För Sverige i framtiden : Bio-objektifiering av ny medicinsk teknologi

Taking Sweden into the future – Bio-objectification of new medical technology In this article, we analyze how contemporary discursive silences around new biotechnologies such as cybrids and induced pluripotent stem cells (iPSC), have been enabled by earlier policy processes in the area, e.g. boundary work around what is human and non-human, living and non-living, subject and object. The analysis of policy processes around xenotransplantations and the use of human embryonic stem cells, shows that the stem cells’ and xenografts’ “bio-identities” become stabilized through high expectations for the future, a lack of therapeutic possibilities and struggles over definitions of life. The policy processes around human embryonic stem cells and organs from other animals, are characterized by a normalization of certain understandings of ”life”, trust in scientific progress and it’s national financial potentials and a categorization of criticism as irrational. Through these “bio-objectification processes”, debate and decision making has been moved from a political and public context into ethical committees and research funding bodies. The article concludes by discussing consequences of this political non-handling of biomedical technologies and how these bioobjects could be re-politicized.

Critical anthropomorphism and animal ethics

Anthropomorphism has long been considered a cardinal error when describing animals. Ethicists have feared the consequences of misrepresenting animals in their reasoning. Recent research within human-animal studies, however, has sophisticated the notion of anthropomorphism. It is suggested that avoiding anthropomorphism merely creates other morphisms, such as mechanomorphism. Instead of avoiding anthropomorphism, it is argued that it is a communicative strategy that should be used critically. Instances of anthropomorphism in animal ethics are analyzed in this paper. Some analogies made between people and non-human animals in present theories of animal ethics are clear instances of psychological anthropomorphism. Other analogies are implicit cases of cultural anthropomorphism. It is argued that animal ethics needs to take the wider discourse of critical anthropomorphism into account in order to sophisticate the understanding and use of anthropomorphic projections. Anthropomorphism is an efficient tool of communication, and it may be made an adequate one as well.

Recent developments in statistical methods for detecting genetic loci affecting phenotypic variability

A number of recent works have introduced statistical methods for detecting genetic loci that affect phenotypic variability, which we refer to as variability-controlling quantitative trait loci (vQTL). These are genetic variants whose allelic state predicts how much phenotype values will vary about their expected means. Such loci are of great potential interest in both human and non-human genetic studies, one reason being that a detected vQTL could represent a previously undetected interaction with other genes or environmental factors. The simultaneous publication of these new methods in different journals has in many cases precluded opportunity for comparison. We survey some of these methods, the respective trade-offs they imply, and the connections between them. The methods fall into three main groups: classical non-parametric, fully parametric, and semi-parametric two-stage approximations. Choosing between alternatives involves balancing the need for robustness, flexibility, and speed. For each method, we identify important assumptions and limitations, including those of practical importance, such as their scope for including covariates and random effects. We show in simulations that both parametric methods and their semi-parametric approximations can give elevated false positive rates when they ignore mean-variance relationships intrinsic to the data generation process. We conclude that choice of method depends on the trait distribution, the need to include non-genetic covariates, and the population size and structure, coupled with a critical evaluation of how these fit with the assumptions of the statistical model.

Iscensättanden av halsfluss : relationella göranden av en sjukdom i medicinska praktiker

Enacting tonsillitis: Relational performances in medical practices In this paper the diagnostic process of bacterial tonsillitis at two Swedish health centres is described and analysed as to how this disease comes into being, or how it is enacted. The concept of enactment implies that disease is constituted in, and through, relational practises involving human and non-human elements. The study is based on interviews with nurses and doctors as well as field observations from the health centres. In the analysis it becomes apparent that different – and sometimes conflicting – enactments of tonsillitis appear in medical practices, depending on the organization of relations between different elements. It is concluded that diagnostic agency is created in relations between both humans and non-humans, and who and what is given diagnostic agency is changeable depending on the relations at hand. The diagnostic process of tonsillitis shows how the most mundane medical diagnoses involves a number of complex relations, that stretches beyond categories such as social and medical.

Internally Displaced Persons Rights in Human Rights Perspective(Specifically Focused on Pakistani IDPs Example) : “Basic Human Rights of IDPs to Attain Equality in Dignity and Rights”

After the WWII, there was much concern to protect human rights situation all over the world. During the cold wars, huge displacement took place within different countries due to internal arms/ethnic conflicts. Millions of IDPs, who were uprooted by armed conflict or ethnic strife faced human rights violence. In 2002, there were estimated between 20-25 millions IDPs in the world (Phuong, p.1). Internally displacement is a worldwide problem and millions of the people displaced in Africa and Asia. These all Internal displacements of the people are only the result of the conflicts or the violations of the Human Rights but also sometimes it happened because of the natural disasters. “All human beings are born free and equal in dignity and rights..."(Streich, Article 1) This article works as the foundation of human rights which gives every human being an equal rights and opportunity to maintain his/her dignity. Human Rights issues related to human dignity must be taken very seriously and should not be ignored at any level; Many human rights issues are not always visible, issues such as: privacy, security, equality, protection of social and cultural values etc. In this paper I am going to apply theoretical approach of “all human being are equal in dignity and rights” to defend IDPs rights.

Understanding the "black box" of a health-promotion program : keys to enable health among older persons aging in the context of migration

Although the need to make health services more accessible to persons who have migrated has been identified, knowledge about health-promotion programs (HPPs) from the perspective of older persons born abroad is lacking. This study explores the design experiences and content implemented in an adapted version of a group-based HPP developed in a researcher-community partnership. Fourteen persons aged 70-83 years or older who had migrated to Sweden from Finland or the Balkan Peninsula were included. A grounded theory approach guided the data collection and analysis. The findings showed how participants and personnel jointly helped raise awareness. The participants experienced three key processes that could open doors to awareness: enabling community, providing opportunities to understand and be understood, and confirming human values and abilities. Depending on how the HPP content and design are being shaped by the group, the key processes could both inhibit or encourage opening doors to awareness. Therefore, this study provides key insights into how to enable health by deepening the understanding of how the exchange of health-promoting messages is experienced to be facilitated or hindered. This study adds to the scientific knowledge base of how the design and content of HPP may support and recognize the capabilities of persons aging in the context of migration.

Can humming caregivers´ facilitate feeding during mealtime situations with persons with dementia? A qualitative study

Background. ‘Music Therapeutic Caregiving’, defined as when caregivers’ sing for or together with persons with dementia care situations, has been shown to facilitate the caring situation, and enhance positive and decrease negative expressions in persons with dementia. No studies about singing during mealtimes have been conducted, and this project was designed to elucidate this. However, since previous studies have shown that there is a risk that persons with dementia will start to sing along with the caregiver, the caregiver in this study hummed such that the person with dementia did not sing instead of eat. Aim. To describe professional caregivers’ experiences of humming during meal time while feeding persons with dementia. Method. An intervention with caregivers humming was implemented during lunch time. Focus group interviews were conducted to fetch the caregivers experiences. Qualitative content analysis was used to analyse the interviews. Results. The caregivers described that humming disseminated relaxation and joy, and awakened memories about the songs hummed which encouraged the persons with the dementia to join in the songs. They also described that humming seemed to make the persons with dementia associate with mealtime and could make them eat more. However it also revealed suspiciousness and agitation from the persons with dementia. Conclusion. Humming during mealtime revealed mainly positive as well as some negative influences. More and larger studies are needed to be able to draw general conclusions.

Evaluation of communication behavior in persons with dementia during caregivers’ singing

The number of persons with dementia (PWD) is increasing rapidly worldwide. Cognitive impairments and communication difficulties are common among PWD. Therefore, gaining mutual togetherness in caring relation between PWD and their caregivers is important. This study was to investigate the effects of music therapeutic care (MTC) during morning care situations on improving verbal and nonverbal communication behaviors in people with dementia. An observation study with 10 PWD participating. Videotaped interactions (VIO) between PWD and their caregivers were conducted during eight weekly sessions, four recordings consisted of usual morning care and four recordings were of morning care with MTC intervention. The Verbal and Nonverbal Interaction Scale was used to analyze the recorded interactions at a later time. The unsociable verbal variable Cursing decreased significantly (P=.037) during MTC when compared with the baseline measurement. A significant (P=.000) reduction was observed for the unsociable nonverbal variable Does not respond to question. MTC significantly (P=.01) increased the mean score for the sociable nonverbal variable – Calm – relaxed. For sociable verbal communication, significant differences were observed for the variables Use coherent communication (P=.012), Use relevant communication (P=.009), Responds to questions (P=.000), Humming (P=.004), Singing (P=.000). MTC during morning care situations can be an effective non-pharmacological treatment, as well as nursing intervention in order to improve sociable communication behaviors, as well as reduce unsociable communication behaviors of PWDs

Persons : their identity and individuation

This study is about the nature of persons and personal identity. It belongs to a tradition that maintains that in order to understand what it is to be a person we must clarify what personal identity consists in. In this pursuit, I differentiate between the problems (i) How do persons persist? and (ii) What facts, if any, does personal identity consist in? Concerning the first question, I argue that persons persist three-dimensionally (the endurance view), and not four-dimensionally (the perdurarne view), on the ground that objects must always fall under some substance sortal concept S (the sortal dependency of individuation), and that the concept person entails that objects falling under it are three-dimensional. Concerning the second question, I differentiate between Criterianists, who maintain that it is possible to specify a non-circular and informative criterion for personal identity, and Non-Criterianists, who deny that such a specification is possible. I argue against Criterianist accounts of personal identity on the ground that they are either (i) circular, (ii) violate the intrinsicality of identity or (iii) do not adequately represent what we are essentially. I further criticise three Psychological Non-Criterianist accounts of personal identity on the ground that they wrongly assume that 'person' refers to mental entities. Instead I formulate the Revised Animal Attribute View where person is understood as a basic sortal concept which picks out a biological sort of enduring animals. In this, I claim that the real essence of a person is determined by the real essence of the kind of animal he is, without thereby denying that persons have a real essence as persons.

Unlicensed personnel administering medications to older persons living at home : a challenge for social and care services

BACKGROUND: Administration of medication to care recipients is delegated to home-care assistants working in the municipal social care, alongside responsibility for providing personal assistance for older people. Home-care assistants have practical administration skills, but lack formal medical knowledge. AIM: The aim of this study was to explore how home-care assistants perceive administration of medication to older people living at home, as delegated to them in the context of social care. METHODS: Four focus groups consisting of 19 home-care assistants were conducted. Data were analysed using qualitative content analysis. RESULTS: According to home-care assistants, health and social care depends on delegation arrangements to function effectively, but in the first place it relieves a burden for district nurses. Even when the delegation had expired, administration of medication continued, placing the statutes of regulation in a subordinate position. There was low awareness among home-care assistants about the content of the statutes of delegation. Accepting delegation to administer medications has become an implicit prerequisite for social care work in the municipality. CONCLUSIONS: Accepting the delegation to administer medication was inevitable and routine. In practice, the regulating statute is made subordinate and consequently patient safety can be threatened. The organisation of health and social care relies on the delegation arrangement to meet the needs of a growing number of older home-care recipients. IMPLICATIONS FOR PRACTICE: This is a crucial task which management within both the healthcare professions and municipal social care needs to address, to bridge the gap between statutes and practice, to create arenas for mutual collaboration in the care recipients' best interest and to ensure patient safety.

Reactions of Persons with Dementia to Caregivers Singing in Morning Care Situations

Music therapeutic caregiving', when caregivers sing for or together with persons with severe dementia during care situations, has been suggested as a way to reduce problematic behaviors in dementia care. The present study implemented this technique as an intervention in dementia care. Six caregivers participated in group interviews about their experiences of morning care situations without and with'Music therapeutic caregiving'. Through a qualitative content analysis two themes emerged.'Being in a different reality' was based on'usual' morning care situations. The caregivers' experienced the persons with dementia as absent-minded; communication and cooperation were difficult. The second theme,'Being present', was based on morning care situations with the intervention. The caregivers described communication as enhanced; the persons with dementia expressed themselves more appropriately, making cooperation possible. The results indicate that'Music therapeutic caregiving' might lead to a more positive experience of the person with dementia and seems to increase receptivity to caregiving.  

A therapy dog's impact on daytime activity and night-time sleep for older persons with Alzheimer's disease : a case study

Background: Animal-Assisted Therapy using dogs have been described as having a calming effect, decrease sundowning and blood-pressure in persons with Alzheimer’s disease. The aim was to investigate how continuous and scheduled visits by a prescribed therapy dog affected daytime and night-time sleep for persons with Alzheimer’s disease. Methods: In this case study, registration of activity and sleep curves was conducted from five persons with moderate to severe Alzheimer’s disease living at a nursing home, over a period of 16 weeks using an Actiwatch. Data was analysed with descriptive statistics. Result: The study shows no clear pattern of effect on individual persons daytime activity and sleep when encounter with a therapy dog, but instead points to a great variety of possible different effects that brings an increased activity at different time points, for example during night-time sleep. Conclusions: Effects from the use of a Animal-Assisted Therapy with a dog in the care of persons with Alzheimer’s disease needs to be further investigated and analysed from a personcentred view including both daytime and nightime activities.

Can therapy dogs evoke awareness of one's past and present life in persons with Alzheimer's disease?

BACKGROUND: Persons with Alzheimer's disease (AD) sometimes express themselves through behaviours that are difficult to manage for themselves and their caregivers, and to minimise these symptoms alternative methods are recommended. For some time now, animals have been introduced in different ways into the environment of persons with dementia. Animal-Assisted Therapy (AAT) includes prescribed therapy dogs visiting the person with dementia for a specific purpose. AIM: This study aims to illuminate the meaning of the lived experience of encounters with a therapy dog for persons with Alzheimer's disease. METHOD: Video recorded sessions were conducted for each visit of the dog and its handler to a person with AD (10 times/person). The observations have a life-world approach and were transcribed and analysed using a phenomenological hermeneutical approach. RESULTS: The result shows a main theme 'Being aware of one's past and present existence', meaning to connect with one's senses and memories and to reflect upon these with the dog. The time spent with the dog shows the person recounting memories and feelings, and enables an opportunity to reach the person on a cognitive level. CONCLUSIONS: The present study may contribute to health care research and provide knowledge about the use of trained therapy dogs in the care of older persons with AD in a way that might increase quality of life and well-being in persons with dementia. IMPLICATIONS FOR PRACTICE: The study might be useful for caregivers and dog handlers in the care of older persons with dementia.