| 51. |
- Sandén, Ulrika, et al.
(författare)
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Breaking the patientification process - through co-creation of care, using old arctic survival knowledge
- 2021
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Ingår i: International Journal of Qualitative Studies on Health and Well-being. - : Informa UK Limited. - 1748-2631 .- 1748-2623. ; 16:1
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: Cancer research and connected innovation processes often lack a major component; patient participation. We revisit three studies (a-c) in order to explore how Momentary contentment theory may be used to improve patient participation and psychosocial health.Method: We revisited data from the initial (a) classic grounded theory study on Momentary contentment, based on four years of observation and 14 interviews. It explains a way of dealing with life close to death and morbidity. In the imminence of danger the studied culture resembles the context of cancer patients. The two following studies used focus group interviews with (b) 19 cancer patients and (c) 17 relatives of cancer patients in southern Sweden.Results: We suggest a process where cancer patients are taught to be submissive and that the support they receive from health providers may be counterproductive to contentment; a patientification process. We present alternative ways for people to handle issues such as hope, waiting, knowledge gaps and healthcare navigation while living with cancer. We introduce an alternative to patientification and passive patients where active patients create their own safety and truly participates in their care. Conclusions: We propose clinical studies to introduce such a shift from patentification to co-creation of care.
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| 52. |
- Sjöbom, Ulrika, et al.
(författare)
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Analysis of Brain Injury Biomarker Neurofilament Light and Neurodevelopmental Outcomes and Retinopathy of Prematurity among Preterm Infants
- 2021
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Ingår i: JAMA Network Open. - : American Medical Association (AMA). - 2574-3805. ; 4:4
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Tidskriftsartikel (refereegranskat)abstract
- Importance: Circulating levels of neurofilament light (NfL) and glial fibrillary acidic protein (GFAP) are important in the course of brain injury in adults, but longitudinal postnatal circulating levels in preterm infants have not been investigated. Objectives: To examine postnatal longitudinal serum levels of NfL and GFAP in preterm infants during the first 15 weeks of life and to explore possible associations between these biomarkers, neonatal morbidities, and neurodevelopmental outcomes at 2 years. Design, Setting, and Participants: This cohort study used data from 3 clinical studies, including 221 infants born before 32 weeks gestational age (GA) from 1999 to 2015; neurodevelopmental outcomes were evaluated in 120 infants. Data were collected at tertiary-level neonatal intensive care units in Gothenburg, Lund, and Uppsala, Sweden. Data analysis was conducted from January to October 2020. Exposure: Preterm birth. Main Outcomes and Measures: Serum NfL and GFAP levels, retinopathy of prematurity (ROP), intraventricular hemorrhage, and Bayley Scales of Infant Development II and III at 2 years of age, analyzed by multivariate logistic regression measured by odds ratio (OR), and receiver operating characteristic curve (ROC) analysis. Area under the curve (AUC) was also measured. Results: The 221 included infants (108 [48.9%] girls) had a mean (SD) GA at birth of 26.5 (2.1) weeks and a mean (SD) birth weight of 896 (301) grams. NfL levels increased after birth, remaining high during the first 4 weeks of life before declining to continuously low levels by postnatal age 12 weeks (median [range] NfL level at birth: 58.8 [11.5-1371.3] ng/L; 1 wk: 83.5 [14.1-952.2] ng/L; 4 wk: 24.4 [7.0-306.0] ng/L; 12 wk: 9.1 [3.7-57.0] ng/L). In a binary logistic regression model adjusted for GA at birth, birth weight SD score, Apgar status at 5 minutes, and mode of delivery, the NfL AUC at weeks 2 to 4 was independently associated with any ROP (OR, 4.79; 95% CI, 2.17-10.56; P <.001). In an exploratory analysis adjusted for GA at birth and sex, NfL AUC at weeks 2 to 4 was independently associated with unfavorable neurodevelopmental outcomes at 2 years corrected age (OR per 10-unit NfL increase, 1.07; 95% CI, 1.02-1.13; P =.01). Longitudinal GFAP levels were not significantly associated with neonatal morbidity or neurodevelopmental outcome. Conclusions and Relevance: In this study, high NfL levels during the first weeks of life were associated with ROP and poor neurodevelopmental outcomes at 2 years of age. Associations between NfL and later neurovascular development in infants born prematurely should be investigated further.
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| 53. |
- Sjöbom, Ulrika, et al.
(författare)
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Inflammatory Markers in Suction Blister Fluid: A Comparative Study Between Interstitial Fluid and Plasma.
- 2020
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Ingår i: Frontiers in immunology. - : Frontiers Media SA. - 1664-3224. ; 11
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Tidskriftsartikel (refereegranskat)abstract
- Biomarker analysis allows for the detection and prediction of disease as well as health monitoring. The use of interstitial fluid (ISF) as a matrix for biomarkers has recently gained interest. This study aimed to compare levels of inflammatory markers in ISF from suction blister fluid (SBF) and plasma.Plasma and SBF were collected from 18 healthy individuals. Samples were analyzed for 92 inflammation-related protein biomarkers by Proximity Extension Assay (PEA). Protein profiles in the two matrices were compared using traditional and multivariate statistics.Out of 92 targeted proteins, 70 were successfully quantified in both plasma and SBF. Overall, plasma and SBF displayed distinct protein profiles with up to 40-fold difference in abundance of specific proteins. The levels of 25 proteins were significantly correlated between plasma and SBF and several of these were recognized as potential markers to monitor health using ISF.Skin ISF and plasma have unique protein profiles but many inflammatory markers are proportionally related between the matrices at the individual level. ISF is a promising biofluid for the monitoring of biomarkers in clinical studies and routine analyses.
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| 54. |
- Wallerstein, Johan, et al.
(författare)
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Entropy-Entropy Compensation between the Protein, Ligand, and Solvent Degrees of Freedom Fine-Tunes Affinity in Ligand Binding to Galectin-3C
- 2021
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Ingår i: Jacs Au. - : American Chemical Society (ACS). - 2691-3704. ; 1:4, s. 484-500
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Tidskriftsartikel (refereegranskat)abstract
- Molecular recognition is fundamental to biological signaling. A central question is how individual interactions between molecular moieties affect the thermodynamics of ligand binding to proteins and how these effects might propagate beyond the immediate neighborhood of the binding site. Here, we investigate this question by introducing minor changes in ligand structure and characterizing the effects of these on ligand affinity to the carbohydrate recognition domain of galectin-3, using a combination of isothermal titration calorimetry, X-ray crystallography, NMR relaxation, and computational approaches including molecular dynamics (MD) simulations and grid inhomogeneous solvation theory (GIST). We studied a congeneric series of ligands with a fluorophenyl-triazole moiety, where the fluorine substituent varies between the ortho, meta, and para positions (denoted O, M, and P). The M and P ligands have similar affinities, whereas the O ligand has 3-fold lower affinity, reflecting differences in binding enthalpy and entropy. The results reveal surprising differences in conformational and solvation entropy among the three complexes. NMR backbone order parameters show that the O-bound protein has reduced conformational entropy compared to the M and P complexes. By contrast, the bound ligand is more flexible in the O complex, as determined by F-19 NMR relaxation, ensemble-refined X-ray diffraction data, and MD simulations. Furthermore, GIST calculations indicate that the O-bound complex has less unfavorable solvation entropy compared to the other two complexes. Thus, the results indicate compensatory effects from ligand conformational entropy and water entropy, on the one hand, and protein conformational entropy, on the other hand. Taken together, these different contributions amount to entropy-entropy compensation among the system components involved in ligand binding to a target protein.
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| 55. |
- Westgård, Theresa, et al.
(författare)
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Voices of Ill Frail Older People: Personal Resources and Experiences of Health Care Services : Special Issue Article “Healthy Aging and Elder Care”
- 2021
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Ingår i: Gerontology and Geriatric Research. ; 4:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: For many older people, ageing may become associated with frailty. Frequently reduced physical functioning and health are common in frailty; however, this is only one part of the big picture that may affect a frail older person’s well�being. To understand a frail older person’s unique capability, the study aimed to identifying their personal resources’ to comprehend how they experienced receiving health care services. Method: Ten participants aged 75 or older, screened as frail were interviewed one month after discharge from the hospital ward practicing the Comprehensive Geriatric Assessment. Result: Frail older people have personal resources established earlier in life and these remained intact and useful when receiving health care services. These personal resources were service: being service minded, having confidence in organizing and conversing and negotiating; and inherent abilities: being resilient and being hopeful and optimistic. Conclusion: Even though people have, personal resources it does not meant that they could use them, since it was dependent upon a collaboration between a person ’s social networks, physical environments and person resources. Identifying personal resources could give frail older people the boost they need to experience that they are still competent and capable when needing and receiving health care services. This would require that the health care staff and the health care organization support frail older people by practicing integrated care that is person-centered.
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