| 1. |
- Blomgren, Johanna, et al.
(författare)
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Maternal health leaders' perceptions of barriers to midwife-led care in Ethiopia, Kenya, Malawi, Somalia, and Uganda
- 2023
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Ingår i: Midwifery. - 0266-6138 .- 1532-3099. ; 124, s. 103734-
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To identify and examine barriers to midwife-led care in Eastern Africa and how these barriers can be reduced DESIGN: A qualitative inductive study with online focus group discussions and semi-structured interviews using content analysis SETTING: The study examines midwife-led care in Ethiopia, Malawi, Kenya, Somalia, and Uganda -five African countries with an unmet need for midwives and a need to improve maternal and neonatal health outcomes.PARTICIPANTS: Twenty-five participants with a health care profession background and current position as a maternal and child health leader from one of the five study countries.FINDINGS: The findings demonstrate barriers to midwife-led care connected to organisational structures, traditional hierarchies, gender disparities, and inadequate leadership. Societal and gendered norms, organisational traditions, and differences in power and authority between professions are some factors explaining why the barriers persist. A focus on intra- and multisectoral collaborations, the inclusion of midwife leaders, and providing midwives with role models to leverage their empowerment are examples of how to reduce the barriers.KEY CONCLUSIONS: This study provides new knowledge on midwife-led care from the perspectives of health leaders in five African countries. Transforming outdated structures to ensure midwives are empowered to deliver midwife-led care at all healthcare system levels is crucial to moving forward.IMPLICATIONS FOR PRACTISE: This knowledge is important as enhancing the midwife-led care provision is associated with substantially improved maternal and neonatal health outcomes, higher satisfaction of care, and enhanced utilisation of health system resources. Nevertheless, the model of care is not adequately integrated into the five countries' health systems. Future studies are warranted to further explore how reducing barriers to midwife-led care can be adapted at a broader level.
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| 2. |
- Dobsicek Trefna, Hana, 1979, et al.
(författare)
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Antenna Applicator for Microwave Hyperthermia Treatment of Pediatric Brain Cancer
- 2014
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Ingår i: 8th European Conference on Antennas and Propagation, EuCAP 2014, The Hague, The Netherlands 6-11 April 2014. - 9788890701849
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- A novel antenna applicator for microwave hyperthermia allowing treatment of deep brain tumors is proposed. The applicator consists of up to 16 antennas placed around the head in a helmet-like set-up and operates at a frequency range of 430-1000~MHz. The self-grounded bow-tie antennas are housed in a molded plastic enclosure with the shape of a truncated cone. The inner space of the enclosure is filled with distilled water. The antennas are attached to a perimetric water bolus with a thickness of 2 cm and aligned with the head shape. The focusing ability of the applicator was investigated on a homogeneous SAM model and on a model of a 13-year old patient containing a spherical tumor of 2 cm radius. Two different tumor positions were investigated: the right frontal lobe and the central brain. The obtained SAR distributions are favorable, although a relatively high level of energy is also absorbed on the surface of the body. This heating is however not expected to cause problems as it can be cooled by blood perfusion and water bolus. Our results show that focused microwave heating in the brain is feasible and warrants further verification on phantoms.
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| 3. |
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| 4. |
- Granhagen Jungner, Johanna, et al.
(författare)
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Creating a Meeting Point of Understanding : Interpreters' Experiences in Swedish Childhood Cancer Care
- 2016
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Ingår i: Journal of Pediatric Oncology Nursing. - : SAGE Publications. - 1043-4542 .- 1532-8457. ; 33:2, s. 137-145
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: Children and families with a foreign background and limited Swedish proficiency have to communicate through interpreters in childhood cancer care centers in Sweden. Interpreter-mediated events deal with many difficulties that potentially hinder the transfer of information. The purpose of our study was to explore interpreters' experiences of interpreting between health care staff and limited Swedish proficiency patients/families in childhood cancer care.DESIGN: Using purposive samples, we interviewed 11 interpreters individually. The interviews were analyzed using qualitative content analysis.FINDINGS: Analyses of the data resulted in the main theme of creating a meeting point of understanding, constructed from 3 subthemes: balancing between cultures, bridging the gaps of knowledge, and balancing between compassion and professionalism.DISCUSSION: Our result shows that in order to create a sustainable meeting point of understanding, it is necessary to explain both the context and cultural differences. These results suggest that the responsibility for information transfer lies with both the health care profession and the interpreters. Tools have to be developed for both parties to contribute to creating the meeting point of understanding.
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| 5. |
- Granhagen Jungner, Johanna, et al.
(författare)
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Development and evaluation of the Communication over Language Barriers questionnaire (CoLB-q) in paediatric healthcare
- 2018
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Ingår i: Patient Education and Counseling. - : Elsevier BV. - 0738-3991 .- 1873-5134. ; 101:9, s. 1661-1668
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To develop a valid and reliable questionnaire addressing the experiences of healthcare personnel of communicating over language barriers and using interpreters in paediatric healthcare. Methods: A multiple- methods approach to develop and evaluate the questionnaire, including focus groups, cognitive interviews, a pilot test and test-retest. The methods were chosen in accordance with questionnaire development methodology to ensure validity and reliability. Results: The development procedure showed that the issues identified were highly relevant to paediatric healthcare personnel and resulted in a valid and reliable Communication over Language Barriers questionnaire (CoLB-q) with 27 questions. Conclusion: The CoLB-q is perceived as relevant, important and easy to respond to by respondents and has satisfactory validity and reliability.& nbsp; Practice implications: The CoLB-q can be used to map how healthcare personnel overcome language barriers through communication tools and to identify problems encountered in paediatric healthcare. Furthermore, the transparently described process could be used as a guide for developing similar questionnaires.
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| 6. |
- Granhagen Jungner, Johanna, et al.
(författare)
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Language barriers and the use of professional interpreters : a national multisite cross-sectional survey in pediatric oncology care
- 2019
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Ingår i: Acta Oncologica. - 0284-186X .- 1651-226X. ; 58:7, s. 1015-1020
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Tidskriftsartikel (refereegranskat)abstract
- Background: Healthcare personnel are responsible for providing patient-centered care regardless of their patients' language skills, but language barriers is identified as the main hindrances providing effective, equitable and safe care to patients with limited proficiency in a country's majority language. This study is a national multisite cross-sectional survey aiming to investigate communication over language barriers in pediatric oncology care. Material and Methods: A survey using the Communication over Language Barriers questionnaire (CoLB-q) distributed to medical doctors, registered nurses and nursing assistants at six pediatric oncology centers in Sweden (response rate 90%) using descriptive statistical analyses. Results: Professional interpreters on site were the most common solution when using an interpreter, although relatives or even children were used. The use of professional interpreters on site differed among the professions and in different clinical situations, such as medical encounter, education or procedure preparation. All professions reported that the use of professional interpreters greatly increased care relationships, patient safety and patient involvement in care. Conclusions: Healthcare personnel seem to believe that professional interpreters are crucial when caring for patients and family members who do not speak the majority language, but there is an obvious discrepancy between this belief and their use of professional interpreters.
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| 7. |
- Granhagen Jungner, Johanna, et al.
(författare)
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The interpreter's voice : Carrying the bilingual conversation in interpreter-mediated consultations in pediatric oncology care
- 2019
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Ingår i: Patient Education and Counseling. - : Elsevier BV. - 0738-3991 .- 1873-5134. ; 102:4, s. 656-662
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: The objective of this study was to explore interpreters' perceived strategies in the interaction in interpreter-mediated consultations between healthcare personnel and patients/families with limited Swedish proficiency in pediatric oncology care. Methods: This study had an inductive approach using an exploratory qualitative design. A total of eleven semi-structured interviews were performed with interpreters who had experience interpreting in pediatric oncology care. Results: The interpreters' perceived strategies were divided into four generic categories; strategies for maintaining a professional role, strategies for facilitating communication, strategies for promoting collaboration, and strategies for improving the framework of interpreting provision. These four generic categories were then merged into the single main category of carrying the bilingual conversation. Conclusions: The interpreters stretch their discretionary power in order to carry the bilingual conversation by using strategies clearly outside of their assignment. Practical implications: The study contributes to the understanding of the interpreter-mediated consultation in pediatric oncology care, and this can be used to improve the care of patients and families in pediatric oncology care with limited knowledge of a country's majority language.
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| 8. |
- Moldan, Filip, et al.
(författare)
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MAGIC library – A tool to assess surface water acidification
- 2020
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Ingår i: Ecological Indicators. - : Elsevier BV. - 1470-160X .- 1872-7034. ; 112
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Tidskriftsartikel (refereegranskat)abstract
- We have developed a tool, the MAGIC library, which provides an acidification assessment for any given lake or stream in Sweden based on ten parameters describing lake geographical position, surface area, annual discharge and observed lake water chemistry. The MAGIC library consists of two key components: a library of the existing MAGIC model simulations for 2438 lakes and an analogue matching routine that selects the library lake which is most similar to the evaluation lake described by the ten parameters. The acidification assessment modelled by MAGIC for the library lake is then assumed valid for the evaluation lake. For more than 90% of the library lakes tested, the MAGIC library provided the same acidification assessment as the site-specific MAGIC model simulation. Labour and data requirements for assessment by the MAGIC library are very modest relative to the needs of site-specific MAGIC (or other similar) model simulations. The relative ease of use is essential for a country like Sweden, with a population of 100 000 lakes. The MAGIC library has a web interface (http://magicbiblioteket.ivl. se) to provide single assessments interactively or multiple assessments by uploading the ten required parameters for multiple sites. Conceptually the library has built-in flexibility and could be adapted for other types of ecosystems or assessments. In this paper we describe the MAGIC library concept and evaluate the performance of the MAGIC library in comparison to site-specific MAGIC modelling.
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| 9. |
- Shen, Xianli, et al.
(författare)
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Glioma-induced inhibition of caspase-3 in microglia promotes a tumor-supportive phenotype
- 2016
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Ingår i: Nature Immunology. - : Springer Science and Business Media LLC. - 1529-2908 .- 1529-2916. ; 17:11, s. 1282-1290
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Tidskriftsartikel (refereegranskat)abstract
- Glioma cells recruit and exploit microglia (the resident immune cells of the brain) for their proliferation and invasion ability. The underlying molecular mechanism used by glioma cells to transform microglia into a tumor-supporting phenotype has remained elusive. We found that glioma-induced microglia conversion was coupled to a reduction in the basal activity of microglial caspase-3 and increased S-nitrosylation of mitochondria-associated caspase-3 through inhibition of thioredoxin-2 activity, and that inhibition of caspase-3 regulated microglial tumor-supporting function. Furthermore, we identified the activity of nitric oxide synthase 2 (NOS2, also known as iNOS) originating from the glioma cells as a driving stimulus in the control of microglial caspase-3 activity. Repression of glioma NOS2 expression in vivo led to a reduction in both microglia recruitment and tumor expansion, whereas depletion of microglial caspase-3 gene promoted tumor growth. Our results provide evidence that inhibition of the denitrosylation of S-nitrosylated procaspase-3 mediated by the redox protein Trx2 is a part of the microglial pro-tumoral activation pathway initiated by glioma cancer cells.
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| 10. |
- stadmark, Johanna, et al.
(författare)
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Identifiering av data och kartläggning av dataluckor : Ett underlag till översynen av den akvatiska miljögiftsövervakningen
- 2023
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- SMED utgör en förkortning för Svenska MiljöEmissionsData, som är ett samarbete mellan IVL, SCB, SLU och SMHI.I samband med översynen av den svenska miljögiftövervakningen under 2021–2023 har SMED på uppdrag av Naturvårdsverket genomfört en kartläggning av vilka regionala och nationella miljögiftsundersökningar som ännu inte rapporterats in till nationell datavärd för miljögifter samt stöttat utförare i rapporteringen av undersökningar.I en inledande enkät, som besvarades av samtliga länsstyrelser och några andra utförare, och under projektteamets arbete med inrapportering av data, identifierades ett antal områden där förändringar i exempelvis leveransmall, stödmaterial och nationellt stationsregister, skulle underlätta för utföraren vid inrapporteringen. I denna rapport ges förslag på sådana förändringar.Inom ramen för projektet har regionala data från mätningar i ytvatten, grundvatten, biota och sediment från tolv län och en kommun rapporterats in av SMED. Undersökningarna varierade i storlek och omfattade mellan 2 och 117 prover med mellan 13 och 250 parametrar. Nationella data över miljögifter i utter, ren, säl, vikare och tumlare samt en effektscreening omfattande sediment och biota har också rapporterats in av SMED. Antalet prover varierade mellan 22 och 60 och antalet parametrar mellan 13 och 198. Därutöver har projektet kompletterat underlaget och rapporterat in data till ICES avseende Biologiska effekter hos vitmärla (1994–2021).Hittills har huvudsakligen miljögiftsdata från nationell och regional miljöövervakning rapporterats till datavärd för miljögifter. Det finns stora mängder miljögiftsdata som samlas in för andra ändamål, till exempel som ett led av recipientkontroll vid punktkällor eller kommunala undersökningar eller inom ramen för EU-projekt. Vid statusklassning av vatten skulle även dessa miljögiftsdata kunna bidra till klassningen om de fanns tillgängliga i datavärdskapet för miljögifter. I detta projekt har därför två pilotstudier genomförts. I den första undersöktes om kommunalt insamlad miljögiftsdata kan rapporteras in till datavärdskapet för miljögifter. Oavsett om det är kommunal eller regional data som rapporteras in är det viktigt att redan i upphandlingsunderlag vara tydlig med vilken information som kommer att behövas för rapporteringen av data så att beställaren kan säkerställa att utföraren levererar alla obligatoriska uppgifter från exempelvis laboratorier.Miljögifter rapporteras idag till flera olika datavärdskap, beroende på ämne och matris. I den andra pilotstudien jämfördes därför vilka uppgifter en verksamhetsutövare behöver sammanställa för att kunna rapportera till de nationella datavärdskapen för miljögifter (SGU), Sjöar och vattendrag (SLU) och Oceanografi och Marin biologi (SMHI). En samordning av inmatning till och uttag från datavärdskapen skulle underlätta kartläggningar och analyser på kommunal, regional och nationell nivå.Under projektets gång har en stor mängd miljögiftsdata, som inte tidigare rapporterats till de nationella datavärdskapen, lagts in i datavärdskapet för miljögifter av SMED och av länsstyrelser runt om i landet. En del data har också lagts in i datavärdskapen för grundvatten och ytvatten. Fortsatt arbete som baseras på hur mängden miljögifter i biota, sediment och vatten har förändrats över tid i Sverige har därför nu ett mer uppdaterat dataunderlag. De uppdaterade databaserna bidrar också med information till översynen av den akvatiska miljögiftsövervakningen.
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