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Sökning: swepub > Umeå universitet > Högskolan i Borås

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1.
  • Wijk, H, et al. (författare)
  • Verksamhetsförlagd utbildning på avancerad nivå : ny utmaning för specialistutbildningar för sjuksköterskor
  • 2009
  • Ingår i: Vård i Norden. - København : Sjuksköterskornas samarbete i Norden. - 0107-4083. ; 29:4, s. 41-43
  • Tidskriftsartikel (övrigt vetenskapligt)abstract
    • The aim of this article is to discuss challenges in the development of Specialist Nursing Educations as a result of the 2007 Swedish Higher Education Reform: the implementation of the so-called Bologna process. Certain challenges follow this reform, particularly since the specialist nursing programmes will be part of the second cycle of the higher education system, and it will be possible to combine the professional degree with a masters degree (one year). Possible strategies in four areas related to the Specialist Nursing Education are discussed: integration of researchbased knowledge, experienced-based knowledge, improvement knowledge, and strategies for collaboration between university institutions and clinics. Specific didactical issues are raised.
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2.
  • Lützen, Kim, et al. (författare)
  • Nurses as guests or professionals in home health care
  • 2008
  • Ingår i: Nursing Ethics. - 0969-7330. ; 15:3, s. 371-383
  • Tidskriftsartikel (refereegranskat)abstract
    • The aim of this study was to explore and interpret the diverse subject of positions, or roles, that nurses construct when caring for patients in their own home. Ten interviews were analysed and interpreted using discourse analysis. The findings show that these nurses working in home care constructed two positions: 'guest' and 'professional'. They had to make a choice between these positions because it was impossible to be both at the same time. An ethics of care and an ethics of justice were present in these positions, both of which create diverse ethical appeals, that is, implicit demands to perform according to a guest or to a professional norm.
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3.
  • Nilsson, Stefan, et al. (författare)
  • School-aged children's experiences of postoperative music medicine on pain, distress, and anxiety.
  • 2009
  • Ingår i: Paediatric anaesthesia. - 1460-9592. ; 19:12, s. 1184-90
  • Tidskriftsartikel (refereegranskat)abstract
    • Aim: To test whether postoperative music listening reduces morphine consumption and influence pain, distress, and anxiety after day surgery and to describe the experience of postoperative music listening in school-aged children who had undergone day surgery. Background: Music medicine has been proposed to reduce distress, anxiety, and pain. There has been no other study that evaluates effects of music medicine (MusiCure((R))) in children after minor surgery. Methods: Numbers of participants who required analgesics, individual doses, objective pain scores (Face, Legs, Activity, Cry, Consolability [FLACC]), vital signs, and administration of anti-emetics were documented during postoperative recovery stay. Self-reported pain (Coloured Analogue Scale [CAS]), distress (Facial Affective Scale [FAS]), and anxiety (short State-Trait Anxiety Inventory [STAI]) were recorded before and after surgery. In conjunction with the completed intervention semi-structured qualitative interviews were conducted. Results: Data were recorded from 80 children aged 7-16. Forty participants were randomized to music medicine and another 40 participants to a control group. We found evidence that children in the music group received less morphine in the postoperative care unit, 1/40 compared to 9/40 in the control group. Children's individual FAS scores were reduced but no other significant differences between the two groups concerning FAS, CAS, FLACC, short STAI, and vital signs were shown. Children experienced the music as 'calming and relaxing.' Conclusions: Music medicine reduced the requirement of morphine and decreased the distress after minor surgery but did not else influence the postoperative care.
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4.
  • Perman, Jeanna, 1981-, et al. (författare)
  • The VLDL receptor promotes lipotoxicity and increases mortality in mice following an acute myocardial infarction.
  • 2011
  • Ingår i: The Journal of clinical investigation. - 1558-8238. ; 121:7, s. 2625-40
  • Tidskriftsartikel (refereegranskat)abstract
    • Impaired cardiac function is associated with myocardial triglyceride accumulation, but it is not clear how the lipids accumulate or whether this accumulation is detrimental. Here we show that hypoxia/ischemia-induced accumulation of lipids in HL-1 cardiomyocytes and mouse hearts is dependent on expression of the VLDL receptor (VLDLR). Hypoxia-induced VLDLR expression in HL-1 cells was dependent on HIF-1α through its interaction with a hypoxia-responsive element in the Vldlr promoter, and VLDLR promoted the endocytosis of lipoproteins. Furthermore, VLDLR expression was higher in ischemic compared with nonischemic left ventricles from human hearts and was correlated with the total lipid droplet area in the cardiomyocytes. Importantly, Vldlr-/- mice showed improved survival and decreased infarct area following an induced myocardial infarction. ER stress, which leads to apoptosis, is known to be involved in ischemic heart disease. We found that ischemia-induced ER stress and apoptosis in mouse hearts were reduced in Vldlr-/- mice and in mice treated with antibodies specific for VLDLR. These findings suggest that VLDLR-induced lipid accumulation in the ischemic heart worsens survival by increasing ER stress and apoptosis.
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5.
  • Herlitz, Johan, 1949-, et al. (författare)
  • Changes in demographic factors and mortality after out-of-hospital cardiac arrest in Sweden
  • 2005
  • Ingår i: Coron Artery Dis. - 0954-6928. ; 16:1, s. 51-7
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective To describe changes between 1992 and 2003 in age, sex, factors at resuscitation and survival among patients suffering from out-of-hospital cardiac arrest in Sweden. Methods This was a prospective observational study including various ambulance organizations in Sweden. Patients suffering from out-of-hospital cardiac arrest between 1992 and 2003 included in the Swedish Cardiac Arrest Registry were followed for survival to 1 month. Results In all 19 791 cases took part in the survey. There was a slight increase in mean age from 68 to 70 years (P=0.025) and an increase of females from 29 to 32% (P=0.0001). There was a change in witnessed status (P<0.0001) with an increase in crew-witnessed cases and a decrease in non-witnessed cases. There was a decrease in cases of a cardiac etiology from 75 to 61% (P<0.0001) and a decrease in the percentage found in ventricular fibrillation from 36 to 25% (P<0.0001). When crew-witnessed cases were excluded the proportion receiving bystander cardiopulmonary resuscitation (CPR) increased from 30 to 42% (P<0.0001). There was a slight increase in the overall proportion of patients hospitalized alive from 16 to 20% (P=0.032). There was no significant change in the overall proportion of survivors at 1 month after cardiac arrest (4.5% in 1992 and 5.0% in 2003). Conclusions Among patients suffering from out-of-hospital cardiac arrest in Sweden some changes took place. The most important ones were a decrease in the proportion of patients found in ventricular fibrillation and an increase in the proportion of patients receiving bystander CPR. The proportion of patients admitted alive to hospital increased moderately, whereas the proportion of patients alive after 1 month remained unchanged.
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6.
  • Herlitz, J, et al. (författare)
  • Characteristics and outcome among children suffering from out of hospital cardiac arrest in Sweden
  • 2005
  • Ingår i: Resuscitation. - 0300-9572. ; 64:1, s. 37-40
  • Tidskriftsartikel (refereegranskat)abstract
    • AIM: To evaluate the characteristics, outcome and prognostic factors among children suffering from out of hospital cardiac arrest in Sweden. METHODS: Patients aged below 18 years suffering from out of hospital cardiac arrest which were not crew witnessed and included in the Swedish cardiac arrest registry were included in the survey. This survey included the period 1990-2001 and 60 ambulance organisations covering 85% of the Swedish population (8 million inhabitants). RESULTS: In all 457 children participated in the survey of which 32% were bystander witnessed and 68% received bystander CPR. Ventricular fibrillation was found in 6% of the cases. The overall survival to 1 month was 4%. The aetiology was sudden infant death syndrome in 34% and cardiac in 11%. When in a multivariate analysis considering age, sex, witnessed status, bystander CPR, initial rhythm, aetiology and the interval between call for, and arrival of, the ambulance and place of arrest only one appeared as an independent predictor of an increased chance of surviving cardiac arrest occurring outside home (adjusted odds ratio 8.7; 95% CL 2.2-58.1). CONCLUSION: Among children suffering from out of hospital cardiac arrest in Sweden that were not crew witnessed, the overall survival is low (4%). The chance of survival appears to be markedly increased if the arrest occurs outside the patients home compared with at home. No other strong predictors for an increased chance of survival could be demonstrated.
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7.
  • Herlitz, J, et al. (författare)
  • Efficacy of bystander CPR: intervention by lay people and by health care professionals
  • 2005
  • Ingår i: Resuscitation. - 0300-9572. ; 66:3, s. 291-5
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Early cardiopulmonary resuscitation (CPR) by bystanders prior to the arrival of the rescue team has been shown to be associated with increased survival after out-of-hospital cardiac arrest. The aim of this survey was to evaluate the impact on survival of no bystander CPR, lay bystander CPR and professional bystander CPR. Methods: Patients suffering an out-of-hospital cardiac arrest in Sweden between 1990 and 2002 who were given CPR and were not witnessed by the ambulance crew were included. Results: In all, 29,711 patients were included, 36% of whom received bystander CPR prior to the arrival of the rescue team. Among the latter, 72% received CPR from lay people and 28% from professionals. Survival to I month was 2.2% among those who received no bystander CPR, 4.9% among those who received bystander CPR from lay people (p<0.0001) and 9.2% among those who received bystander CPR from professionals (p < 0.0001 compared with bystander CPR by lay people). In a multivariate analysis, lay bystander CPR was associated with improved survival compared to no bystander CPR (OR: 2.04; 95% Cl: 1.72-2.42), and professional bystander CPR was associated with improved survival compared to lay bystander CPR (OR: 1.37; 95% CI: 1. 12-1.67). Conclusion: Among patients suffering an out-of-hospital cardiac arrest, bystander CPR by lay persons (excluding health care professionals) is associated with an increased chance of survival. Furthermore, there is a distinction between lay persons and health care providers; survival is higher when the latter perform bystander CPR. However, these results may not be explained by differences in the quality of CPR.
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8.
  • Herlitz, J, et al. (författare)
  • Factors associated with an increased chance of survival among patients suffering from an out-of-hospital cardiac arrest in a national perspective in Sweden
  • 2005
  • Ingår i: Am Heart J. - 1097-6744. ; 149:1, s. 61
  • Tidskriftsartikel (refereegranskat)abstract
    • AiM To describe factors associated with an increased chance of survival among patients suffering from an out-of-hospital cardiac arrest in Sweden. Patients and Methods All patients suffering from an out-of-hospital cardiac arrest, which were not crew witnessed, in Sweden and in,whom cardiopulmonary resuscitation (CPR) was attempted and who were registered in the Swedish Cardiac Arrest Registry. This registry covers about 85% of the Swedish population and has been running since 1990. Results In all, 33 453 patients, 71% of whom had a cardiac etiology, were included in the survey. The following were independent predictors for an increased chance of survival in order of magnitude: (1) patients found in ventricular fibrillation (odds ratio OR 5.3, 95% confidence limits CL 4.2-6.8), (2) the interval between call for and arrival of the ambulance less than or equal to the median (OR 3.6, 95% CL 2.9-4.6), (3) cardiac arrest occurred outside the home (OR 2.2, 95% CL 1.9-2.7), (4) cardiac arrest was witnessed (OR 2.0, 95% CL 1.6-2.7), (5) bystanders performing CPR before the arrival of the ambulance (OR 2.0, 95% CL 1.7-2.4), and (6) age less than or equal to the median (OR 1.6, 95% CL 1.4-2.0). When none of these factors were present, survival to 1 m was 0.4%; when all factors were present, survival was 23.8%. Conclusion Among patients suffering from an out-of-hospital cardiac arrest, which were not crew witnessed, in Sweden and in whom CPR was attempted, 6 factors for an increased chance of survival could be defined. These include (1) initial rhythm, (2) delay to arrival of the rescue team, (3) place of arrest, (4) witnessed status, (5) bystander CPR, and (6) age.
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9.
  • Munthe, Christian, et al. (författare)
  • Person centred care and shared decision making:
  • 2012
  • Ingår i: Health Care Analysis. - 1065-3058. ; 20:3, s. 231-249
  • Tidskriftsartikel (refereegranskat)abstract
    • This paper presents a systematic account of ethical issues actualised in different areas, as well as at different levels and stages of health care, by introducing organisational and other procedures that embody a shift towards person centred care and shared decision-making (PCC/SDM). The analysis builds on general ethical theory and earlier work on aspects of PCC/SDM relevant from an ethics perspective.This account leads up to a number of theoretical as well as empirical and practice oriented issues that, in view of broad advancements towards PCC/SDM, need to be considered by health care ethics researchers. Given a PCC/SDM-based reorientation of health care practice, such ethics research is essential from a quality assurance perspective.
10.
  • Öresland, Stina, et al. (författare)
  • Patients as 'safeguard' and nurses as 'substitute' in home health care
  • 2009
  • Ingår i: Nursing Ethics. - Sage Publications. - 0969-7330. ; 16:2, s. 219-230
  • Tidskriftsartikel (refereegranskat)abstract
    • One aim of this study was to explore the role, or subject position, patients take in the care they receive from nurses in their own home. Another was to examine the subject position that patients say the nurses take when giving care to them in their own home. Ten interviews were analysed and interpreted according to a discourse analytical method. The findings show that patients constructed their subject position as 'safeguard', and the nurses' subject position as 'substitute' for themselves. These subject positions provided the opportunities, and the obstacles, for the patients' possibilities to receive care in their home. The subject positions described have ethical repercussions and illuminate that the patients put great demands on tailored care.
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