Exploring Paths of Justice in the Digital Healthcare : A Socio-Legal Study of Swedish Online Doctors

Online doctor services, healthcare provided via smartphone apps, have gone from being peripheral to seriously challenging the conventional Swedish way of providing healthcare services. The accessibility of online doctors is unsurpassed but all patient groups have not gotten better access to healthcare thanks to online doctors.The aim of this study was to investigate how perceptions of the online doctor service Kry influence the willingness to use said service. This has been achieved through two online surveys conducted in 2016 and 2017, generating two study samples of 1,264 and 882 cases, respectively. Survey items operationalised perceptions of justice as well as benefits and risk beliefs associated with Kry. Statistical modelling was performed, applying PLS path analysis.Inspired by the meta-theoretical perspective of critical realism, the aim was also to explain the underlying mechanisms that cause online doctors as a Swedish healthcare phenomenon. This has been achieved through a descriptive analysis based on, for instance, legal documents, governmental reports, regional recommendations, statistics, and newspaper articles. The descriptive study has been guided by Alan Norrie’s sociology of law and the theoretical figure of law’sarchitectonic, where the legal is always also the ethico-legal, the juridico political, and the socio-legal.Results from the surveys and the subsequent statistical modelling showed that the willingness to use Kry was predicted by perceptions of distributive justice, i.e., whether the service was perceived as accessible and inclusive (equality), and whether it was perceived as providing value for time and money spent (equity). Furthermore, perceptions of equality and equity were mediated by perceptions of perceived trust and interest in Kry. Perceptions of procedural justice did not impact the willingness to use Kry to the same extent.The descriptive study showed that Swedish online doctors as a phenomenon has emerged in a health system shaped by ethico-legal, juridico-political, and what I call econo-legal conflicts. Swedish healthcare law is based on the principle stating that those in most need of care should receive care first and on the overarching goal stating that the healthcare should strive towards an equal healthcare for the entire population. With the free choice of care reform, implemented in 2010, the Swedish health system was transformed into a quasi market and the principle of demand, stating that the patient should receive healthcare when she demands it rather than when she needs it, has entered the health system under the label free choice. This ethical and normative ambivalence is found in and expressed through healthcare law.Unlike the health system at large, online doctors are well equipped for a healthcare that is becoming increasingly consumer-driven. This may explain why distributive justice predict the will to use Kry. Much like the online marketplaceexperience, patients are judging the online doctor experience based on value for time and money spent

Kastrering av smågris

The castration of piglets is performed routinely all around the world. Most castrations are done without anaesthesia and analgesia, despite the fact that this procedure has been proved to induce acute pain and stress for the piglets. The procedure regarding castration of piglets is currently a hot topic of debate and an important political issue. The underlying issue is the boar taint which are highlighted in the heating of the meat after slaughter, which in turn can lead to reduced meat sales as it can be perceived as unpleasant for many consumers. The purpose of this study is to examine alternative drugs which may be selected in order to replace the practice of castration of piglets without anaesthesia, in light of improved animal welfare. The pharmacological options I have reviewed are: Non-Steroidal-Anti-Inflammatory-Drug (NSAID) for pain relief, general anaesthesia in the form of carbon, halothane, isoflourane and N2O, local anaesthesia and immunocastration. NSAIDs has been proven to be an effective adjunct to different methods of stunning and has a positive effect post-operative affect, since it speeds up the healing process. Some countries apply to general anesthesia today for stunning piglet. In the Netherlands, for example, they use carbon dioxide. This is a less expensive option than halothane and isoflorane, however, studies have shown that the induction of carbon dioxide may be complicated. Local anaesthesia has been practiced in Norway since 2002 and has been proven to be successful. Immunocastration is when pigs get vaccinated with a synthetic analogue of GnRH (Gonadotropin-releasing hormone) so that antibodies against the animal's own GnRH is produced. This leads to lower concentrations of luteinising hormone (LH) and follicle stimulating hormone (FSH), which results in a delayed sexual maturation. Some consumers are skeptical about this approach, as they proved to be concerned about the remnants of the vaccine in the meat. By comparison, these studies have shown that immunocastration, from animal welfare point of view, is the best approach for the castration of piglets. It results in the same outcome and quality as neuters, moreover, it provides better animal welfare by reducing stress and pain in piglets

Less repressive and fairer foreclosure. Evidence from a randomized experiment at Kronofogden regarding the possibilities to break economic exclusion

Homeowners are facing worse personal finances with high inflation and increasing interest rates. New groups are at risk of overindebtedness and foreclosure. The entire household, including children, are affected by worse health and well-being. This leads to large societal costs. Hence, it is imperative to break the negative cycle of overindebtedness for these households. Foreclosure is enforced by Kronofogden (the Swedish Enforcement Authority) and aims to pay the debts. However, an unintended consequence may be that foreclosure is perceived as repressive. The degree of repression depends on how Kronofogden handles the proceedings. This research project contributes with knowledge about these mechanisms and how they may make it more difficult to break social and economic exclusion by answering the following research question: How repressive are the foreclosure proceedings at Kronofogden?It is important to understand when and why foreclosure becomes repressive because it may reduce the possibilities to exit overindebtedness as the homeowner’s social network is reduced and their social trust is lowered. Today we have limited knowledge about the mechanisms that make the exercise of public authority unintentionally repressive. The knowledge is relevant for public authoritative proceedings both in Sweden and internationally. The authorities may use this knowledge to adapt their handling protocol to avoid future repression

Kränkning och upprättelse. En replikation av en rättssociologisk enkätstudie

I rapporten presenteras ett rättssociologiskt forskningsprojekt som haft arbetstiteln ”Replika av en rättssociologisk undersökning om det allmänna rättsmedvetandet och brottsskadeersättningen”. Att projektet är en ”replika” innebär att syftet har varit att göra en uppföljning på ett ursprungligt forskningsprojekt som i det aktuella fallet utgörs av de enkätundersökningar som presterades i avhandlingen ”Kränkning och upprättelse. En rättssociologisk studie av kränkningsersättning till brottsoffer” (Dahlstrand, 2012). Forskningsprojektet har gått ut på att återupprepa en empiriinsamling och metoddesign som utarbetades för ungefär tio år sedan. Det ursprungliga projektet finansierades av Brottsofferfonden och pågick 2007–2012 medan den replika som kommer att presenteras i denna rapport har finansierats av Ulla V Bondesons stiftelse för rättssociologisk och kriminologisk forskning och pågått 2018–2020. Tanken på att genomföra en replika av de två enkätstudier som presenterades i avhandlingen föddes tack vare att resultaten från avhandlingen fick en del uppmärksamhet. Under flera år efter disputationen återkom kommentaren att det hade varit intressant att se om resultaten som presenterades i avhandlingen skulle upprepas om enkätundersökningarna replikerades. Eftersom ”Ulla V Bondesons Stiftelse för rättssociologisk och kriminologisk forskning” ger forskningsanslag för replikationer av Ulla V Bondesons egna eller andra motsvarande studier söktes finansiering för att följa upp den empiriska studie som under Karl Dahlstrands doktorandprojekt hade titeln ”Rättssociologisk undersökning om det allmänna rättsmedvetandet och brottsskadeersättningen” som professor Karsten Åström var huvudansvarig för. Det rättssociologiska kunskapsintresset, som motiverar replikan utgår delvis från de teoretiska och praktiska svårigheterna att värdera brottsoffrens kränkningsersättning. I Brottsoffermyndighetens referatsamling anges att ersättning för kränkning utgår från ett ”angrepp på den skadelidandes personliga integritet, vilket i detta sammanhang bäst kan beskrivas som dennes privatliv och människovärde” och ”utgångspunkten vid bestämmande av kränkningsersättning är en skönsmässig bedömning utifrån förhärskande etiska och sociala värderingar.” Syftet med kränkningsersättningen är, förenklat uttryckt, att den ska bidra till en känsla av upprättelse hos brottsoffret men om nivån på ersättningsbeloppet ligger för långt ifrån brottsoffrets egna förväntningar på kränkningsersättningen så finns en risk att ersättningen inte leder till upprättelse. Det är alltså viktigt att ersättningsbeloppet står i proportion till hur allvarlig kränkningen kan anses vara, såväl objektivt som sett ur brottsoffrets perspektiv. Frågan vi ställer oss är således: anser brottsoffer att kränkningsersättningen bidrar till en känsla av upprättelse?Rapporten är tillägnad minnet av Ulla V Bondeson (1937-2009), professor i kriminologi vid Köpenhamns universitet 1980-2007

Tidal Dwarf Candidates in a Sample of Interacting Galaxies. II. Properties and Kinematics of the Ionized Gas

We present low-resolution spectroscopy of the ionized gas in a sample of optical knots located along the tidal features of 14 interacting galaxies and previously selected as candidates of Tidal Dwarf Galaxies (TDGs). From redshift measurements, we are able to confirm their physical association with the interacting system in almost all cases. For most knots, the oxygen abundance does not depend on the blue luminosity. The average, 12+log(O/H)=8.34+-0.20, is typical of TDGs and comparable to that measured in the outer stellar disk of spirals from which they were formed. A few knots showing low metallicities are probably pre-existing low-mass companions. The estimated Ha luminosity of the TDG candidates is higher than the one of typical individual HII regions in spiral disks and comparable to the global Ha luminosity of dwarf galaxies. We find several instances of velocity gradients with amplitudes apparently larger than 100 km/s in the ionized gas in the tidal knots and discuss various possible origins for the large velocity amplitudes. While we can exclude tidal streaming motions and outflows, we cannot rule out projection effects with the current resolution. The velocity gradients could be indicative of the internal kinematics characteristic of self-gravitating objects. Higher resolution spectra are required to confirm whether the tidal knots in our sample have already acquired their dynamical independence and are therefore genuine Tidal Dwarf Galaxies.Comment: 12 pages, 7 figures, partly color (but printable in greyscale without loss of information). Paper is accepted by A&A. The appendix with images of the galaxies can be downloaded from http://www.uni-sw.gwdg.de/~weilbach/pubs/pub.htm

The 2MASS Redshift Survey - Description and Data Release

We present the results of the 2MASS Redshift Survey (2MRS), a ten-year project to map the full three-dimensional distribution of galaxies in the nearby Universe. The 2 Micron All-Sky Survey (2MASS) was completed in 2003 and its final data products, including an extended source catalog (XSC), are available on-line. The 2MASS XSC contains nearly a million galaxies with Ks <= 13.5 mag and is essentially complete and mostly unaffected by interstellar extinction and stellar confusion down to a galactic latitude of |b|=5 deg for bright galaxies. Near-infrared wavelengths are sensitive to the old stellar populations that dominate galaxy masses, making 2MASS an excellent starting point to study the distribution of matter in the nearby Universe. We selected a sample of 44,599 2MASS galaxies with Ks =5 deg (>= 8 deg towards the Galactic bulge) as the input catalog for our survey. We obtained spectroscopic observations for 11,000 galaxies and used previously-obtained velocities for the remainder of the sample to generate a redshift catalog that is 97.6% complete to well-defined limits and covers 91% of the sky. This provides an unprecedented census of galaxy (baryonic mass) concentrations within 300 Mpc. Earlier versions of our survey have been used in a number of publications that have studied the bulk motion of the Local Group, mapped the density and peculiar velocity fields out to 50 Mpc, detected galaxy groups, and estimated the values of several cosmological parameters. Additionally, we present morphological types for a nearly-complete sub-sample of 20,860 galaxies with Ks = 10 deg.Comment: Accepted for publication in The Astrophysical Journal Supplement Series. The 2MRS catalogs and a version of the paper with higher-resolution figures can be found at http://tdc-www.harvard.edu/2mrs

A Podocyte view on RhoGTPases and actin cytoskeleton regulation

Proteinuria is a hallmark symptom of chronic kidney disease, that if left to persist constitutes a risk for progression of disease. Symptomatic treatment aiming at decreasing proteinuria is therefore standard practice. Curative treatments for the underlying cause of disease are however lacking and treatments currently in use to induce disease remission are associated with unfavorable side effects. Dysregulation of the podocyte actin cytoskeleton underlies the pathological process called foot process effacement (FPE), which is one of the leading causes of proteinuria. The studies included in this thesis have focused on podocyte actin cytoskeleton regulation and a group of proteins called RhoGTPases, known to be involved in actin cytoskeleton regulation in podocytes. In the first study, glomerular microarray analysis showed an increase in the expression of the melanocortin 1-receptor (MC1R) in renal diseases focal segmental glomerulosclerosis and membranous nephropathy. Subsequent mass spectrometry analysis in combination with pathway and biochemical analysis revealed the podocyte protective effects of MC1R stimulation in vitro. Activation of MC1R proved to be stabilizing the podocyte actin cytoskeleton through inhibition of the epidermal growth factor receptor (EGFR) and maintenance of the actin associated protein synaptopodin. In the second study, the depletion of the prenylation enzyme Geranylgeranyl transferase type I (GGTase-I) in podocytes led to the development of proteinuria and FPE in mice due to an imbalanced RhoGTPase activity and disruption of the actin cytoskeleton. These findings suggest that GGTase-I activity is essential for podocyte function. In the last study, a guanine nucleotide exchange factor (activator of RhoGTPases) named Bpix was identified to be modulated in podocytes following treatment with a renal stressor, using mass spectrometry analysis. Gene silencing of Bpix protected against actin cytoskeleton remodulation in a model of podocyte injury, demonstrating the importance of Bpix for podocyte actin cytoskeleton regulation. In conclusion, the results in this thesis confirm the importance of actin cytoskeleton regulation for podocyte integrity. Further on, the results provide new information on actin cytoskeleton regulatory pathways involving RhoGTPases in podocytes, which can be of importance for future attempts in finding targeted treatments of proteinuria and chronic kidney disease

The Stepchild Controversy : Unfortunate Dichotomies in Socio-Legal Theory

Kapitlet handlar om beklagliga dikotomier i rättssociologisk teori, som till exempel dikotomin rätt/samhälle. Upprätthållandet av sådana dikotomier hämmar rättssociologisk teoriutveckling. Kapitlet tar sin utgångspunkt i en debatt som initierades 1998 av Reza Banakar och som handlade om vad Banakar ansåg vara den rättssociologiska teorins underutvecklade tillstånd, eller rättssociologins identitetskris som styvbarn till juridik och sociologi. De flesta av inspelen i debatten accepterar dikotomin rätt/samhälle, det vill säga en syn på rätten som teoretiskt frikopplad från samhället. I kapitlet hävdas att detta är ett misstag och att vi istället bör inse att rätten är djupt invecklad i allt samhällsliv. Rättssociologin bör fokusera på att att studera normativitet i samhället och utgå från att rätten först och främst är ett socialt fenomen och inte ett slutet system, avskuret från övriga samhället. Mina argument är influerade av den vetenskapsfilosofiska riktningen kritisk realism

Denitrification as an adaptive trait in soil and groundwater bacteria

The focus of the thesis is on selection and adaptation processes in bacteria with emphasis on denitrifying bacteria in groundwater. Other nitrogen transformation processes such as dissimilatory nitrate reduction to ammonium (nitrate ammonification) and nitrification of forest soil bacteria are briefly discussed. Intensive fertilisation of agricultural soils in southern Sweden have been performed during the last 20-30 years and has resulted in accumulation of nitrate in many aquifers. Selection of denitrifiers in environments with high nitrate concentrations may occur since nitrate may act as a selective agent to alter gene frequencies in natural denitrifier populations. Selection may be accompanied by a community shift with a larger part of the community being denitrifiers with enhanced activity. In essence, a denitrifier that can utilise increased nitrate concentrations more efficiently than its neighbours, becomes more competitive and can allocate increasing amounts of energy to growth and reproduction which would result in an increase in fitness. The community shift may be reflected in the isolation frequencies in which about 50% of strains isolated from two nitrate contaminated aquifers with in situ nitrate-nitrogen concentrations of 24.1 and 35.2 mg/l, respectively, were denitrifiers compared to about 20% for a pristine site with an in situ nitrate-nitrogen concentration of 6.3 mg/l. Microcosms with sterile sediment and groundwater were inoculated with single denitrifying strains isolated from the three groundwater aquifers and the denitrifying activity was quantified using gas chromatography. The average denitrification activity for strains from the nitrate contaminated sites were twice as high as the activity of the strains from the pristine site. Denitrification were carbon limited and glucose amendment increased the denitrification activity about a 2-fold for all strains. The strain specific differences in denitrification rates increased to a 2.5-fold after carbon addition indicating that the differences in reduction rates cannot be explained by different carbon utilisation rates but rather reflect innate differences in the reductases of the strains. A preliminary identification of the molecular target for adaptation was performed with artificial electron donors and electron acceptors for all enzymatic steps in the denitrification pathway using a spectrophotometrical method. Nitrous oxide reductase activity was significantly higher in denitrifiers from the nitrate contaminated sites. This suggests that nitrous oxide reductase genes may be the molecular target, possibly by mutation or gene duplication, for adaptation to high nitrate concentrations. Two anaerobic denitrifiers from each of the contaminated sites were capable of aerobic denitrification indicating that high nitrate concentrations may select for strains that denitrifies in the presence of both oxygen and nitrate. Microcosm experiments with fertilised coniferous forest soil were performed to elucidate whether selection of denitrifiers, nitrate ammonifiers and nitrifiers have occurred as a response to nitrogen fertilisation. The activity of the nitrogen transformers were quantified using a gas chromatograph coupled to a mass spectrometer. The dominating fate of added 15NO3- and 15NH4+ was immobilisation in microorganisms or organic matter. The activity of denitrifiers, nitrate ammonifiers and nitrifiers were negligible, suggesting that microorganisms that immobilise or mobilise nitrogen control the major fate of fertiliser nitrogen