| 31. |
- Langegård, Ulrica, 1969, et al.
(författare)
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Development and initial psychometric evaluation of a radiotherapy-related symptom assessment tool, based on data from patients with brain tumours undergoing proton beam therapy
- 2021
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Ingår i: Scandinavian Journal of Caring Sciences. - : John Wiley & Sons. - 0283-9318 .- 1471-6712. ; 35:3, s. 796-804
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Tidskriftsartikel (refereegranskat)abstract
- Background: Currently, no available tool easily and effectively measures both the frequency, intensity and distress of symptoms among patients receiving radiotherapy. A core symptom set (fatigue, insomnia, pain, appetite loss, cognitive problems, anxiety, nausea, depression, constipation, diarrhoea and skin reaction) has been identified and assessed across oncology research to better understand the pattern of symptoms and treatment side effects.Aim: The aim was to develop a tool measuring the multiple‐symptom experience in patients undergoing radiotherapy and evaluate its psychometric properties (validity, reliability and responsiveness).Design: This study has a prospective, longitudinal and quantitative design.Methods: We developed a patient‐reported outcome questionnaire, the Radiotherapy‐Related Symptoms Assessment Scale to assess the frequency, intensity and distress associated with symptoms. Patients (n = 175) with brain tumours undergoing proton beam therapy completed the Radiotherapy‐Related Symptoms Assessment Scale and the health‐related quality of life questionnaire (EORTC QLQ‐C30) during treatment. We assessed the validity, reliability and responsiveness of the Radiotherapy‐Related Symptoms Assessment Scale and evaluated the validity against QLQ‐C30.Results: There were significant questionnaire–questionnaire correlations regarding selected items, primarily fatigue, insomnia and pain, indicating satisfactory criterion‐related validity. The Radiotherapy‐Related Symptoms Assessment Scale had fair to good retest reliability.Conclusion: The Radiotherapy‐Related Symptoms Assessment Scale is a valid instrument for assessing symptom intensity and distress in patients with brain tumour undergoing PBT, with psychometric properties within the expected range. The Radiotherapy‐Related Symptoms Assessment Scale provides nurses with substantial information on symptom experience but requires little effort from the patient. Additional studies are required to further assess the psychometric properties in patients with different cancer diagnoses receiving conventional radiotherapy.
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| 32. |
- Sjövall, Katarina, et al.
(författare)
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To become part of the team-patient experiences of participating in decision-making for a new treatment (proton beam therapy)
- 2024
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Ingår i: Supportive Care in Cancer. - : Springer Nature. - 0941-4355 .- 1433-7339. ; 32:7
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: The aim of this study was to explore patients' experience of participation in the treatment decision of proton beam therapy versus conventional radiotherapy. BACKGROUND: Proton beam therapy (PBT) has become a treatment option for some cancer patients receiving radiotherapy. The decision to give PBT instead of conventional radiotherapy (CRT) needs to be carefully planned together with the patient to ensure that the degree of participation is based on individuals' preferences. There is a knowledge gap of successful approaches to support patients' participation in the decision-making process, which is particularly important when it comes to the situation of having to choose between two treatment options such as PBT and CRT, with similar expected outcomes.METHOD: We conducted a secondary analysis of qualitative data collected from interviews with patients who received PBT for their brain tumor. Transcribed verbatims from interviews with 22 patients were analyzed regarding experiences of participation in the decision-making process leading to PBT.FINDINGS: Participants experienced their participation in the decision-making process to a varying degree, and with individual preferences. Four themes emerged from data: to be a voice that matters, to get control over what will happen, being in the hand of doctors' choice, and feeling selected for treatment.CONCLUSION: A decision for treatment with PBT can be experienced as a privilege but can also cause stress as it might entail practical issues affecting everyday life in a considerable way. For the patient to have confidence in the decision-making process, patients' preferences, expectations, and experiences must be included by the healthcare team. Including the patient in the healthcare team as an equal partner by confirming the person enables and facilitates for patients' voice to be heard and reckoned with. Person-centered care building on a partnership between patients and healthcare professionals should provide the right basis for the decision-making process.
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| 33. |
- Gunnarsson, Gunnar, et al.
(författare)
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Zero Prevalence of Influenza A Virus in Two Raptor Species by Standard Screening
- 2010
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Ingår i: Vector-borne and zoonotic diseases. - : Mary Ann Liebert Inc. - 1530-3667 .- 1557-7759. ; 10:4, s. 387-390
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Tidskriftsartikel (refereegranskat)abstract
- Disease can have sever impact on animal populations, especially in rare species. Baseline data for atypical host species are missing for a range of infectious diseases, although such hosts are potentially more affected than the normal vectors and reservoir species. If highly pathogenic avian influenza strikes rare birds of prey, this may have crucial impact on the predator species itself, but also on the food web in which it interacts. Here we present the first large-scale screening of raptors that regularly consume birds belonging to the natural reservoir of influenza A viruses. Influenza A virus prevalence was studied in two rare raptors, the white-tailed sea eagle (Haliaetus albicilla) and the peregrine falcon (Falco peregrinus). Nestlings were screened for active (181 white-tailed sea eagles and 168 peregrine falcons) and past (123 white-tailed sea eagles and 6 peregrine falcons) infection in 2006-2007, and an additional 20 succumbed adult white-tailed sea eagles were sampled in 2003-2006. Neither high- nor low-pathogenic influnza infections were found in our sample, but this does not rule out that the former may have major impact on rare raptors and their food webs.
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| 34. |
- Argento, Daniela, et al.
(författare)
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The ‘externalisation’ of local public service delivery : experience in Italy and Sweden
- 2010
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Ingår i: International Journal of Public Policy. - Olney : InderScience Publishers. - 1740-0600 .- 1740-0619. ; 5:1, s. 41-56
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Tidskriftsartikel (refereegranskat)abstract
- In recent years, the local government sector in European countries has undergone important changes involving, among other things, the externalisation of local public service provision through various forms of corporatisation, public-public collaboration, public-private partnerships and contracting out. An important consequence of these institutional changes has been the recasting of local governance systems through the need for increased cooperation between public and private actors. This article addresses these matters with comparative reference to the experience in Italy and Sweden. In doing so, it considers local governments in their constitutional and legal contexts, leading to more detailed discussions of their externalisation initiatives and resultant organisational forms and governance arrangements. Issues of ownership have been important concerning the significance of 'community' and 'place' in the management of public affairs. © 2010 Inderscience Enterprises Ltd.
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| 35. |
- Jönsson, K. Ingemar, et al.
(författare)
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Implementering av ekosystemtjänstbegreppet i kommunal verksamhet
- 2017
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Projektet ECOSIMP handlar om förutsättningen för att implementera begreppet ekosystemtjänst, i fortsättningen kallat EST-begreppet, i kommunerna, och undersöker bland annat hur kommunala tjänstemän och politiker ser på denna utmaning. En intervjustudie genomfördes med tjänstemän och politiker i de sju medverkande kommunerna. I en studie av Malmö stad undersöktes hur ekosystemtjänst-relaterade begrepp har integrerats i översiktsplaner och utvecklats till ett verktyg i hållbar samhällsplanering. Ett annat delprojekt handlar om miljökonsekvens-bedömningar (MKB) och behovet av metodutveckling för att integrera ekosystemtjänstansatsen i MKB, där möjligheten att integrera ekosystemtjänster i den så kallade RIAM-metoden analyserades. Projektet innehåller också en analys av arbetet med att integrera ekosystemtjänster i kommunernas klimatanpassning, så kallad ekosystembaserad klimatanpassning (EbA). Slutligen redovisas en analys av det transdisciplinära arbetssättet inom ECOSIMP-projektet. Resultaten visar att EST-begreppet idag är relativt välkänt i kommunerna och att det finns en övervägande positiv inställning till det och förhoppningar om att det ska skapa större möjlighet till miljöhänsyn. Förståelsen av begreppet behöver dock fördjupas i den kommunala verksamheten och distinktionen mellan implicit och explicit användning av EST-begreppet och den relaterade EST-ansatsen förtydligas. Ett antal hinder och möjligheter för att börja använda begreppet och för att uppnå etappmålet 2018 identifierades också. Bland annat upplevs innebörden av etappmålet 2018 som oklar, och bara en mindre del av de intervjuade i kommunerna ansåg att etappmålet skulle nås. Betydelsen av att politiker och allmänhet får kännedom om, och förståelse för, EST-begreppet betonades också. Malmö framstår som ett bra exempel på hur långsiktigt arbete för en hållbar stadsutveckling kan skapa förutsättningar att integrera ekosystemtjänster i den fysiska planeringen. Analysen av EbA i kommunerna visade att initiativ relaterade till klimatanpassning och ekosystemtjänster oftast inte är samordnade, men de skulle kunna utvecklas i den riktningen genom bättre samordning mellan kommunernas olika enheter och integrering av EbA i den långsiktiga planeringen utifrån kunskap om nutida och framtida klimatrisker. Verktyg för att värdera förändringar i EST till följd av mänsklig exploatering behövs och här föreslås en utveckling av den så kallade RIAM-metoden, som kan erbjuda ett sätt att väga in olika EST i planeringen. Den transdisciplinära analysen visar på värdet av nära samverkan mellan forskning och kommuner kring implementeringen av EST-ansatsen, men också på behovet av politiskt och ekonomiskt stöd för att frigöra tid för kommunerna att delta i sådana projekt.
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| 36. |
- Latorre-Margalef, Neus, et al.
(författare)
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Effects of influenza A virus infection on migrating mallard ducks
- 2009
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Ingår i: Proceedings of the Royal Society of London. Biological Sciences. - : The Royal Society. - 0962-8452 .- 1471-2954. ; 276:1659, s. 1029-1036
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Tidskriftsartikel (refereegranskat)abstract
- The natural reservoir of influenza A virus is waterfowl, particularly dabbling ducks (genus Anas). Although it has long been assumed that waterfowl are asymptomatic carriers of the virus, a recent study found that low-pathogenic avian influenza (LPAI) infection in Bewick's swans (Cygnus columbianus bewickii) negatively affected stopover time, body mass and feeding behaviour. In the present study, we investigated whether LPAI infection incurred ecological or physiological costs to migratory mallards (Anas platyrhynchos) in terms of body mass loss and staging time, and whether such costs could influence the likelihood for long-distance dispersal of the avian influenza virus by individual ducks. During the autumn migrations of 2002-2007, we collected faecal samples (n = 10 918) and biometric data from mallards captured and banded at Ottenby, a major staging site in a flyway connecting breeding and wintering areas of European waterfowl. Body mass was significantly lower in infected ducks than in uninfected ducks (mean difference almost 20 g over all groups), and the amount of virus shed by infected juveniles was negatively correlated with body mass. There was no general effect of infection on staging time, except for juveniles in September, in which birds that shed fewer viruses stayed shorter than birds that shed more viruses. LPAI infection did not affect speed or distance of subsequent migration. The data from recaptured individuals showed that the maximum duration of infection was on average 8.3 days (s.e. 0.5), with a mean minimum duration of virus shedding of only 3.1 days (s.e. 0.1). Shedding time decreased during the season, suggesting that mallards acquire transient immunity for LPAI infection. In conclusion, deteriorated body mass following infection was detected, but it remains to be seen whether this has more long-term fitness effects. The short virus shedding time suggests that individual mallards are less likely to spread the virus at continental or intercontinental scales.
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| 37. |
- Svärd, Anna, et al.
(författare)
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Antibodies against Porphyromonas gingivalis in serum and saliva and their association with rheumatoid arthritis and periodontitis. : Data from two rheumatoid arthritis cohorts in Sweden
- 2023
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Ingår i: Frontiers in Immunology. - : Frontiers Media SA. - 1664-3224. ; 14
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Tidskriftsartikel (refereegranskat)abstract
- Background: Periodontitis and oral pathogenic bacteria can contribute to the development of rheumatoid arthritis (RA). A connection between serum antibodies to Porphyromonas gingivalis (P. gingivalis) and RA has been established, but data on saliva antibodies to P. gingivalis in RA are lacking. We evaluated antibodies to P. gingivalis in serum and saliva in two Swedish RA studies as well as their association with RA, periodontitis, antibodies to citrullinated proteins (ACPA), and RA disease activity.Methods: The SARA (secretory antibodies in RA) study includes 196 patients with RA and 101 healthy controls. The Karlskrona RA study includes 132 patients with RA >= 61 years of age, who underwent dental examination. Serum Immunoglobulin G (IgG) and Immunoglobulin A (IgA) antibodies and saliva IgA antibodies to the P. gingivalis-specific Arg-specific gingipain B (RgpB) were measured in patients with RA and controls.Results: The level of saliva IgA anti-RgpB antibodies was significantly higher among patients with RA than among healthy controls in multivariate analysis adjusted for age, gender, smoking, and IgG ACPA (p = 0.022). Saliva IgA anti-RgpB antibodies were associated with RA disease activity in multivariate analysis (p = 0.036). Anti-RgpB antibodies were not associated with periodontitis or serum IgG ACPA.Conclusion: Patients with RA had higher levels of saliva IgA anti-RgpB antibodies than healthy controls. Saliva IgA anti-RgpB antibodies may be associated with RA disease activity but were not associated with periodontitis or serum IgG ACPA. Our results indicate a local production of IgA anti-RgpB in the salivary glands that is not accompanied by systemic antibody production.
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| 38. |
- Westergren, Albert, et al.
(författare)
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Measurement properties of the minimal insomnia symptom scale as insomnia screening tool for adults and the elderly
- 2015
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Ingår i: Sleep Medicine. - : Elsevier. - 1389-9457 .- 1878-5506. ; 16:3, s. 379-384
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Tidskriftsartikel (refereegranskat)abstract
- Background The psychometric properties of the three-item Minimal Insomnia Symptom Scale (MISS) were evaluated using the classical test theory. Different cut-offs for identifying insomnia were suggested in two age groups (≥6 and ≥7 among adult and elderly people, respectively). The aim of the present study was to test the measurement properties of the MISS using the Rasch measurement model, with special emphasis on differential item functioning by gender and age. Methods Cross-sectional MISS data from adult (age 20–64 years, n = 1075) and elderly (age 65+, n = 548) populations were analysed using the Rasch measurement model. Results Data generally met Rasch model requirements and the scale could separate between two distinct groups of people. Differential item functioning was found by age but not gender. The difference between the adult and elderly samples was lower for the originally recommended ≥6 points cut-off (0.09 logits) than for the ≥7 points cut-off (0.23 logits), but greater at the lower and higher ends of the scale. Conclusions This study provides general support for the measurement properties of the MISS. Caution should be exercised in comparing raw MISS scores between age groups, but applying a ≥6 cut-off appears to allow for valid comparisons between adults and the elderly regarding the presence of insomnia. Nevertheless, additional studies are needed to determine the clinically optimal cut-score for identification of insomnia.
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| 39. |
- Alden-Joyce, Tara, et al.
(författare)
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Tanzanian Nursing Students' Experiences of Student Exchange in Sweden : A Qualitative Case Study
- 2023
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Ingår i: Sage Open Nursing. - : Sage Publications. - 2377-9608. ; 9
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Tidskriftsartikel (refereegranskat)abstract
- IntroductionNeeds within healthcare are changing and nurses require new skills and knowledge in global nursing. Student exchange programs in global contexts provide an opportunity to develop the necessary skills. ObjectiveThe aim of this study was to describe Tanzanian nursing students' experiences of student exchange in Sweden. MethodsA qualitative design was used for this empirical study. Semistructured interviews were conducted with six Tanzanian nursing students who had participated in student exchange in Sweden. The participants were recruited by purposeful sampling. Inductive reasoning and qualitative content analysis were applied. ResultsFour main themes were formed; new roles, experience a new culture, establish new competencies, and global work ambitions. The findings revealed that the students experienced new approaches in Sweden, giving them new competencies and understanding. Furthermore, they increased their global perspectives on nursing and interest in working with global health issues, but they also experienced challenges in the new environment. ConclusionThe present study showed that Tanzanian nursing students benefitted from their student exchange, both personally, as well as for their future careers as nurses. More research is needed in examining nursing students from low-income countries participating in student exchange in high-income countries.
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| 40. |
- Henriksson (Alvariza), Anette, et al.
(författare)
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Use of the Preparedness for Caregiving Scale in Palliative Care : A Rasch Evaluation Study
- 2015
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Ingår i: Journal of Pain and Symptom Management. - : Elsevier BV. - 0885-3924 .- 1873-6513. ; 50:4, s. 533-541
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Tidskriftsartikel (refereegranskat)abstract
- Context. Studies have shown that family carers who feel more prepared for the caregiver role tend to have more favorable experiences. Valid and reliable methods are needed to identify family carers who may be less prepared for the role of supporting a person who needs palliative care. Objectives. The aim of this study was to evaluate the measurement properties of the original English version and a Swedish version of the Preparedness for Caregiving Scale (PCS). Methods. The sample (n = 674) was taken from four different intervention studies from Australia and Sweden, all focused on improving family carers' feelings of preparedness. Family carers of patients receiving palliative home care were selected, and baseline data were used. The measurement properties of the PCS were evaluated using the Rasch model. Results. Both the English and Swedish versions of the PCS exhibit sound measurement properties according to the Rasch model. The items in the PCS captured different levels of preparedness. The response categories were appropriate and corresponded to the level of preparedness. No significant differential item functioning for age and sex was detected. Three items demonstrated differential item functioning by language but did not impact interpretation of scores. Reliability was high (>0.90) according to the Person Separation Index. Conclusion. The PCS is valid for use among family carers in palliative care. Data provide support for its use across age and gender groups as well as across the two language versions. (C) 2015 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.
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