Blood samples are often used to investigate the possible presence of disease and to make treatment decisions. In the interpretation of the results, comparison either with previous values from the same individual or with a set of appropriate group-based reference intervals are used. Current reference intervals for common laboratory analytes are often based on measurements from apparently healthy persons aged 18–65 years. Age is accompanied by a general decline in organ functions and it is difficult to determine whether a change in levels of laboratory analytes in an elderly individual can be attributed to age alone, independent of environmental or disease processes. Frailty can be seen as a consequence of age-related multifactorial deterioration – physical, cognitive and sensory – resulting in vulnerability and lack of adaptability to internal stressors such as infection or new medication and/or external stressors such as fall at home. Consensus about the definition of “frail” and “frailty” is missing, both nationally and internationally, the question arises whether different definitions of “frailty” affect the interpretation of analytes when comparing different groups of elderly. The overarching aim of the thesis was to interpret and assess circulating levels of some clinical laboratory analytes in relation to conventional reference values in ?80-year-old, “apparently healthy”, “moderately healthy”, and “frail” individuals. Data originated from other studies, in which blood samples were collected from individuals ?80-year-old. Comparisons in Paper I of levels of some laboratory analytes, from 138 nursing home residents (NHRs), was made with blood from reference populations, both blood donor and the NORIP study. The results indicated differences for some immunological (complement factor 3 and 4, immunoglobulin G and M) and chemical analytes (alanine aminotransferase (ALT), phosphate, albumin, sodium, creatinine and urea), but no differences in levels occurred for aspartate aminotransferase (AST), gamma-glutamyltransferase (?-GT) or lactate dehydrogenase (LDH). It was unclear whether the differences were due to differences in age between the elderly and the reference populations or whether the elderly individuals had chronic diseases and were on medication. In Paper II, 569 individuals elderly individuals ?80 years old were classified as “healthy”, “moderately healthy”, and “frail”, based on diseases, medications and physical and cognitive abilities. Statistical differences between the groups were found for the investigated analytes; albumin, ALT, AST, creatinine and ?-GT. In Paper IV, individuals from Paper II (n=569) were divided into two groups and thereafter divided into “apparently healthy”, “moderately healthy”, and “frail”. One group was subdivided into “apparently healthy”, “moderately healthy” and “frail” based on physical and cognitive abilities and the other group was divided based on the frailty index (FI). There was no statistical difference found between “apparently healthy” and “moderately healthy" groups, regardless of classification model used. Among “frail” individuals, differences in levels occurred for three out of the five investigated analytes: ALT, creatinine and g-GT, with lower levels occurring when the FI classification model was used. No differences in levels occurred for albumin or AST in “frail” individuals, regardless of classification model used. The aim of Paper III was to study whether 1-year changes in complete blood count (CBC) (including haemoglobin (Hb), red blood cell (RBC), erythrocyte volume fraction (EVF), mean corpuscular volume (MCV), mean corpuscular Hb concentration (MCHC), white blood cell (WBC) and platelet count (PLT)), C-reactive protein (CRP) and interleukin (IL)-1?, IL-1RA, IL-6, IL-8 and IL-10 are associated with survival in elderly NHRs aged >80 years. Elevated levels of CRP and IL-8 during 1-year follow-up were associated with reduced length of survival in elderly NHRs. Based on the present thesis it is clear that there is need for reference intervals that consider both age and health status in elderly individuals. A reasonable conclusion when interpreting levels of analytes in elderly individuals with disease or frailty is that individual evaluation based on the individual’s previous levels, is recommended. Blodprover används ofta för att undersöka ev förekomst av sjukdomar och för att fatta behandlingsbeslut. Vid tolkningen av resultaten används jämförelse antingen med tidigare värden från samma individ eller med en uppsättning lämpliga gruppbaserade referensintervall. Nuvarande referensintervall för vanliga laboratorieanalyter baseras ofta på mätningar från tillsynes friska personer i åldern 18–65 år. Åldern åtföljs av en allmän nedgång i organfunktioner och det är svårt att avgöra om en ev förändring av nivåerna av laboratorieanalyterna kan enbart beror på skillnaden i ålder, oberoende av miljö- eller sjukdomsprocesser. Skörhet kan ses som en konsekvens av åldersrelaterad multifaktoriell försämring - fysisk, kognitiv och sensorisk - vilket resulterar i sårbarhet och brist på anpassningsförmåga till interna stressfaktorer som infektion eller ny medicinering och/eller yttre stressorer, såsom att ramla hemma. Konsensus om definitionen av "skörhet" saknas, både nationellt och internationellt och frågan uppstod om olika definitioner av "skörhet" påverkar tolkningar och referensintervall för laboratorieanalyter, när man jämför olika grupper av äldre individer. Det övergripande syftet med avhandlingen var att tolka och bedöma cirkulerande nivåer för några kliniska laboratorieanalyser i förhållande till gällande referensvärden hos ?80-åriga, ”hälsosamma”, ”måttligt friska” och ”sköra” individer. Data kommer från andra studier, inom vilka blodprov samlades, alla från individer ?80 år. Jämförelser i studie I gjordes mellan blodprover från 138 individer i särskilt boende, med blodprover från referenspopulationer, både blodgivare och från NORIP-studien. Resultaten visade skillnader för vissa immunologiska (komplementfaktor 3 och 4) och kemiska analyser (alaninaminotransferas (Alat), fosfat, albumin, natrium, kreatinin och urea), men inte alla (aspartataminotransferas (Asat), gamma-glytamyltransferas (?-GT) eller laktatdehydrgenas (LD)). Det var oklart om skillnaderna berodde på skillnader i ålder mellan de äldre och referenspopulationerna eller om de äldre individerna hade kroniska sjukdomar och medicinerade. I studie II klassificerades 569 individer >80 år som ”hälsosamma”, ”måttligt friska” och ”sköra”, baserat på sjukdomar, medicinering och fysiska och kognitiva förmågor. Statistiska skillnader mellan grupperna hittades för de undersökta analyterna: albumin, Alat, Asat, kreatinin och y-GT. I studie IV delades individer från papper II (n = 569) in i två grupper och delades därefter upp i "hälsosamma", "måttligt friska" och "sköra". En grupp delades in i ”hälsosamma”, ”måttligt friska” och ”sköra” baserat på fysiska och kognitiva förmågor och den andra gruppen delades in baserat på skörhetsindex. Det fanns ingen statistisk skillnad mellan ”hälsosamma” och ”måttligt friska” grupperna, oavsett vilken klassificeringsmodell som användes. Bland ”sköra” individer inträffade skillnader i nivåer för tre av de fem undersökta analyterna: Alat, kreatinin och ?-GT, med lägre nivåer där skörhetsindex hade använts som klassificeringsmodell jämfört klassificering baserad på fysiska och kognitiva förmågor. Syftet med studie III var att studera om 1-års förändringar i blodstatusparametrar (hemoglobin (Hb), erytrocytpartikelkoncentration (EPK), erytrocytvolymfraktion (EVF), medelcellvolym (MCV), mean corpuscular Hb concentration (MCHC), leukocytpartikelkoncentration (LPK) och trombocytpartikelkoncentration (TPK)), C-reaktivt protein (CRP) och interleukin (IL)-1?, IL-1Ra, IL-6, IL-8 och IL-10 var associerade med överlevnad hos individer från särskilt boende > 80 år. De mest framträdande resultaten var att förhöjda nivåer av CRP och IL-8 under 1-års uppföljning var förknippade med förkortad överlevnadstid hos äldre från särskilt boende. Baserat på den aktuella avhandlingen är det tydligt att det finns behov av referensintervall som beaktar både ålder och hälsostatus hos äldre individer. En rimlig slutsats när man tolkar nivåer av laboratorieanalyter hos äldre individer med sjukdom eller skörhet är att individuell utvärdering baserad på individens tidigare nivåer rekommenderas.

Building on the success of the bestselling The SAGE Handbook of Grounded Theory (2007), this title provides a much-needed and up-to-date overview, integrating some revised and updated chapters with new ones exploring recent developments in grounded theory and research methods in general. The highly-acclaimed editors have once again brought together a team of leading academics from a wide range of disciplines, perspectives and countries. This is a method-defining resource for advanced students and researchers across the social sciences. Part One: The Grounded Theory Method: 50 Years On Part Two: Theories and Theorizing in Grounded Theory Part Three: Grounded Theory in Practice Part Four: Reflections on Using and Teaching Grounded Theory Part Five: GTM and Qualitative Research Practice Part Six: GT Researchers and Methods in Local and Global Worlds

This forth updated edition contains the latest developments in analytical techniques. An international team of authors summarizes the information on biological influences, analytical interferences and on the variables affecting the collection, transport and storage as well as preparation of samples. They cover age, gender, race, pregnancy, diet, exercise and altitude, plus the effects of stimulants and drugs. National and international standards are described for sampling procedures, transport, sample identification and all safety aspects, while quality assurance procedures are shown for total laboratory management. In addition, the authors provide a glossary as well as a separate list of analytes containing the available data on reference intervals, biological half-life times, stability and influence and interference factors. For everyone involved in patient care and using or performing laboratory tests.

The Second Edition offers an innovative extension of grounded theory useful in qualitative research projects that draws on interviews, observations, and visual, narrative, and historical discourse materials. To engage the dense complexities of real world situations, Situational Analysis (SA) braids together Strauss's ecological social worlds/arenas theory, Foucault’s discourse analysis, and Deleuze and Guattari’s rhizomes and assemblages. The book will serve as an invaluable resource for advanced undergraduate and graduate-level students, as well as professional researchers and consultants from diverse backgrounds pursuing qualitative projects.

Classic Grounded Theory: Applications With Qualitative and Quantitative Data provides practical “how to” guidance for doing grounded theory (GT) using the classic approach articulated by Barney Glaser. Authors Judith A. Holton and Isabelle Walsh emphasize the philosophical flexibility of classic GT as a “full package” approach that can be applied to any study and any type of data where the goal is to discover and generate a conceptually integrated theory. Drawing on the experiences of novice researchers who have participated in GT troubleshooting seminars, the book provides step-by-step guidance on undertaking a research study that stays true to the classic GT practice paradigm.

Fresh, insightful and clear, this exciting textbook provides an engaging introduction to the application of qualitative methodology in the real world. Expert researchers then trace the history and philosophical underpinnings of different methodologies, explore the specific demands each places upon the researcher and robustly set out relevant issues surrounding quality and rigor. Featured methodologies include action research, discourse analysis, ethnography, grounded theory, case studies and narrative inquiry. This practical book provides a helpful guide to the research process - it introduces the relevant methods of generating, collecting and analysing data for each discrete methodology and then looks at best practice for presenting findings. This enables new researchers to compare qualitative methods and to confidently select the approach most appropriate for their own research projects. Key features include: Summary table for each chapter - allowing quick checks to test knowledge ′Window into′ sections - real world examples showing each methodology in action Student activities Learning objectives Full glossary Annotated suggestions for further reading Links to downloadable SAGE articles Links to relevant websites and organizations This is an invaluable resource for students and researchers across the social sciences and a must-have guide for those embarking on a research project.

In Grounded Theory and Grounded Theorizing, the key features of the grounded theory method are discussed and illustrated by showcasing examples taken from several of author Antony Bryant's most successful doctoral students. In this accessible volume, Bryant provides expert guidance on the use of grounded theory method in data collection, addressing key issues around quality and research methods.

This broad-ranging and clearly structured book critically overviews the many themes of social constructionism and its relevance to contemporary social and political issues. It brings together leading international contributors from across the social sciences, drawing on insights from psychology, sociology, politics, philosophy, cultural, gender and science studies. Major questions and topics explored in its critique and application of constructionist ideas include the theory and practice of scientific method, the development of social and political policy, the use of social science statistical methods, self-identity and the politics of collective identities, and technological advances in reproductive medicine.

Fieldwork is widely practiced but little written about, yet accounts of the exotic, mundane, complex, and often dangerous are central to not only sociology and anthropology but also geography, social psychology, and criminology. This handbook presents the first major overview of this method in all its variety, introducing the reader to the strengths, weaknesses, and "real world" applications of fieldwork techniques.