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  • 301.
    Hamberg, Katarina
    et al.
    Umeå University, Faculty of Medicine, Public Health and Clinical Medicine, Family Medicine.
    Johansson, Eva
    Mattsson, B
    [The picture of the psychiatrist should be more nuanced. General practitioners react to articles on depression in primary health care]1998In: Lakartidningen, ISSN 0023-7205, Vol. 95, no 12, p. 1291-2, 1295; discussion 1295Article in journal (Other academic)
  • 302.
    Hamberg, Katarina
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Naredi, Peter
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Surgery.
    Genusperspektiv i kirurgi2010In: Kirurgi / [ed] Bengt Jeppsson, Peter Naredi, Jörgen Nordenström, Bo Risberg, Studentlitteratur , 2010, p. 195-210Chapter in book (Other academic)
  • 303.
    Hamberg, Katarina
    et al.
    Umeå University, Faculty of Medicine, Public Health and Clinical Medicine, Family Medicine.
    Nordlund, C
    risk för könsstereotypa idéer. Om vikten av att granska forskning kring biologiska könsskillnader.2004Collection (editor) (Other (popular science, discussion, etc.))
  • 304.
    Hamberg, Katarina
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Phillips, Susan P
    Queens University, Department of Family Medicine and Public Health Sciencies, Kingstone, Ontario, Canada.
    Sex or gender? Conceptual confusion is common.2015In: Hypertension News. Web Journal for International Society of Hypertension., no 12, p. 13-14Article in journal (Other academic)
    Abstract [en]

    When researchers study sex or gender differences in health outcomes they often find significant disparities. But what do sex or gender actually mean and measure? The simplest answer is to consider that all subjects are either women or men and to group them accordingly. Historically differences between the women and men were thought to arise from biology, reproductive organs, hormones or biological processes. This is what the term 'sex' generally means. The division between sex and gender in social science research developed in the 1960s. The split highlighted the need to move beyond a narrow focus on biology and recognize that socioeconomic conditions and cultural norms also shape and constrain education, career choices, salaries, and health. The term, gender refers to social aspects of being a man and woman, features that are formed in relation to upbringing, conditions in daily life, norms and culture.

  • 305.
    Hamberg, Katarina
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Risberg, Gunilla
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Johansson, Eva
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Male and female physicians show different patterns of gender bias: a paper-case study of management of irritable bowel syndrome.2004In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 32, no 2, p. 144-152Article in journal (Refereed)
    Abstract [en]

    AIMS: Research has raised concerns about gender bias in medicine, i.e. that men and women might be treated differently due to gender-stereotyped attitudes among physicians. The authors investigated gender differences in medical management of a common health problem, irritable bowel syndrome (IBS). METHOD: In a national examination for Swedish house officers, the examinees were allocated to suggest management of IBS in either a male or female paper-patient. The case description was identical in both genders with the exception of prior prostate and gynaecological symptoms. The open answers were coded for analysis. A total of 289 physicians (45% women) participated. Chi-squared tests were used to measure differences in proportions. RESULTS: In variables focusing on medication, weight, gynaecological problems, tobacco, alcohol, thyroid function, proposed diagnoses, X-ray of the colon, and advice about lifestyle, significant or close to significant gender differences were seen. Both male and female physicians made gender differences but they did not show the same pattern of differences. CONCLUSIONS: The results suggest that gender bias is involved in medical management of IBS but men and women physicians may show disparate patterns of gender bias. There is a need for larger studies on gender differences in medical management with designs making it possible to consider the gender of both the patient and the physician. Furthermore, the results call attention to 'knowledge-mediated gender bias', a phenomenon implying that once knowledge about gender differences in a condition has been established, this might in fact cause gender-biased assessments of individual patients in clinical practice.

  • 306.
    Hamberg, Katarina
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Risberg, Gunilla
    Johansson, Eva
    Westman, Göran
    Gender bias in physicians' management of neck pain: a study of the answers in a Swedish national examination.2002In: J Womens Health Gend Based Med, ISSN 1524-6094, Vol. 11, no 7, p. 653-66Article in journal (Refereed)
  • 307. Hamblin, Lydia E.
    et al.
    Essenmacher, Lynnette
    Luborsky, Mark
    Russell, Jim
    Janisse, James
    Upfal, Mark
    Arnetz, Judith
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine. Michigan State Univ, Dept Family Med, E Lansing, MI 48824 USA; Uppsala Univ, Dept Publ Hlth & Caring Sci, Uppsala, Sweden.
    Worksite Walkthrough Intervention Data-driven Prevention of Workplace Violence on Hospital Units2017In: Journal of Occupational and Environmental Medicine, ISSN 1076-2752, E-ISSN 1536-5948, Vol. 59, no 9, p. 875-884Article in journal (Refereed)
    Abstract [en]

    Objective: The aim of this study was to describe the implementation of a data-driven, unit-based walkthrough intervention shown to be effective in reducing the risk of workplace violence in hospitals. Methods: A structured worksite walkthrough was conducted on 21 hospital units. Unit-level workplace violence data were reviewed and a checklist of possible prevention strategies and an Action Plan form guided development of unit-specific intervention. Unit supervisor perceptions of the walkthrough and implemented prevention strategies were reported via questionnaires. Prevention strategies were categorized as environmental, behavioral, or administrative. Results: A majority of units implemented strategies within 12 months' postintervention. Participants found the walkthrough useful, practical, and worthy of continued use. Conclusions: Structured worksite walkthroughs provide a feasible method for workplace violence reduction in hospitals. Core elements are standardized yet flexible, promoting fidelity and transferability of this intervention.

  • 308.
    Hammarström, Anne
    Umeå University, Faculty of Medicine, Public Health and Clinical Medicine, Family Medicine.
    A gender perspective on public health politics.: In the Swedish National Institute of Public Health: Report on Public Health Policy.2005Report (Other (popular science, discussion, etc.))
  • 309.
    Hammarström, Anne
    Umeå University, Faculty of Medicine, Public Health and Clinical Medicine, Family Medicine.
    A Tool for Developing Gender Research in Medicine: Examples from the Medical Literature on Work Life.2007In: Gender Medicine, ISSN 1550-8579, Vol. 4S2, p. S123-S132Article in journal (Refereed)
  • 310.
    Hammarström, Anne
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Det behövs tillämpad genusforskning inom folkhälsoområdet!2008In: Socialmedicinsk Tidskrift, ISSN 0037-833X, Vol. 385, no 3, p. 191-193Article in journal (Other academic)
  • 311.
    Hammarström, Anne
    Umeå University, Faculty of Medicine, Public Health and Clinical Medicine, Family Medicine.
    Gender perspective on medicine - 20 years´development of awareness about sex and gender within medicine.2005Report (Other (popular science, discussion, etc.))
  • 312.
    Hammarström, Anne
    Umeå University, Faculty of Medicine, Public Health and Clinical Medicine, Family Medicine.
    I spänningsfälten mellan biologi och kultur - en vetenskapsanalys av könskonstruktoner vid depression.2004In: Teori- och begreppsutveckling inom medicinsk genusforskning.: Rapport från en workshop., Stockholm: Vetnskapsrådet , 2004Chapter in book (Other (popular science, discussion, etc.))
  • 313.
    Hammarström, Anne
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    In the tension fields between biology and culture: analyses of science of gendered constructions of depression2004In: Development of concepts and theory within medical gender research. Report from a workshop., 2004Chapter in book (Other academic)
  • 314.
    Hammarström, Anne
    Umeå University, Faculty of Medicine, Public Health and Clinical Medicine, Family Medicine.
    Public Health questions from a gender perspective: labour market, masculinities and gender-relatd violence.2008Report (Other (popular science, discussion, etc.))
  • 315.
    Hammarström, Anne
    Umeå University, Faculty of Medicine, Public Health and Clinical Medicine, Family Medicine.
    Which is the difference between gender research and research about gender differences?2004In: Body, gender and medicine., Lund: Studentlitteratur , 2004, p. 79-86Chapter in book (Other (popular science, discussion, etc.))
  • 316.
    Hammarström, Anne
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Annandale, Ellen
    A Conceptual Muddle: An Empirical Analysis of the Use of 'Sex' and 'Gender' in 'Gender-Specific Medicine' Journals2012In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 7, no 4, p. e34193-Article in journal (Refereed)
    Abstract [en]

    Background: At the same time as there is increasing awareness in medicine of the risks of exaggerating differences between men and women, there is a growing professional movement of 'gender-specific medicine' which is directed towards analysing 'sex' and 'gender' differences. The aim of this article is to empirically explore how the concepts of 'sex' and 'gender' are used in the new field of 'gender-specific medicine', as reflected in two medical journals which are foundational to this relatively new field. Method and Principal Findings: The data consist of all articles from the first issue of each journal in 2004 and an issue published three years later (n = 43). In addition, all editorials over this period were included (n = 61). Quantitative and qualitative content analyses were undertaken by the authors. Less than half of the 104 papers used the concepts of 'sex' and 'gender'. Less than 1 in 10 papers attempted any definition of the concepts. Overall, the given definitions were simple, unspecific and created dualisms between men and women. Almost all papers which used the two concepts did so interchangeably, with any possible interplay between 'sex' and gender' referred to only in six of the papers. Conclusion: The use of the concepts of 'sex' and gender' in 'gender-specific medicine' is conceptually muddled. The simple, dualistic and individualised use of these concepts increases the risk of essentialism and reductivist thinking. It therefore highlights the need to clarify the use of the terms 'sex' and 'gender' in medical research and to develop more effective ways of conceptualising the interplay between 'sex' and 'gender' in relation to different diseases.

  • 317.
    Hammarström, Anne
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine. Umeå University, Faculty of Social Sciences, Umeå Centre for Gender Studies (UCGS).
    Fjellman-Wiklund, Anncristine
    Umeå University, Faculty of Social Sciences, Umeå Centre for Gender Studies (UCGS). Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Lindahl, Bernt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Larsson, Christel
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition. Department of Food and Nutrition, and Sport Science, University of Gothenburg, Sweden.
    Ahlgren, Christina
    Umeå University, Faculty of Social Sciences, Umeå Centre for Gender Studies (UCGS). Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Experiences of barriers and facilitators to weight-loss in a diet intervention: a qualitative study of women in Northern Sweden2014In: BMC Women's Health, ISSN 1472-6874, E-ISSN 1472-6874, Vol. 14, p. 59-Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: There is a lack of research about the experiences of participating in weight-reducing interventions. The aim of this study was to explore barriers and facilitators to weight-loss experienced by participants in a diet intervention for middle-aged to older women in the general population in Northern Sweden.

    METHOD: In the intervention the women were randomised to eat either a Palaeolithic-type diet or a diet according to Nordic Nutrition recommendations for 24 months. A strategic selection was made of women from the two intervention groups as well as from the drop-outs in relation to social class, civil status and age. Thematic structured interviews were performed with twelve women and analysed with qualitative content analyses.

    RESULTS: The results showed that the women in the dietary intervention experienced two main barriers - struggling with self (related to difficulties in changing food habits, health problems, lack of self-control and insecurity) and struggling with implementing the diet (related to social relations and project-related difficulties) - and two main facilitators- striving for self-determination (related to having clear goals) and receiving support (from family/friends as well as from the project) - for weight-loss. There was a greater emphasis on barriers than on facilitators.

    CONCLUSION: It is important to also include drop-outs from diet interventions in order to fully understand barriers to weight-loss. A gender-relational approach can bring new insights into understanding experiences of barriers to weight-loss.

  • 318.
    Hammarström, Anne
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Gustafsson, Per E
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Strandh, Mattias
    Umeå University, Faculty of Social Sciences, Department of Sociology.
    Virtanen, Pekka
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Janlert, Urban
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    It´s no surprise! Men are not hit more than women by the health consequences of unemployment in the Northern Swedish Cohort2011In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 39, no 2, p. 187-193Article in journal (Refereed)
    Abstract [en]

    Aims: Research often fails to ascertain whether men and women are equally hit by the health consequences of unemployment. The aim of this study was to analyze whether men’s self-reported health and health behaviour were hit more by unemployment than women’s in a follow-up of the Northern Swedish Cohort.

    Methods: A follow-up study of a cohort of all school leavers in a middle-sized industrial town in northern Sweden was performed from age 16 to age 42. Of those still alive of the original cohort, 94% (n = 1,006) participated during the whole period. A sample was made of participants in the labour force and living in Sweden (n = 916). Register data were used to assess the length of unemployment from age 40 to 42, while questionnaire data were used for the other variables.

    Results: In multivariate logistic regression analyses significant relations between unemployment and mental health/smoking were found among both women and men, even after control for unemployment at the time of the investigation and indicators of health-related selection. Significant relations between unemployment and alcohol consumption were found among women, while few visits to a dentist was significant among men.

    Conclusions: Men are not hit more by the health consequences of unemployment in a Swedish context, with a high participation rate of women in the labour market. The public health relevance is that the study indicates the need to take gendered contexts into account in public health research.

  • 319.
    Hammarström, Anne
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Haukenes, Inger
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Fjellman Wiklund, Anncristine
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Lehti, Arja
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation. Umeå University, Faculty of Medicine, Department of Clinical Sciences, Professionell Development.
    Wiklund, Maria
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Evengard, Birgitta
    Umeå University, Faculty of Medicine, Department of Clinical Microbiology, Infectious Diseases.
    Stålnacke, Britt-Marie
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Rehabilitation Medicine.
    Low-Educated Women with Chronic Pain Were Less Often Selected to Multidisciplinary Rehabilitation Programs2014In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 9, no 5, article id e97134Article in journal (Refereed)
    Abstract [en]

    Background: There is a lack of research about a potential education-related bias in assessment of patients with chronic pain. The aim of this study was to analyze whether low-educated men and women with chronic pain were less often selected to multidisciplinary rehabilitation than those with high education. Methods: The population consisted of consecutive patients (n = 595 women, 266 men) referred during a three-year period from mainly primary health care centers for a multidisciplinary team assessment at a pain rehabilitation clinic at a university hospital in Northern Sweden. Patient data were collected from the Swedish Quality Registry for Pain Rehabilitation National Pain Register. The outcome variable was being selected by the multidisciplinary team assessment to a multidisciplinary rehabilitation program. The independent variables were: sex, age, born outside Sweden, education, pain severity as well as the hospital, anxiety and depression scale (HADS). Results: Low-educated women were less often selected to multidisciplinary rehabilitation programs than high-educated women (OR 0.55, CI 0.30-0.98), even after control for age, being born outside Sweden, pain intensity and HADS. No significant findings were found when comparing the results between high-and low-educated men. Conclusion: Our findings can be interpreted as possible discrimination against low-educated women with chronic pain in hospital referrals to pain rehabilitation. There is a need for more gender-theoretical research emphasizing the importance of taking several power dimensions into account when analyzing possible bias in health care.

  • 320.
    Hammarström, Anne
    et al.
    Umeå University, Faculty of Medicine, Public Health and Clinical Medicine, Family Medicine.
    Hensing, H
    Folkhälsofrågor ur ett genusperspektiv.: Arbetsmarknad, maskuliniteter, medikalisering och könsrelaterat våld.2008Report (Other (popular science, discussion, etc.))
  • 321.
    Hammarström, Anne
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Janlert, Urban
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences.
    An agenda for unemployment research: a challenge for public health.2005In: Int J Health Serv, ISSN 0020-7314, Vol. 35, no 4, p. 765-77Article in journal (Refereed)
  • 322.
    Hammarström, Anne
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Janlert, Urban
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Cohort Profile: The Northern Swedish Cohort2012In: International Journal of Epidemiology, ISSN 0300-5771, E-ISSN 1464-3685, Vol. 41, no 6, p. 1545-1552Article in journal (Refereed)
  • 323.
    Hammarström, Anne
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Janlert, Urban
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences.
    Do health consequences of unemployment differ among young men and women?2006In: Unemployment and health: International and interdisciplinary perspectives, Bowen Hills , 2006, p. 135-142Chapter in book (Other academic)
  • 324.
    Hammarström, Anne
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Janlert, Urban
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences.
    Health selection in a 14-year follow-up study--a question of gendered discrimination?2005In: Soc Sci Med, ISSN 0277-9536, Vol. 61, no 10, p. 2221-32Article in journal (Refereed)
  • 325.
    Hammarström, Anne
    et al.
    Umeå University, Faculty of Medicine, Public Health and Clinical Medicine, Family Medicine.
    Johansson, Eva
    Umeå University, Faculty of Medicine, Public Health and Clinical Medicine, Family Medicine.
    Genusvetenskapens utveckling inom medicinen.2002In: Genusvägar - antologi om genusforskning, Stockholm: Liber förlag , 2002Chapter in book (Other academic)
  • 326.
    Hammarström, Anne
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Johansson, Klara
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Annandale, Ellen
    Ahlgren, Christina
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Aléx, Lena
    Umeå University, Faculty of Medicine, Department of Nursing.
    Christianson, Monica
    Umeå University, Faculty of Medicine, Department of Nursing.
    Elwer, Sofia
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Eriksson, Carola
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Fjellman-Wiklund, Anncristine
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Gilenstam, Kajsa
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Gustafsson, Per E.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Harryson, Lisa
    Umeå University, Faculty of Social Sciences, Department of Sociology.
    Lehti, Arja
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Professionell Development.
    Stenberg, Gunilla
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Verdonk, Petra
    Central gender theoretical concepts in health research: the state of the art2014In: Journal of Epidemiology and Community Health, ISSN 0143-005X, E-ISSN 1470-2738, Vol. 68, no 2, p. 185-190Article in journal (Refereed)
    Abstract [en]

    Despite increasing awareness of the importance of gender perspectives in health science, there is conceptual confusion regarding the meaning and the use of central gender theoretical concepts. We argue that it is essential to clarify how central concepts are used within gender theory and how to apply them to health research. We identify six gender theoretical concepts as central and interlinked-but problematic and ambiguous in health science: sex, gender, intersectionality, embodiment, gender equity and gender equality. Our recommendations are that: the concepts sex and gender can benefit from a gender relational theoretical approach (ie, a focus on social processes and structures) but with additional attention to the interrelations between sex and gender; intersectionality should go beyond additive analyses to study complex intersections between the major factors which potentially influence health and ensure that gendered power relations and social context are included; we need to be aware of the various meanings given to embodiment, which achieve an integration of gender and health and attend to different levels of analyses to varying degrees; and appreciate that gender equality concerns absence of discrimination between women and men while gender equity focuses on women's and men's health needs, whether similar or different. We conclude that there is a constant need to justify and clarify our use of these concepts in order to advance gender theoretical development. Our analysis is an invitation for dialogue but also a call to make more effective use of the knowledge base which has already developed among gender theorists in health sciences in the manner proposed in this paper.

  • 327.
    Hammarström, Anne
    et al.
    Umeå University, Faculty of Medicine, Public Health and Clinical Medicine, Family Medicine.
    Månsdotter, A
    Varför behövs ett genusperspektiv inom folkhälsoområdet?2007In: Socialmedicinsk Tidskrift, ISSN 0037-833X, Vol. 3, p. 196-203Article in journal (Refereed)
    Abstract [en]

    Summary in English

  • 328.
    Hammarström, Anne
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Naredi, Peter
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Surgery.
    Dags att bryta den mansdominerade katedrala undervisningen2007In: Socialmedicinsk Tidskrift, ISSN 0037-833X, Vol. 84, no 6, p. 560-562Article in journal (Refereed)
    Abstract [en]

    Students at the medical programme at Umeå university point out the lack of female lecturers. The aim of this study was to see how many men respectively women our students meet as teachers in different teaching situations and to analyze the result from a student perspective. Students more often meet men than women in cathedral lectures. The male dominance is less obvious in group teaching and supervision. The medical programme should pay effort to have more women as cathedral lecturers.

  • 329.
    Hammarström, Anne
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Phillips, Susan P.
    Gender inequity needs to be regarded as a social determinant of depressive symptoms: Results from the Northern Swedish cohort2012In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 40, no 8, p. 746-752Article in journal (Refereed)
    Abstract [en]

    Background: The importance of social and avoidable determinants of depressive symptoms has been increasingly recognized in public health research. However, when it comes to determinant of gender differences in depressive symptoms the focus is predominantly on biological unavoidable determinants. Thus, there is a need for more focus on gendered social determinants of health. The aim of this study was to analyse the importance of gender relations for depressive symptoms after taking socioeconomic factors and earlier depressive symptoms into account in the Northern Swedish cohort. Methods: A 26-year follow-up study of a cohort of all school leavers in a middle-sized industrial town in Northern Sweden was performed from age 16 until age 42. Of those still alive of the original cohort, 94% participated during the whole period and answered extensive questionnaires. Exposure was measured as socioeconomic status, financial strain, perceived gender inequity in the couple relationship and division of responsibility for domestic work. The outcome was depressive symptoms at age 42, while depressive symptoms were controlled at age 30. Results: In multivariate logistic regression analyses significant relations between financial strain and, among women only, also perceived gender equity in the couple relationship and depressive symptoms after adjustment for earlier health status, as well as for all other exposure measures. Conclusions: Financial strain, and among women, also gender inequity in the couple relationship was related to depressive mood. There is a need to pay more attention to gender relations in future research on social determinants of depressive mood.

  • 330.
    Hammarström, Anne
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Virtanen, Pekka
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Janlert, Urban
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Are the health consequences of temporary employment worse among low educated than among high educated?2011In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 21, no 6, p. 756-761Article in journal (Refereed)
    Abstract [en]

    Background: Despite the inconsistent findings of the growing amount of research analysing the possible health consequences of temporary employment, there is a lack of heterogeneous perspectives. The aim of the study was to analyse whether the health consequences of temporary employment are worse among low educated compared with high educated, after control for health-related selection.

    Methods: A 26-year follow-up study of a cohort of all school leavers in a middle-sized industrial town in northern Sweden was performed between 1981 and 2007. Of those still alive of the original cohort, 94% participated during the whole period. For this study, a sample of participants with temporary and permanent employment contracts between the age of 30 and 42 years was selected (n = 660).

    Results: In multivariate logistic regression analyses, an additive synergistic interaction effect was found for low education and high exposure to temporary employment in relation to suboptimal self-rated health, after controlling for health-related selection and sex. An additive antagonistic interaction was found between low education in combination with high exposure to temporary employment in relation to psychological distress, whereas no interaction was found for depressive symptoms.

    Conclusion: Our hypothesis regarding worse health effects of temporary employment among low educated was partly confirmed. Our results indicate the need to analyse temporary employment from a more heterogeneous perspective as well as in relation to different health outcomes.

  • 331. Hampe, C S
    et al.
    Hall, T R
    Ågren, Åsa
    Umeå University, Faculty of Medicine, Public Health and Clinical Medicine. Umeå University, Faculty of Medicine, Public Health and Clinical Medicine, Nutritional Research.
    Rolandsson, Olov
    Umeå University, Faculty of Medicine, Public Health and Clinical Medicine, Family Medicine. Allmänmedicin.
    Longitudinal changes in epitope recognition of autoantibodies against glutamate decarboxylase 65 (GAD65Ab) in prediabetic adults developing diabetes.2007In: Clin Exp Immunol, ISSN 0009-9104, Vol. 148, no 1, p. 72-8Article in journal (Refereed)
  • 332. Hampe, C. S.
    et al.
    Radtke, J. R.
    Wester, A.
    Carlsson, A.
    Cedervall, E.
    Jönsson, B.
    Ivarsson, S. A.
    Elding Larsson, H.
    Larsson, K.
    Lindberg, B.
    Neiderud, J.
    Rolandsson, Olov
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Lernmark, Å.
    Reduced display of conformational epitopes in the N-terminal truncated GAD65 isoform: relevance for people with stiff person syndrome or DQ8/8-positive Type 1 diabetes mellitus2019In: Diabetic Medicine, ISSN 0742-3071, E-ISSN 1464-5491, Vol. 36, no 11, p. 1375-1383Article in journal (Refereed)
    Abstract [en]

    Aims: To investigate whether the N‐terminal truncated glutamic acid decarboxylase 65 (GAD65) isoform is as well recognized by people with stiff person syndrome as it is by people with Type 1 diabetes, and whether conformational GAD65 antibody epitopes are displayed properly by the isoform.

    Methods: GAD65 antibody‐positive healthy individuals (n=13), people with stiff‐person syndrome (n=15) and children with new‐onset Type 1 diabetes (n=654) were analysed to determine binding to full‐length GAD65 and the N‐terminal truncated GAD65 isoform in each of these settings. GAD65 autoantibody epitope specificity was correlated with binding ratios of full‐length GAD65/N‐terminal truncated GAD65.

    Results: The N‐terminal truncated GAD65 isoform was significantly less recognized in GAD65Ab‐positive people with stiff‐person syndrome (P=0.002) and in healthy individuals (P=0.0001) than in people with Type 1 diabetes. Moreover, at least two specific conformational GAD65Ab epitopes were not, or were only partially, presented by the N‐terminal truncated GAD65 isoform compared to full‐length GAD65. Finally, an N‐terminal conformational GAD65Ab epitope was significantly less recognized in DQ8/8 positive individuals with Type 1 diabetes (P=0.02).

    Conclusions: In people with stiff person syndrome preferred binding to the full‐length GAD65 isoform over the N‐terminal truncated molecule was observed. This binding characteristic is probably attributable to reduced presentation of two conformational epitopes by the N‐terminal truncated molecule. These findings support the notion of disease‐specific GAD65Ab epitope specificities and emphasize the need to evaluate the applicability of novel assays for different medical conditions.

  • 333. Hansson, Ida
    et al.
    Lynch, Kristian F
    Hallmans, Göran
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research.
    Lernmark, Åke
    Rolandsson, Olov
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    High-titer GAD65 autoantibodies detected in adult diabetes patients using a high efficiency expression vector and cold GAD65 displacement.2011In: Autoimmunity, ISSN 0891-6934, E-ISSN 1607-842X, Vol. 44, no 2, p. 129-136Article in journal (Refereed)
    Abstract [en]

    Adult type 2 diabetes patients with GAD65 autoantibodies (GADA) are known as latent autoimmune diabetes in adults (LADA). It has been suggested that GADA in LADA patients preferentially bind to the N-terminal end of GAD65. Using the N-terminal end extension of ³⁵S-GAD65 generated by the pEx9 plasmid, we tested the hypothesis that GADA in LADA patients preferentially react with ³⁵S-GAD65 from the pEx9 plasmid compared to the normal length pThGAD65 plasmid. Healthy control subjects (n = 250) were compared with type 1 (n = 23), type 2 (n = 290), and unspecified (n = 57) diabetes patients. In addition, radio-binding assays for GADA with ³⁵S-GAD65 generated from both the pEx9 and pThGAD65 plasmids were used in displacement assays with an excess of recombinant human GAD65 (2 μg/mL) to correct for non-specific binding. ³⁵S-GAD65 produced by either pEx9 or pThGAD65 did not differ in binding among the healthy controls and among the type 1 diabetes patients. Among the type 2 and unspecified patients, there were 4/290 and 3/57 patients, respectively, with binding to the pEx9 but not to the pThGAD65 generated ³⁵S-GAD65. In the displacement assay, we discovered 14 patients with very high-titer GADA among the type 1 (n = 3, 12,272-29,915 U/mL), type 2 (n = 7; 12,398-334,288 U/mL), and unspecified (n = 4; 20,773-4,053,580 U/mL) patients. All samples were fully displaced following appropriate dilution. We conclude that pThGAD65 is preferred for the coupled in vitro transcription translation of ³⁵S-GAD65 and that displacement with recombinant GAD65 may detect very high-titer GADA with possible clinical relevance.

  • 334.
    Hansson Vikström, Nils
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Anxiety, depression and help-seeking behaviors in women with urinary incontinence using E-health.2018Independent thesis Basic level (professional degree), 20 credits / 30 HE creditsStudent thesis
  • 335.
    Hariz, Gun-Marie
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy. Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Clinical Neuroscience.
    Hamberg, Katarina
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Perceptions of living with a device-based treatment: an account of patients treated with deep brain stimulation for Parkinson’s disease2014In: Neuromodulation (Malden, Mass.), ISSN 1094-7159, E-ISSN 1525-1403, Vol. 17, no 3, p. 272-278Article in journal (Refereed)
    Abstract [en]

    Objectives Deep brain stimulation (DBS) is an established treatment for Parkinson's disease. Little is known about patients' own perceptions of living with the implanted hardware. We aimed to explore patients' own perceptions of living with an implanted device. Materials and Methods Semistructured interviews with open-ended questions were conducted with 42 patients (11 women) who had been on DBS for a mean of three years. The questions focused on patients' experiences of living with and managing the DBS device. The interviews were transcribed verbatim and analyzed according to the difference and similarity technique in grounded theory. Results From the patients' narratives concerning living with and managing the DBS device, the following four categories emerged: 1) The device—not a big issue: although the hardware was felt inside the body and also visible from outside, the device as such was not a big issue. 2) Necessary carefulness: Patients expressed the need to be careful when performing certain daily activities in order not to dislocate or harm the device. 3) Continuous need for professional support: Most patients relied solely on professionals for fine-tuning the stimulation rather than using their handheld controller, even if this entailed numerous visits to a remote hospital. 4) Balancing symptom relief and side-effects: Patients expressed difficulties in finding the optimal match between decrease of symptoms and stimulation-induced side-effects. Conclusions The in-depth interviews of patients on chronic DBS about their perceptions of living with an implanted device provided useful insights that would be difficult to capture by quantitative evaluations.

  • 336.
    Hariz, Gun-Marie
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy. Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Clinical Neuroscience. UCL Institute of Neurology, Queen Square, London, UK.
    Limousin, P.
    Zrinzo, L.
    Tripoliti, E.
    Aviles-Olmos, I.
    Jahanshahi, M.
    Hamberg, Katarina
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Foltynie, T.
    Gender differences in quality of life following subthalamic stimulation for Parkinson's disease2013In: Acta Neurologica Scandinavica, ISSN 0001-6314, E-ISSN 1600-0404, Vol. 128, no 4, p. 281-285Article in journal (Refereed)
    Abstract [en]

    Objectives - Surveys of subthalamic nucleus (STN) deep brain stimulation (DBS) for Parkinson's disease (PD) have shown that this procedure is roughly twice more common in men than in women. Here, we investigate possible differences between women and men undergoing STN DBS, with respect to health-related quality of life.

    Materials and methods - Forty-nine consecutive patients (18 women) received STN DBS. The impact of PD and its surgical treatment was compared between women and men, before and at mean of 19 +/- 11months after surgery, using the Unified Parkinson Disease Rating Scale (UPDRS) and the Parkinson's Disease Questionnaire-39 (PDQ-39).

    Results - Duration of disease at surgery and off-medication scores of the motor part of the UPDRS were similar in women and men. At baseline, women had lower doses of dopaminergic medication than men, experienced more disability due to dyskinesias, had more sensory symptoms and perceived more difficulties in mobility. Following DBS, both men and women showed equal and significant (P<0.001) improvement in off-medication scores on the UPDRS III. On the PDQ-39, women expressed improvement in ADL to a greater extent than men. Moreover, women but not men showed a positive effect on mobility, stigma and cognition as well as on the summary score of PDQ-39.

    Conclusions - Although STN DBS results in equal degree of motor improvement between women and men, health-related quality of life seems to improve to a greater extent in women.

  • 337.
    Hariz, Gun-Marie
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy. Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Clinical Neuroscience.
    Limousin, Patricia
    Hamberg, Katarina
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    "DBS means everything - for some time": Patients' Perspectives on Daily Life with Deep Brain Stimulation for Parkinson's Disease2016In: Journal of Parkinson's Disease, ISSN 1877-7171, E-ISSN 1877-718X, Vol. 6, no 2, p. 335-347Article in journal (Refereed)
    Abstract [en]

    Background: Deep brain stimulation (DBS) is an established treatment for Parkinson's disease. However, patients' own perceptions of the impact of DBS on their daily living is not fully explored. 

    Objective: We aimed to collect and analyse patients' narratives about their everyday experiences of being on chronic DBS. 

    Methods: Semi-structured interviews with open-ended questions were conducted with 42 patients (11 women) who had been on DBS for a mean of three years. The questions were related to patients' ordinary daily life and eventual changes, both negative and positive, brought about by DBS. The interviews were transcribed verbatim and analysed according to the difference and similarity technique in grounded theory. 

    Results: From the patients' narratives the core category `DBS means everything - for some time' was established, and supported by the following categories: 1) Relief from invasive tremor. 2) A rescue from cramps and pain. 3) Easier movement swings and more predictable living space. 4) Hard, but compared to previous suffering, bearable adverse events. 5) Parkinson's disease is progressing despite DBS. 

    Conclusions: The analysis of the participants' narratives shed light on patients' unique perceptions and perspectives of the impact of DBS on their everyday lives. Patients with advanced PD highly appreciated the positive impact of DBS on their daily life even if this impact is limited in time. For the majority, the relief from the severe parkinsonian symptoms, especially tremor and painful cramps, outweighed the side effects of DBS. The study provided information not readily captured by pre-formulated questionnaires and scales.

  • 338.
    Hariz, Gun-Marie
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy. Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Clinical Neuroscience.
    Nakajama, Takeshi
    UCL Institute of Neurology, Queen Square, London, UK; Department of Neurosurgery, Tokyo Women’s Medical University, Tokyo, Japan.
    Limousin, Patricia
    UCL Institute of Neurology, Queen Square, London, UK.
    Foltynie, Tom
    UCL Institute of Neurology, Queen Square, London, UK.
    Zrinzo, Ludvic
    UCL Institute of Neurology, Queen Square, London, UK.
    Jahanshahi, Marjan
    UCL Institute of Neurology, Queen Square, London, UK.
    Hamberg, Katarina
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Gender distribution of patients with Parkinson's disease treated with subthalamic deep brain stimulation: a review of the 2000-2009 literature2011In: Parkinsonism & Related Disorders, ISSN 1353-8020, E-ISSN 1873-5126, Vol. 17, no 3, p. 146-149Article, review/survey (Refereed)
    Abstract [en]

    Purpose: Deep brain stimulation (DBS) of the subthalamic nucleus (STN) has been the mainstream surgical procedure for advanced Parkinson’s disease (PD) during the last decade. Reports from a few individual centres have hinted that women who receive STN DBS are under-represented. We aimed to evaluate the gender distribution of patients with PD who had received STN DBS during the last ten years, and to discuss the findings in relation to studies on gender prevalence of PD.

    Methods: A search of the PubMed database of clinical papers in English language related to STN DBS between 2000 and 2009 was conducted. Care was taken to minimize redundancies in reporting of published patients. The proportion of men and women were expressed in total and according to pre-defined geographic regions.

    Results: One hundred and thirty five papers were eligible for review. The gender of the patients was specified in 119 papers on a total of 3880 patients, of which 63% were men. According to geographic origin of publications, the percentage of men with STN DBS was 68% in North America, 62% in Europe, 69% in Australia and 50% in Asia.

    Conclusions: The proportion of male patients who undergo STN DBS seems to exceed the reported male/female ratio of patients with PD.

  • 339.
    Hariz, Gun-Marie
    et al.
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Clinical Neuroscience. Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Rehncrona, Stig
    Blomstedt, Patric
    Limousin, Patricia
    Hamberg, Katarina
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Hariz, Marwan
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Clinical Neuroscience. UCL Institute of Neurology, Queen Square, London, UK.
    Women pioneers in basal ganglia surgery2014In: Parkinsonism & Related Disorders, ISSN 1353-8020, E-ISSN 1873-5126, Vol. 20, no 2, p. 137-141Article, review/survey (Refereed)
    Abstract [en]

    Background: Stereotactic functional neurosurgery on basal ganglia has a long history and the pioneers are mostly men. We aimed at finding out if there were women who have contributed pioneering work in this field. Methods: The literature was searched to identify women who have been first to publish innovative papers related to human basal ganglia surgery. Results: Six women fulfilling our criteria were found: Marion Smith, a British neuropathologist, made unique observations on stereotactic lesions of basal ganglia and thalamus on autopsied brains, and the lesions' relation to the reported clinical outcome. Natalia Bechtereva, a Russian neurophysiologist, pioneered the technique of therapeutic chronic deep brain stimulation to treat various brain disorders, including Parkinson's disease (PD). Denise Albe-Fessard, a French neurophysiologist, pioneered the technique of microelectrode recording (MER) in stereotactic functional neurosurgery. Gunvor Kullberg, a Swedish neurosurgeon, contributed in early CT imaging as well as early functional imaging of stereotactic lesions in PD and psychiatric patients. Hilda Molina, a Cuban neurosurgeon, established the Centro Internacional de Restauracion Neurologica (CIREN) and pioneered there MER-guided transplant surgery in PD patients. Veerle Vandewalle, a Belgian neurosurgeon, pioneered in 1999 deep brain stimulation (DBS) for Tourette Syndrome. Conclusion: Although men constitute the great majority of neurosurgeons, neurologists and other neuro-specialists who have made groundbreaking contributions in basal ganglia surgery, there are women who have made equally important and unique contributions to the field. The principal two techniques used today in functional stereotactic neurosurgery, MER and DBS, have once upon a time been pioneered by women. (C) 2013 Elsevier Ltd. All rights reserved.

  • 340.
    Harryson, Lisa
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine. Umeå University, Faculty of Social Sciences, Umeå Centre for Gender Studies (UCGS).
    “An equal share, that’s my medicine”. Work, gender relations and mental illness in a Swedish context.2013Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Background: Women and men in Sweden are in paid work to almost the same extent, but are found in different occupations and positions in the labour market. Still, women perform the bulk of the unpaid domestic work at home. Gendered inequalities in these respects leave women and men exposed to different work environments and responsibilities, which in turn can have gendered health consequences. In public health research there is a lack of studies on domestic work that include women and men, as well as a lack of qualitative studies exploring individuals’ experiences of domestic work and mental health. At the workplace level, few attempts have been made to analyse how several dimensions of gender equality at workplaces are related to health status and there is a lack of studies with a contextual approach combining many different variables that are at play simultaneously. Because of the cross-sectional design of previous studies on paid and domestic work there is a lack of analyses taking possible health-related selection into account, which makes it difficult to ascertain whether gender equality leads to better health or if good health is a prerequisite for gender equality.

    Aim: The aim of this thesis was to analyse gender relations of work (at workplaces and at home) in relation to mental illness among women and men.

    Methods: The thesis was based on data from the Northern Swedish Cohort. The baseline survey was conducted in 1981 when the participants were 16 years old (n= 1080, 574 boys and 506 girls), with follow-up at age 18, 21, 30 and 42. The response rate was 94 % throughout the last follow-up in 2007. Data from the Northern Swedish Cohort were supplemented with register data about the employees at the participants’ workplaces. The analysis methods for the questionnaire and register data were logistic regression analysis and cluster analysis. Interviews were performed with four women and four men in the Northern Swedish Cohort and were analysed with a Grounded Theory approach.

    Results: Women had overall greater responsibility for domestic work. Gender inequality in responsibility for domestic work and perceptions of gender inequality in the couple relationship (after adjustments for background variables and previous psychological distress) were associated with psychological distress among women and men. However, among men the relation between domestic work inequalities and psychological distress was affected by socioeconomic position relative to the partner. Having less responsibility for domestic work and a partner with higher socioeconomic position was associated with psychological distress among men. The qualitative analysis showed that gender relations were an important part of how the domestic work was unequally organised and related to experiences of mental illness among women and men. Among women the high burden of domestic work was experienced as an obstacle to experiencing good health. Among men the experience of being trapped in an outmoded masculinity was related to feelings of stress. At the workplace level, patterns of gender inequality were associated with psychological distress among women, but not among men. However, the most gender-equal pattern was related to lower as well as more similar levels of mental illness among women and men, which supports a convergence in health when women’s and men’s work conditions become more similar.

    Conclusion: Gender equality at home and at work is central for reducing mental illness among both women and men, but also for achieving a good average health status in the population, which is a central public health target. When investigating social inequalities in health, gender perspectives are of great importance for deepening the understanding of how and why gender inequalities in paid and domestic work are related to mental illness. Integrating gender perspectives into public health policy could be a way to acknowledge power relations that hinder good public health.

  • 341.
    Harryson, Lisa
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine. Umeå University, Faculty of Social Sciences, Umeå Centre for Gender Studies (UCGS).
    Aléx, Lena
    Umeå University, Faculty of Medicine, Department of Nursing.
    Hammarström, Anne
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    “An equal share, that’s my medicine”. Experiences of domestic work, health and illness from a gender relational perspective.Manuscript (preprint) (Other academic)
    Abstract [en]

    Introduction: Gender inequalities in domestic work have been shown to be related to mental illness among both women and men. The aim of this study was to analyse experiences of domestic work, health and illness among women and men from a gender relational perspective. Methods: A strategic section from the Northern Swedish Cohort of four women and four men living in couple relationships with children was included in the study. The strategic selection included variation socioeconomic class and perception of gender equality in the couple relationship. Interviews were conducted in 2012 when the participants were 47 years old. Data collection and analysis was performed with a Grounded Theory approach. Results: We identified three categories. “Living with the burden of domestic work –an obstacle for women’s health” was built on women’s experiences of having the main responsibility for everyday domestic work as burdensome, stressful and something that caused sleeping and mental illness problems. “Being trapped in an outmoded masculinity – a stressful situation” was built on men’s experiences of domestic work such as fixing things that were broken at home as well as having responsibility for the seasonal outdoor work, something that was connected to feelings of stress. “Negotiating gender equality” included women’s and men’s experiences of striving for gender equality in the couple relationship as a possible way to improved health. Conclusions: Gender relations are an important part of how the domestic work is unequally organized and related to experiences of mental illness. We found that gender constructions in the domestic sphere included various dimensions of gender inequality that were constantly negotiated in order to improve health.

  • 342.
    Harryson, Lisa
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine. Umeå University, Faculty of Social Sciences, Umeå Centre for Gender Studies (UCGS).
    Novo, Mehmet
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine. Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Rehabilitation Medicine.
    Hammarström, Anne
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Is gender inequality in the domestic sphere associated with psychological distress among women and men? Results from the Northern Swedish Cohort2012In: Journal of Epidemiology and Community Health, ISSN 0143-005X, E-ISSN 1470-2738, Vol. 66, no 3, p. 271-276Article in journal (Refereed)
    Abstract [en]

    Aim The aim of this study was to analyse whether gender inequality in the domestic sphere was associated with psychological distress among women and men.

    Methods In a cohort study, all pupils in the last year of compulsory school in a middle-sized industrial town in northern Sweden were followed until the age of 42. For this study a sample of cohabiting participants (n¼372 women, 352 men) was selected. Gender inequality was measured as perceptions of gender inequality in the couple relationship, time spent on household work, responsibility for domestic work and childcare, and was analysed in relation to psychological distress, after taking possible background variables as well as earlier health status into account.

    Results In the multivariate analyses, perception of gender inequality in the couple relationship was associated with psychological distress for both women (OR 2.23, CI 1.20 to 4.18) and men (OR 3.51, CI 1.69 to 7.31). For women only, taking whole responsibility for domestic work was associated with the outcome (OR 2.17, CI 1.05 to 4.48). For men, taking less than half of the responsibility for domestic work was associated with psychological distress (OR 2.25, CI 1.24 to 3.91).

    Conclusions Gender inequality in the domestic sphere seems to be an important determinant of psychological distress for both women and men.

  • 343.
    Harryson, Lisa
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine. Umeå University, Faculty of Social Sciences, Umeå Centre for Gender Studies (UCGS).
    Strandh, Mattias
    Umeå University, Faculty of Social Sciences, Department of Sociology. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Hammarström, Anne
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Domestic work and psychological distress: what is the importance of relative socioeconomic position and gender inequality in the couple relationship?2012In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 7, no 6, p. e38484-Article in journal (Refereed)
    Abstract [en]

    Aims: The aim of this study was to investigate whether the relation between responsibility for domestic work and psychological distress was influenced by perception of gender inequality in the couple relationship and relative socioeconomic position.

    Methods: In the Northern Swedish Cohort, all pupils who studied in the last year of compulsory school in a northern Swedish town in 1981 have been followed regularly until 2007. In this study, participants living with children were selected (n = 371 women, 352 men). The importance of relative socioeconomic position and perception of gender inequality in the couple relationship in combination with domestic work for psychological distress was examined through logistic regression analysis.

    Results: Two combinations of variables including socioeconomic position ('having less than half of the responsibility for domestic work and partner higher socioeconomic position' and 'having more than half the responsibility for domestic work and equal socioeconomic position') were related to psychological distress. There were also higher ORs for psychological distress for the combinations of having 'less than half of the responsibility for domestic work and gender-unequal couple relationship' and 'more than half the responsibility for domestic work and gender-unequal couple relationship'. Having a lower socioeconomic position than the partner was associated with higher ORs for psychological distress among men.

    Conclusions: This study showed that domestic work is a highly gendered activity as women tend to have a greater and men a smaller responsibility. Both these directions of inequality in domestic work, in combination with experiencing the couple relationship as gender-unequal, were associated with psychological distress There is a need for more research with a relational approach on inequalities in health in order to capture the power relations within couples in various settings.

  • 344.
    Hedblad, B
    et al.
    Lund Univ, Malmö, Sweden .
    Melander, H
    Med Prod Agcy, Uppsala, Sweden .
    de Faire, U
    Karolinska Inst, Stockholm, Sweden .
    Lindholm, Lars H
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Kahan, T
    Karolinska Inst, Stockholm, Sweden .
    Beta blockers reduce left ventricular mass less than other antihypertensive drugs: a systematic review and meta analysis2009In: Journal of Hypertension, ISSN 0263-6352, E-ISSN 1473-5598, Vol. 27, no Suppl. 4, p. s319-s319Article in journal (Refereed)
  • 345. Hedenmalm, Karin
    et al.
    Samuelsson, Eva
    Umeå University, Faculty of Medicine, Public Health and Clinical Medicine, Family Medicine.
    Fatal venous thromboembolism associated with different combined oral contraceptives: a study of incidences and potential biases in spontaneous reporting.2005In: Drug Saf, ISSN 0114-5916, Vol. 28, no 10, p. 907-16Article in journal (Refereed)
  • 346. Hedenmalm, Karin
    et al.
    Samuelsson, Eva
    Umeå University, Faculty of Medicine, Public Health and Clinical Medicine, Family Medicine.
    Spigset, Olav
    Pulmonary embolism associated with combined oral contraceptives: reporting incidences and potential risk factors for a fatal outcome.2004In: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, Vol. 83, no 6, p. 576-85Article in journal (Refereed)
  • 347. Hedman, M H
    et al.
    Rolandsson, Olov
    Umeå University, Faculty of Medicine, Public Health and Clinical Medicine, Family Medicine. Allmänmedicin.
    Hägg, Erik
    Umeå University, Faculty of Medicine, Public Health and Clinical Medicine, Medicine. Medicin.
    Mincheva-Nilsson, Lucia
    Umeå University, Faculty of Medicine, Clinical Microbiology, Clinical Immunology.
    Lindahl, Bernt
    Umeå University, Faculty of Medicine, Public Health and Clinical Medicine.
    Association between insulin resistance and GAD65-autoantibody levels--a pilot study in an adult non-diabetic population.2004In: Autoimmunity, ISSN 0891-6934, Vol. 37, no 1, p. 33-6Article in journal (Refereed)
  • 348.
    Hellström, Olle
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Social medicine.
    Bullington, J
    Karlsson, G
    Lindqvist, P
    Mattsson, Bengt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    A phenomenological study of fibromyalgia: Patient perspectives1999In: Scandinavian Journal of Primary Health Care, ISSN 0281-3432, E-ISSN 1502-7724, Vol. 17, no 1, p. 11-16Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To describe the way in which the fibromyalgia patients understand the meaning of their illness. DESIGN: Qualitative, empirical phenomenological psychological method. SETTING: A collaborative transdisciplinary interview study of patients' described experiences of living with fibromyalgia. No therapeutic relationships existed between patients and researchers. SUBJECTS: Eighteen patients with fibromyalgia were interviewed. Ten of the 18 taped interviews were transcribed and analysed. MAIN OUTCOME MEASURES: Patients' narratives, described experiences of living with fibromyalgia. RESULTS: The patients were intensively involved in efforts to get their self-images as ill persons confirmed. Their experience was that the disease started dramatically, with a variety of capriciously appearing symptoms of unknown cause that gave rise to the suffering. The fibromyalgia patients seemed to develop strategies to cope with a precarious self-image and find ways to manage the thought of what the future would bring. CONCLUSION: The meaning structures revealed in the patients' ways of describing their experiences of living with fibromyalgia seemed to be partially constituted by their efforts to stand forth as afflicted with a disease, which could be a way to help them to manage the demands that they placed upon themselves.

  • 349.
    Hellström, Olle
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine. Vansbro Primary Health Care Unit, Vansbro, Sweden..
    Bullington, J
    Karlsson, G
    Lindqvist, P
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Mattsson, Bengt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Doctors' attitudes to fibromyalgia: a phenomenological study1998In: Scandinavian Journal of Social Medicine, ISSN 0300-8037, Vol. 26, no 3, p. 232-237Article in journal (Refereed)
    Abstract [en]

    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.

  • 350.
    Hellström, Olle
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Social medicine.
    Lindqvist, P
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Mattsson, Bengt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    A phenomenological analysis of doctor-patient interaction: a case study1998In: Patient Education and Counseling, ISSN 0738-3991, E-ISSN 1873-5134, Vol. 33, no 1, p. 83-89Article in journal (Refereed)
    Abstract [en]

    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.

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