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Biomedical subjects

P Rosén

Publications and source records attributed to P Rosén.

8 recordsLinked to original sources
PubMed2001

Patient views on choice and participation in primary health care.

Within modern health care, much attention is given to the tasks of identifying patient preferences and then delivering health care services accordingly. Standardised solutions are not always acceptable to patients with divergent needs and preferences, and the growing number of treatment alternatives makes patient participation increasingly important. In order to identify individual preferences for choice and shared decision making, a survey was conducted among 1543 primary care patients in Sweden. As suggested by earlier work, special attention was paid to the strong link between patient preferences and age. Results show both similarities and differences in attitudes among young and old patient groups, and differences could be explained by a combination of life-cycle effects, cohort effects and expectations ensuing from the need for future health care contacts.

Adolescent↗
PubMed1998

IL-1beta, IL-6, TNFalpha, fetal fibronectin, and endotoxin in the lower genital tract of pregnant women with bacterial vaginosis.

BACKGROUND: In our studies on women with bacterial vaginosis (BV) in early pregnancy a strong association has been found between BV and the levels of endotoxin or interleukin-1alpha (IL-1alpha) in the lower genital tract. In the present study we investigated if an association could be found between BV and other cytokines (IL-1beta, IL-6, tumor necrosis factor alpha, TNF) or fetal fibronectin (FFN). The cytokine-inducing capacity of endotoxins present in the cervical mucus was explored in a monocytic cell assay. METHODS: Cervical mucus or cervicovaginal fluid was collected from women with (BV) and without BV (nonBV) attending a family planning unit for first trimester abortion. The concentrations of IL-1beta, IL-6, TNF and FFN were determined by quantitative enzyme immunoassays. TNF was determined in 63 women (BV, n=25) out of whom 37 (BV, n=11) were analyzed for IL-1beta and the remaining 26 for IL-6 (BV, n=14). FFN was determined in another 36 women (BV, n= 19). The cytokine-inducing capacity of endotoxin-containing cervical mucus and purified endotoxin of Prevotella bivia were studied by an in vitro cell assay using a human monocytic cell line (THP-1). RESULTS: IL-lbeta and IL-6 were found in almost all women. The levels of IL-1beta, but not IL-6, TNF or FFN, were significantly increased in women with BV compared with the nonBV women (p<0.05). Purified endotoxin from P. bivia, and cervical mucus from BV women containing high levels of endotoxin were able to induce a cytokine response (IL-6) in monocytic cells in vitro. CONCLUSION: BV is associated with increased levels of IL-1beta in the lower genital tract of pregnant women in the first trimester. The ability of BV-associated endotoxins to induce cytokine production in monocytic cells may partly explain the increased IL-1beta levels.

Adult↗
PubMed1997

Choice and participation in the health services: a survey of preferences among Swedish residents.

Extending the possibilities for health-service consumers to choose among providers has been an important objective on the political agenda in Sweden and elsewhere. Little is known, however, about individual and group preferences concerning the demand for choices. It is often implicitly assumed that individuals can be treated as a group with similar values and demands, but is this true? To what extent do individuals want more options in health care? Do preferences vary depending on age, education and place of living? This article explores these questions, starting from a survey of 2,000 residents in four Swedish counties. The results of the survey point to many similarities, but also indicate important differences among residents. In particular, preferences seem to vary significantly depending on age and level of education. On the other hand, older people are more favourably inclined towards the free choice of physician. On the other hand, members of the younger generation, as well as well-educated residents, demand a more active part in the process of medical decision making. These differences, as well as expectations from younger generations, pose a great challenge to the future management of health services.

Choice Behavior↗
PubMed1993

Setting health care priorities in Sweden: the politician's point of view.

In this report, the results of interviews with sixty local health care politicians in southern Sweden will be presented. It is evident from the material that despite their formal responsibility, the politicians are of the opinion that other actors exert greater influence upon the allocation of resources. They do not think that health care expenditure need be extended, whereas fields such as care of the elderly and preventive medicine ought to receive extended contributions at the expense of other publicly financed activities such as general mammography and in vitro fertilization. Somewhat more than a third of the politicians hold that the goal stipulated in the Swedish Health Care Act, i.e. to provide good health and care on equal terms, has not been fulfilled. Their attitudes towards priority criteria such as personal responsibility, age, life expectancy, parenthood and productivity differ from case to case, and there is no clear-cut consensus. However, approximately half of the respondents agree wholly or partly that a person who promises to alter his or her unhealthy habits should be treated before someone who does not make such a promise. The same applies to the principle that those employed ought to be given priority in operating queues, and in consequence of this utility perspective there are also increased demands upon the physicians to take economy into consideration in treating an individual patient.

Attitude to Health↗