalent feelings about the coming abortion, using words such as anxiety, responsibility, guilt, relief and grief. In spite of these contradictory feelings, prevailing expectations concerning lifestyle make abortion an acceptable form of birth control. A deeper understanding of the complexity of legal abortion makes it necessary to accept the role of paradox, which the ambivalence reflects. Obviously, men must constitute a target group in efforts to prevent abortions.

Abortion, Legal↗

Extra-articular rheumatoid arthritis: prevalence and mortality.

OBJECTIVE: The prevalence and distribution of extra-articular manifestations of rheumatoid arthritis (ExRA) and associated mortality were studied retrospectively in a cohort of RA patients admitted to University Hospital, Malmö, Sweden, during the period 1990-94. RESULTS: Of 489 patients who fulfilled the 1987 ACR criteria for RA, 37 manifested onset of ExRA, predominantly serositis and cutaneous vasculitis, during the period, corresponding to a cumulative incidence of 7.9%. The occurrence of ExRA was independent of disease stage. Among patients with ExRA, 1 death/4.3 person-years at risk (pyr) occurred, as compared with 1 death/11.4 pyr in the non-ExRA subgroup. The age- and sex-adjusted mortality rate ratio was 2.49 (95% confidence interval 1.43-4.03). The major cause of death among ExRA cases was heart disease, which occurred in 9/13 cases (69%) in comparison to the expected 2.4 cases. CONCLUSION: In this series, serositis and cutaneous vasculitis were predominant extra-articular manifestations of RA; and mortality was greater in the ExRA than in the non-ExRA subgroup, perhaps due to a high frequency of associated heart disease.

Adolescent↗

Administered activity of 99Tcm-MAG3 for gamma camera renography in children.

A method of calculating the activity of 99Tcm-MAG3 to be administered to children of different ages has been developed and evaluated. The suggested administered activity schedule is only valid for estimation of split renal function. The activity required to obtain the same count rate over the kidneys for all ages was calculated as a fraction of the activity administered to an adult by using a biokinetic model and taking attenuation effects into account. The activity schedule is based on the age of the child and was tested using renograms from patients of different ages. Statistical noise was added to the smoothed renograms simulating an injected activity corresponding to 45 MBq for an adult. The precision in the determination of split renal function calculated with four different methods was determined for 500 simulated renograms. The precision was approximately the same for all ages, but varied with the method used. The activity to be administered to a very small child is 90% of the adult activity, decreases to less than 50% between 2 and 5 years of age, and then slowly increases to 100% as the child grows to adulthood.

Adolescent↗

How are mental disorders seen and where is help sought in a rural Ethiopian community? A key informant study in Butajira, Ethiopia.

One hundred key informants were interviewed about their awareness, attitudes and practices regarding mental illness using the Key Informant Questionnaire developed by WHO. Case vignettes of seven common neuropsychiatric disorders were presented to the key informants. Informants' awareness about these disorders and help-seeking practices for mental and physical symptoms or conditions were assessed. An additional question on the prototype symptoms of mental disorders was also posed. Among the presented seven conditions, epilepsy was perceived as the most common condition and major depression was regarded as the least common one. Schizophrenia was judged as the most severe problem, and mental retardation was considered the second most severe condition. Talkativeness, aggression and strange behaviour were the most frequently perceived prototype symptoms of mental illness. Traditional treatment methods were preferred more often for treating symptoms of mental disorders and modern medicine was preferred more often for treating physical diseases or symptoms. Findings of this study are similar to other studies conducted in socio-culturally different communities. Working in close connection with traditional healers would give the primary health care worker a better opportunity to gain acceptance from the community and modify certain harmful practices.

Adult↗

The prevalence and socio-demographic correlates of mental distress in Butajira, Ethiopia.

A cross-sectional survey was conducted on 10,468 rural and semi-urban adults in an Ethiopian district using the Self Reporting Questionnaire (SRQ) to detect the prevalence of mental distress and its association with socio-demographic risk factors. Fifty-eight per cent of the study population were women, 74% were Muslim, 79% were illiterate. Those experiencing 11 or more symptoms out of the 20 SRQ items were considered as having mental distress. Accordingly, the prevalence of mental distress was 17%, which is comparable with the previous hospital-based studies in Ethiopia and elsewhere. However, it was higher than the previous community-based studies in Ethiopia. Mental distress was more prevalent among women. Part of the explanation was that women in the study population were older and that they were more often widowed or divorced, which were factors associated with mental distress. Illiteracy, which was more common among women and older individuals, was also independently associated with mental distress.

Adolescent↗

Awareness and attitudes of a rural Ethiopian community toward suicidal behaviour. A key informant study in Butajira, Ethiopia.

One hundred key informants were interviewed regarding their awareness and attitudes toward suicidal behaviour. Eighty-eight informants were male, 58 were Muslim and 42 were Christian. Informants on average, claimed to know more persons who had completed suicide than those who had attempted suicide. Almost all informants mentioned more than one cause for suicide. Of these, frustration was the most frequently mentioned cause. Most informants believed that suicide attempters are cruel, feared and not trustworthy. Their attitude toward suicide completers was expressed as condemned sinners, do not deserve funeral ceremony, and should be buried separately from others. Christians gave importance to the funeral issue more than did the Muslims. Generally, the attitudes of informants were punitive and disapproving.

Adult↗

Suicide attempts among adults in Butajira, Ethiopia.

In a cross-sectional survey, 10,468 adults of a rural and semi-urban community were interviewed to determine lifetime suicide attempts. Among the study population, 58% were female, 74.4% were Muslim and 79.3% had had no formal education. The majority of the population were in the age group 25-59 years. Lifetime suicide attempt was reported by 3.2% (n = 332) of the study population. Of these, 63% (n = 208) were women. The most frequent age of attempt was between 15 and 24 years and the frequency of attempt decreased with increasing age. Hanging and poisoning were the most frequently reported methods of attempting suicide. Marital or family conflict was the most frequently reported cause for attempting suicide and most of those who reported this cause were women (Chi-square = 17.42; P < 0.001). Men were significantly more likely to use hanging to attempt suicide than women (Chi-square = 8.21; P < 0.001). Among Christians 3.9% had a lifetime suicide attempt compared to 2.9% among Muslims (Chi-square = 6.15; P < 0.05). People who currently had mental distress and problem drinking reported lifetime suicide attempt more often than others.

Adolescent↗

Fraud, misconduct or normal science in medical research--an empirical study of demarcation.

OBJECTIVES: To study and describe how a group of senior researchers and a group of postgraduate students perceived the so-called "grey zone" between normal scientific practice and obvious misconduct. DESIGN: A questionnaire concerning various practices including dishonesty and obvious misconduct. The answers were obtained by means of a visual analogue scale (VAS). The central (two quarters) of the VAS were designated as a grey zone. SETTING: A Swedish medical faculty. SURVEY SAMPLE: 30 senior researchers and 30 postgraduate students. RESULTS: Twenty of the senior researchers and 25 of the postgraduate students answered the questionnaire. In five cases out of 14 the senior researchers' median was found to be clearly within the interval of the grey zone, compared with three cases for the postgraduate students. Three examples of experienced misconduct were provided. Compared with postgraduate students, established researchers do not call for more research ethical guidelines and restrictions. CONCLUSION: Although the results indicate that consensus exists regarding certain obvious types of misconduct the response pattern also indicates that there is no general consensus on several procedures.

Attitude of Health Personnel↗

Research ethics committees: a comparative study of assessment of ethical dilemmas.

Research ethics committees (REC) constitute an important instrument for the regulation of biomedical research involving human beings. The purposes of this work were to study the ethical reasoning in RECs and to ascertain whether the composition of RECs has any bearing on the decisions subsequently made by them. We used a postal questionnaire, containing authentic cases of research ethical dilemmas, sent to the ten RECs in Sweden (n = 124) and to comparison groups consisting of 200 randomly selected medical researchers, 200 randomly selected healthcare politicians and 200 randomly selected district nurses. The average response rate was 68%. A difference was found in how REC members assess a project in comparison with researchers, healthcare politicians and district nurses. Differences depended on the type of project assessed. The study indicates that membership in RECs may exert a normative influence on its members. It is proposed that this investigation should be followed up by a study with a qualitative design.

Adult↗

The transition from mental hospital based to community based psychiatry.

The reformation of psychiatry has been a central topic in health planning and care in most industrialized countries during the last decades. A short review of the political, professional and other forces behind this development is done. A short history of the development in Sweden is given as an example of the general tendencies in this change and the actors involved. There is now a rapidly growing scientific basis for the psychiatric service with a definite shift into a community based orientation. It is concluded that early intervention and prevention will be in focus for the development during the next decades.

Community Mental Health Services↗

On suicide and suicide prevention as a public health issue.

Suicide is becoming one of the major causes of death especially amongst men. In Europe suicide is the second most common cause of death in the ages of 15-44 years. For women in the same age group suicide is the fourth most common cause of death. Suicide causes a lot of suffering not only in the victim but also in persons close to him. As the causative factors are complex, and suicide also costs the community a lot of money suicide and self destructive behavior must be considered an important public health issue. A couple of models which are helpful when trying to develop treatment and preventive strategies for suicided persons are presented. The basic principles for contemporary suicide prevention programmes are also described.

Adolescent↗

Identification of rat susceptibility loci for adjuvant-oil-induced arthritis.

One intradermal injection of incomplete Freund's adjuvant-oil induces a T cell-mediated inflammatory joint disease in DA rats. Susceptibility genes for oil-induced arthritis (OIA) are located both within and outside the major histocompatibility complex (MHC, Oia1). We have searched for disease-linked non-MHC loci in an F2 intercross between DA rats and MHC-identical but arthritis-resistant LEW.1AV1 rats. A genome-wide scan with microsatellite markers revealed two major chromosome regions that control disease incidence and severity: Oia2 on chromosome 4 (P = 4 x 10(-13)) and Oia3 on chromosome 10 (P = 1 x 10(-6)). All animals homozygous for DA alleles at both loci developed severe arthritis, whereas all those homozygous for LEW.1AV1 alleles were resistant. These results have general implications for situations where nonspecific activation of the immune system (e.g., incomplete Freund's adjuvant-oil) causes inflammation and disease, either alone or in conjunction with specific antigens. They may also provide clues to the etiology of inflammatory diseases in humans, including rheumatoid arthritis.

Animals↗

Chloramine-T in high-specific-activity radioiodination of antibodies using N-succinimidyl-3-(trimethylstannyl)benzoate as an intermediate.

Monoclonal antibodies C215 and MOv18 have been radiohalogenated, using a single-batch method employing N-succinimidyl-3-(trimethylstannyl)benzoate, m-MeATE. Labelling to the stannyl ester was optimized using chloramine-T as oxidizing agent. The results show that the stannyl ester is effectively labelled with short reaction times giving reproducible yields from 85% to 95%. Subsequent antibody conjugation, 10 to 80 microg MAb, resulted in biologically active, labelled antibodies with overall radiochemical yields of 50% to 80%, with corresponding specific activities of 490-50 kBq(125I)/microg.

Antibodies↗

When others decide: reasons for allowing patients with Alzheimer's disease to participate in nontherapeutic research.

The quality of information given to family members of patients with Alzheimer's disease was studied. The patients had participated in a pharmacological investigation. The relatives were generally satisfied with the information given, and perceived it as adequate. The reasons given for allowing the patients to participate in the investigation were mainly altruistic.

Aged↗

Nurses' narratives about using coercion in psychiatric care.

To illuminate nurses' experience of using coercion against psychiatric patients, a phenomenological hermeneutic study was conducted with seven registered nurses and seven enrolled mental nurses. The findings revealed that these nurses desired to be seen by themselves, their co-workers and patients as doing good, being good and providing good care but they experienced the use of coercion as not good. This conflict made it difficult for these nurses to question the use of coercion and consider alternative solutions. The theory of change by Watzlawick et al. (1974) served as a theoretical framework for the interpretation of all interviews regarded as one text. In order to explore alternatives to the use of coercion in psychiatric care, nurses need assistance to step outside the traditional way of regarding coercion in psychiatric care and seek to create new solutions.

Adult↗