Från politiskt håll finns idag en tydlig politisk intention att studenter med funktionshinder ska inkluderas i högskolornas och universitetens utbildningar. Denna artikel tar upp vad som hindrar respektive möjliggör att dessa politiska intentioner om tillgänglighet och mångfald implementeras i undervisningen. Analysen baseras på en fallstudie av en samhällsvetenskaplig institution vid ett svenskt lärosäte och frågeställningarna handlar om lärarna vill, förstår och kan implementera dessa intentioner. I studien framgår att även om det finns en tydlig vilja hos lärarna och den administrativa stödpersonalen att dessa studenter ska kunna delta i och tillgodogöra sig utbildningen, råder det ingen samsyn kring varför det är viktigt med en mångfald i studentpopulationen. Det pedagogiska stöd som finns tillgängligt för enskilda studenter anses vara värdefullt men inte särskilt flexibelt. Den mer generella anpassning lärarna gör av undervisningen beskrivs som viktig men tidskrävande. Förståelsen för studenters behov grundas mer på personliga erfarenheter hos lärarna än på en pedagogisk diskussion mellan kolleger på arbetsplatsen. Att göra anpassningar och delta i en pedagogisk diskussion tar tid och kräver prioriteringar. Här får undervisningen ofta stå tillbaka till förmån för den forskningsrelaterade verksamheten.

Research shows that working is positive for people with long-term pain but that work-related support from health professionals is inadequate. One explanation for this inadequacy is that patients and providers differ in terms of perspectives on motivation to work. In this article, we compare factors that 31 patients and 15 general practitioners consider important to promote return to work for people with long-term pain. We analyzed the interviews with thematic analysis and a motivational push and pull framework to cover different motivational factors, societal and individual, that might push or pull patients from or toward work. Providers said that a difference between working and nonworking patients is their level of individual motivation, while the patients’ stories showed that the main difference was the physical (non)ability to push themselves to work. We suggest that work-related support can be improved by addressing such differences in clinical practice.

The aim of this study was to explore how general practitioners cope with the challenges they face when trying to provide effective interventions to pain patients within the organizational context of a health center. Based on interviews with 15 Swedish providers, the study suggests that the challenges that general practitioners experience in the consultations with patients must be understood in a temporal perspective related to the process of care (from initial consultations to “post-treatment”) and the help-seeking process (close to the onset of problems or later). The coping strategies used to handle these challenges can be summarized into four major domains. First, participants adopted a biopsychosocial model to provide proper care. Second, they employed strategies to enhance communication. Third, they coped with the organizational environment, and fourth, they used strategies to cope emotionally. The study contributes to a holistic perspective on providers’ coping strategies by addressing temporal and organizational aspects.

Inflammatory pseudotumour is a rare condition that can affect various organs. The clinical and histologic appearance of the pseudotumour may mimic haematological, lymphoproliferative, paraneoplastic or malignant processes. A previously healthy 39-year-old man presented with nephrotic syndrome. He had a history of headaches, nausea and swollen ankles. Computed tomography of the abdomen revealed a 6-cm mass in the spleen. Following a renal biopsy, a diagnosis of membranoproliferative glomerulonephritis (MPGN) type I was made. Splenectomy was performed and the examination revealed a mixed population of lymphocytes with predominantly T-cells, B-cells and lymphoplasmacytoid cells. Immunostaining confirmed that the small cells were mostly T-cells positive for all T-cell markers including CD2, CD3, CD4, CD5, CD7 and CD8. A diagnosis of inflammatory pseudotumour was established. The removal of the spleen was followed by remission of glomerulonephritis, but it was complicated by a subphrenic abscess and pneumonia. This association between an inflammatory pseudotumour of the spleen and MPGN has not been previously described. Abnormal immune response due to the inflammation leading to secondary glomerulonephritis might be the main pathogenic mechanism.

Approximately 20% of the population experience long-term pain. Women are generally more affected than men. Currently, pain researchers advocate a biopsychosocial perspective, which emphasises the importance of addressing psychological and social factors as well as biomedical ones in clinical practice. However, previous research shows that this holistic perspective is not always materialized in medical practice. The main objective of this article is to explore what obstructs the biopsychosocial approach from being explicitly used in primary care services. Our empirical material consists of qualitative interviews conducted with 33 pain patients and 15 general practitioners. The results suggest that participants agree that a biopsychosocial perspective is important to promote good care. However, the underpinning conditions for the clinical consultation, implicating a lack of time, continuity and knowledge as well as requirements related to societal regulations, limited the possibilities to adopt a biopsychosocial perspective in practice. Instead, many consultations focused on medications and work ability, which, in turn, led to gendered consequences. Women and men agreed that work was an important part of their identity. However, men described different opportunities than women to invest all their energy in work. A main focus on work ability in consultations therefore confirmed the values highlighted by men, but at the same time obscured many areas that were the everyday reality of many of the women. Finally, all patients described an ambivalent stance towards being a patient. Many distanced themselves from the shameful and negative gendered patient stereotypes, but also needed to make their patienthood convincing to general practitioners in order to receive care. We conclude that important life areas affecting pain can be uncovered, and a less shameful patienthood enabled, when a biopsychosocial perspective is materialized with dignity in clinical practice.