Läkartidningen
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Comparative Study
[Unbroken continuity of patient care in shoulder pain. Same initial care in primary health services as in hospitals].
Thirty percent of all patients that consult their primary care physicians for pain in their musculoskeletal systems have pain in the neck/shoulder region, while 23% have lower back pain. Of major concern in Sweden is a patient's lengthy waiting period before seeing a specialist, with a resultant delay in treatment. ⋯ Axelina is the tool that provides all the standardized treatment algorithms, rehabilitation plans and detailed home exercises. Axelina also contains a two-day instructional package with case studies presented on video.
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As of today, more than 130 million girls and women worldwide are genitally mutilated. Female genital mutilation (FGM) exists primarily on the African continent (along and north of the equator), but the practice is also carried out elsewhere. Clitoridectomy was performed in medicine both in the United States and in Europe as late as in the 1950s. ⋯ From a psychosexual perspective FGM is interpreted as a practice that has been made possible in patriarchal societies where the sexuality of women has to be controlled and where unequal gender relationships are preserved. FGM is practiced by people from various religious denominations, among them Copts, Animists, Catholics, Protestants and Muslims, something that goes against the relatively common belief that FGM is practiced only among Muslims. The resistance to FGM found in countries where the practice is rife clearly demonstrates that patriarchal structures and what gets defined as "culture" are indeed possible to change and renegotiate.
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The number of patients handicapped by chronic pain is increasing in Sweden. Many of these patients do not receive adequate care despite guidelines issued in 1994 by the National Board of Health and Welfare recommending councils to establish multidisciplinary pain teams according to the guidelines issued by the International Association for the Study of Pain. A survey of Swedish general hospitals reveals that these recommendations have not yet been implemented. With the exception of university hospitals only one out of five hospitals has set up specialised pain care teams; in remaining hospitals the organisation of pain management leaves much to be desired.