Självbildens resa genom kriminalvården

Författare: Anders Wiklander Titel: Självbildens resa genom kriminalvården Kandidatuppsats: SOCK01, 15 hp Internet Handledare: Åke Nilsén Sociologiska institutionen, Vårterminen 2013 Problem/Bakgrund: När en blivande kriminalvårdsklient för första gången kommer till en kriminalvårdsanstalt, ställs han inför något som på många sätt kan betecknas som en annan värld. Mycket av den sociala bas som skapat hans självbild börjar suddas ut i och med vistelsen i anstalten. Det påtvingade umgänget med andra människor, som den nyanlända klienten kanske aldrig skulle ha träffat i friheten, skapar en möjlig grogrund för en ändrad självbild. Forskning visar på att den före detta kriminalvårdsklienten visserligen återfår en del av sin sociala status efter frigivningen, medan en del blir bestående förluster. Kopplat till risken för stigmatisering på grund av det avtjänade straffet, ställs den frigivne inför kravet på att kunna hantera stigmat. Syfte: Studiens syfte är att ta reda på om och i så fall hur självbilden förändras under en vistelse inom svensk kriminalvård och hur det stigma som uppstår till följd av ett avtjänat fängelsestraff hanteras av den före detta kriminalvårdsklienten. Den målgrupp som valts ut inom ramen för studien har varit klienter som för första gången verkställer fängelsedomar. Fem djupintervjuer har genomförts med klienterna under tiden de vistats i en kriminalvårdsanstalt av lägsta säkerhetsnivå. Dessa har sedan kompletterats med intervjuer med samma klienter efter frigivningen från kriminalvården. Slutsatser/Resultat: Teorin lämnar ett svar på frågan om vad som händer med självbilden hos en klient som verkställer en fängelsedom. De genomförda intervjuerna pekar i samma riktning, men pekar på att domen i sig spelar en stor roll för självbildens förändring och på fördelar med att ha ett starkt socialt fotfäste för att dels kunna behålla självbilden intakt, dels hantera den stigmatisering som teorin visar att en verkställd fängelsedom kan innebära

Optimum take-off angle in the standing long jump

The aim of this study was to identify and explain the optimum projection angle that maximises the distance achieved in a standing long jump. Five physically active males performed maximum-effort jumps over a wide range of take-off angles, and the jumps were recorded and analysed using a 2-D video analysis procedure. The total jump distance achieved was considered as the sum of three component distances (take-off, flight, and landing), and the dependence of each component distance on the take-off angle was systematically investigated. The flight distance was strongly affected by a decrease in the jumper’s take-off speed with increasing take-off angle, and the take-off distance and landing distance steadily decreased with increasing take-off angle due to changes in the jumper’s body configuration. The optimum take-off angle for the jumper was the angle at which the three component distances combined to produce the greatest jump distance. Although the calculated optimum take-off angles (19–27º) were lower than the jumpers’ preferred take-off angles (31–39º), the loss in jump distance through using a sub-optimum take-off angle was relatively small

Therapeutic potential of extracellular vesicles

Extracellular vesicles (EVs) are nanometer-sized, lipid membrane enclosed, vesicles that are secreted by most, if not all, cells and contain macromolecular material of the source cell including lipids, proteins and various nucleic acid species. Over the last two decades, EVs have been recognized as important mediators of cell-to-cell communication that influence both physiological and pathological conditions. Owing to their ability to transfer bioactive components and surpass biological barriers, EVs are increasingly explored as therapeutics, both as natural delivery vectors and in its own right, as improved cell based therapies. In paper I, the great potential of EVs as therapeutic entities is explored by equipping EVs with the brain targeting rabies viral glycoprotein peptide and load them with siRNA against alpha-synuclein (a-Syn). The findings demonstrate that EVs efficiently deliver the siRNA to the target with subsequent reduction of a-Syn pathology in vitro as well as in the brains of a- Syn overexpressing transgenic mice. Thus, this indicates that targeted EVs can be employed as efficient vectors for siRNA therapy against Parkinson’s disease and other a-Syn related pathological conditions. In pursuance of using EVs for therapeutic purposes, the fate of injected EVs must be understood. Consequently, the aim of paper II was to elucidate the biodistribution of injected EVs and to investigate factors that may influence the tissue distribution of exogenous EVs. The use of the fluorescent lipophilic dye DiR was thoroughly assessed and found to be a suitable labelling method for biodistribution studies that allowed for in vivo EV tracing with high sensitivity. EVs displayed a general distribution pattern with high accumulation in liver, lung and spleen, which is in line with previous findings of mononuclear phagocyte system (MPS)-associated EV uptake. In addition, the biodistribution profile of EVs was, to a varying degree, influenced by the administration route, cell source, dosing and targeting. These variables may thus be adopted for future EV-based therapies to reflect the preferred biodistribution and/or pharmacokinetic profile for a given therapeutic approach. Furthermore, EVs have been found to convey the beneficial immunomodulatory effects of mesenchymal stromal cell (MSC)-based cell therapy. Based on these findings and studies demonstrating that EVs can be engineered to display surface moieties, the objective of paper III was to produce MSC-derived EVs that express therapeutic proteins. A chimeric construct, with an EV sorting domain fused to a non-signalling cytokine receptor, was introduced to the parental cell to produce EVs that can sequester cytokines, termed decoy EVs. By targeting the central inflammatory pathways of TNFa and IL-6 trans-signalling, these decoy EVs significantly ameliorate systemic inflammation and neuroinflammation in vivo. This novel concept thus combines the beneficial effects of stem cell therapy, EVs as delivery agents and cytokine targeted biologics. Taken together, the findings in this thesis suggest that EVs have the potential to be utilized as a future platform of highly potent multifaceted biopharmaceutical

How to teach about sustainable development in physical education? Examples from the perspectives of certified teachers in Sweden

Introduction: Teachers have a vital role in educating and empowering students to become informed and active agents of change in promoting sustainable development (SD). Little is known what PE teachers teach about SD. The aim of the present study was to explore what certified compulsory school and upper-secondary school physical education (PE) teachers in Sweden teach about SD within their practice. Methods: An online survey was used to collect data about background information and what the PE teachers had taught about SD in PE. Data from 653 PE teachers was used and the teaching examples were analyzed through thematic analysis. Results: The analysis resulted in eight themes: Equality, inclusion, and norms, Exploring the local environment, Outdoor education and care of nature, Interdisciplinary projects, Picking waste and recycling, Sustainable bodies, Sustainable lifestyles, health and well-being, and Sustainable use of products and consumption. Discussion: The findings suggest that PE can have distinct subject-specific contribution to aspects of the SD agenda, but also a role to empower students of how movement, exercise, and sport can be embedded within a broader ecological perspective. Furthermore, the described themes may open for research about what competences that are particularly relevant for PE teachers in the context of SD.This study was supported by funds from the Swedish Research Council for Sport Science (#02022-0141)

Attempted suicide and shame

A suicide attempt constitutes not only a risk factor for suicide, but also an expression of human suffering. As therapists, physicians and caring personnel we have an opportunity to reach out to this suffering individual and offer help. However, suicidal individuals often decline psychiatric follow-up or drop out of treatment prematurely. An improved understanding of these patients’ needs and problems may enhance our capability to treat them. This thesis is focusing on attempted suicide patients’ experiences. In the first study, eighteen patients were interviewed about their experiences of psychiatric inpatient treatment after a suicide attempt. Mixed feelings of relief and shame were common. Since shame is an emotion that triggers avoidance behaviors, and thus could lead to help negation, non-attendance and treatment drop-out, the following studies focused on shame in attempted suicide patients. The second study explored the shame theme in the interviews from the first study. The finding of shame with qualitative method also raised the question whether suicide attempters were generally shame-prone, that is, if suicide attempters in common were inclined to react with shame. A self-rating scale of shame-proneness, the Test of Self-Conscious Affect (TOSCA), was translated into Swedish and used as measurement of shame in the last two studies. In the third study, the propensity to shame in suicide attempters was compared with shame-proneness in non-suicidal psychiatric patients and healthy controls. In the fourth study, the TOSCA results of a small group of individuals who completed suicide were explored. The interviews with attempted suicide patients (study I and II) indicated that shame was common after a suicide attempt; thirteen out of eighteen participants described feelings and behaviors that were interpreted as shame reactions. Most women and two thirds of the men described shame reactions in the interviews. In the investigation of shame-proneness in groups of suicide attempters and non-suicidal controls, a more complex pattern emerged. Large gender differences in shame-proneness were found among the attempted suicide patients (but also among the non-suicidal controls). Female suicide attempters with borderline personality disorder (BPD) had the highest shame scores, while male suicide attempters (without BPD) had the lowest shame scores in the study. Shame-proneness among patients was also investigated with multiple regressions. It was found that shame-proneness in these samples of psychiatric patients was predicted by BPD and depression severity (but not by suicidality) in women, and level of depression and non-suicidality in men. Our studies indicated that shame reactions after attempted suicide are common, but that shame-proneness in everyday life is not typical for all groups of suicide attempters. A small group of suicide attempters who subsequently committed suicide did not differ in shame-proneness, from suicide attempters who were alive

Optimum take-off angle in the standing long jump

The aim of this study was to identify and explain the optimum projection angle that maximises the distance achieved in a standing long jump. Five physically active males performed maximum-effort jumps over a wide range of take-off angles, and the jumps were recorded and analysed using a 2-D video analysis procedure. The total jump distance achieved was considered as the sum of three component distances (take-off, flight, and landing), and the dependence of each component distance on the take-off angle was systematically investigated. The flight distance was strongly affected by a decrease in the jumper’s take-off speed with increasing take-off angle, and the take-off distance and landing distance steadily decreased with increasing take-off angle due to changes in the jumper’s body configuration. The optimum take-off angle for the jumper was the angle at which the three component distances combined to produce the greatest jump distance. Although the calculated optimum take-off angles (19–27º) were lower than the jumpers’ preferred take-off angles (31–39º), the loss in jump distance through using a sub-optimum take-off angle was relatively small

Development and psychometric testing of a barriers to HIV testing scale among individuals with HIV infection in Sweden; The Barriers to HIV testing scale-Karolinska version

© 2015 Wiklander et al. Background: Barriers to HIV testing experienced by individuals at risk for HIV can result in treatment delay and further transmission of the disease. Instruments to systematically measure barriers are scarce, but could contribute to improved strategies for HIV testing. Aims of this study were to develop and test a barriers to HIV testing scale in a Swedish context. Methods: An 18-item scale was developed, based on an existing scale with addition of six new items related to fear of the disease or negative consequences of being diagnosed as HIV-infected. Items were phrased as statements about potential barriers with a three-point response format representing not important, somewhat important, and very important. The scale was evaluated regarding missing values, floor and ceiling effects, exploratory factor analysis, and internal consistencies. Results: The questionnaire was completed by 292 adults recently diagnosed with HIV infection, of whom 7 were excluded (≥9 items missing) and 285 were included (≥12 items completed) in the analyses. The participants were 18-70 years old (mean 40.5, SD 11.5), 39 % were females and 77 % born outside Sweden. Routes of transmission were heterosexual transmission 63 %, male to male sex 20 %, intravenous drug use 5 %, blood product/transfusion 2 %, and unknown 9 %. All scale items had <3 % missing values. The data was feasible for factor analysis (KMO = 0.92) and a four-factor solution was chosen, based on level of explained common variance (58.64 %) and interpretability of factor structure. The factors were interpreted as; personal consequences, structural barriers, social and economic security, and confidentiality. Ratings on the minimum level (suggested barrier not important) were common, resulting in substantial floor effects on the scales. The scales were internally consistent (Cronbach's aα 0.78-0.91). Conclusions: This study gives preliminary evidence of the scale being feasible, reliable and valid to identify different types of barriers to HIV testing

Development of a 12-item short version of the HIV stigma scale

BACKGROUND: Valid and reliable instruments for the measurement of enacted, anticipated and internalised stigma in people living with HIV are crucial for mapping trends in the prevalence of HIV-related stigma and tracking the effectiveness of stigma-reducing interventions. Although longer instruments exist, e.g., the commonly used 40-item HIV Stigma Scale by Berger et al., a shorter instrument would be preferable to facilitate the inclusion of HIV stigma in more and broader surveys. Therefore, the aim of this work was to develop a substantially shorter, but still valid, version of the HIV Stigma Scale. METHODS: Data from a psychometric evaluation of the Swedish 40-item HIV Stigma Scale were reanalysed to create a short version with 12 items (three from each of the four stigma subscales: personalised stigma, disclosure concerns, concerns with public attitudes and negative self-image). The short version of the HIV stigma scale was then psychometrically tested using data from a national survey investigating stigma and quality of life among people living with HIV in Sweden (n = 880, mean age 47.9 years, 26% female). RESULTS: The hypothesized factor structure of the proposed short version was replicated in exploratory factor analysis without cross loadings and confirmatory factor analysis supported construct validity with high standardised effects (>0.7) of items on the intended scales. The χ(2) test was statistically significant (χ(2) = 154.2, df = 48, p 0.4 for all items, with a variation indicating that the broadness of the concept of stigma had been captured. All but two aspects of HIV-related stigma that the instrument is intended to cover were captured by the selected items in the short version. The aspects that did not lose any items were judged to have acceptable psychometric properties. The short version of the instrument showed higher floor and ceiling effects than the full-length scale, indicating a loss of sensitivity in the short version. Cronbach's α for the subscales were all >0.7. CONCLUSIONS: Although being less sensitive in measurement, the proposed 12-item short version of the HIV Stigma Scale has comparable psychometric properties to the full-length scale and may be used when a shorter instrument is needed

Psychometric properties of a short version of the HIV stigma scale, adapted for children with HIV infection

Background: HIV is a stigmatizing medical condition. The concept of HIV stigma is multifaceted, with personalized stigma (perceived stigmatizing consequences of others knowing of their HIV status), disclosure concerns, negative self-image, and concerns with public attitudes described as core aspects of stigma for individuals with HIV infection. There is limited research on HIV stigma in children. The aim of this study was to test a short version of the 40-item HIV Stigma Scale (HSS-40), adapted for 8–18 years old children with HIV infection living in Sweden. Methods: A Swedish version of the HSS-40 was adapted for children by an expert panel and evaluated by think aloud interviews. A preliminary short version with twelve items covering the four dimensions of stigma in the HSS-40 was tested. The psychometric evaluation included inspection of missing values, principal component analysis (PCA), internal consistency, and correlations with measures of health-related quality of life (HRQoL). Results: Fifty-eight children, representing 71% of all children with HIV infection in Sweden meeting the inclusion criteria, completed the 12-item questionnaire. Four items concerning participants’ experiences of others’ reactions to their HIV had unacceptable rates of missing values and were therefore excluded. The remaining items constituted an 8-item scale, the HIV Stigma Scale for Children (HSSC-8), measuring HIV-related disclosure concerns, negative self-image, and concerns with public attitudes. Evidence for internal validity was supported by a PCA, suggesting a three factor solution with all items loading on the same subscales as in the original HSS-40. The scale demonstrated acceptable internal consistency, with exception for the disclosure concerns subscale. Evidence for external validity was supported in correlational analyses with measures of HRQoL, where higher levels of stigma correlated with poorer HRQoL. Conclusion: The results suggest feasibility, reliability, as well as internal and external validity of the HSSC-8, an HIV stigma scale for children with HIV infection, measuring disclosure concerns, negative self-image, and concerns with public attitudes. The present study shows that different aspects of HIV stigma can be assessed among children with HIV in the age group 8–18

Novel Assay of Metformin Levels in Patients With Type 2 Diabetes and Varying Levels of Renal Function: Clinical recommendations

AbstractObjective: To study trough levels of metformin in serum and its intra individual variation in patients using a newly developed assay. Research Design and Methods: Trough serum levels of metformin was measured once using Liquid Chromatography Tandem Mass Spectrometry (LcMSMS) in 137 type 2 diabetes patients with varying renal function (99 men) and followed repeatedly during two months in 20 patients (16 men) with estimated GFR (eGFR) below 60 ml/min/1.73 m(2) body surface. Results: Patients with eGFR >60, 30-60, and <30 ml/min/1.73 m(2) had a median trough metformin concentration of 4.5 mumol/l (range 0.1-20.7, n=107), 7.71 mumol/l (0.12-15.15, n=21), and 8.88 mumol/l (5.99-18.60, n=9), respectively. The median intraindividual overall coefficient of variation (CV) was 29.4 % (range 9,8-74,2). Conclusions: Determination of serum metformin with the LCMSMS technique is useful in patients on metformin treatment. Few patients had values over 20 mumol/L. Metformin measurement is less suitable for dose titration