| 1. |
- Johansson, Jan, et al.
(författare)
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Spider silk proteins and methods for producing spider silk proteins
- 2012
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Patent (övrigt vetenskapligt/konstnärligt)abstract
- The invention provides an isolated major ampullate spidroin protein, which consists of from 150 to 420 amino acid residues and is defined by the formula REP-CT. REP is a repetitive, N-terminally derived protein fragment having from 80 to 300 amino acid residues. CT is a C-terminally derived protein fragment having from 70 to 120 amino acid residues. The invention further provides an isolated fusion protein consisting of a first protein fragment, which is a major ampullate spidroin protein, and a second protein fragment comprising a fusion partner and a cleavage agent recognition site. The first protein fragment is coupled via said cleavage agent recognition site to the fusion partner. The invention also provides a method of producing a major ampullate spidroin protein and polymers thereof.
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| 2. |
- Johansson Stark, Åsa, 1959-
(författare)
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Empowering knowledge and Quality of Recovery after hip or knee replacement
- 2016
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- BackgroundArthroplasty is commonly used for an increasing population of patients with osteoarthritis, and the recovery process starts directly after surgery. Today’s shorter hospital stay may be a challenge for the patients and their spouses. Patient education is linked to and promotes the recovery process and can improve the outcome after elective hip or knee replacement. Fulfilment of knowledge expectations is essential for enabling people to become empowered during the period of recovery.AimThe overall aim was to explore the association between empowering knowledge and patients’ quality of recovery after elective hip or knee replacement.MethodsThe design of the four papers was descriptive, prospective and comparative. Consecutively included patients and their spouses from Cyprus, Finland, Greece, Iceland and Sweden answered questionnaires before surgery and at discharge from hospital. Data was collected during the years 2009-2012. Relationships and associations between a number of factors and fulfilment of knowledge expectations, and patients’ quality of recovery were investigated. Comparisons between patients undergoing hip or knee replacement and between patients and their spouses were made.ResultsPatients and their spouses had similar knowledge expectations, and these were not fulfilled during the hospital stay. Spouses had less fulfilled knowledge expectations compared with the patients. Swedish patients and spouses had less fulfilled knowledge expectations compared with the Icelandic and Finnish ones. Patients who experienced the hospital stay as meeting their general expectations had more fulfilled knowledge expectations compared with those who did not.Access to knowledge was the main predictor of the variance in fulfilment of knowledge expectations. Negative emotions, such as depressive state and impatience, were associated with less fulfilled knowledge expectations. For patients undergoing hip replacement, a higher level of professional education was associated with less fulfilled knowledge expectations. For patients undergoing knee replacement, a history of employment in social services or healthcare was associated with less fulfilled knowledge expectations.Patients’ experience of greater satisfaction with care was associated with better quality of recovery for both kinds of arthroplasty. Patients with fulfilled knowledge expectations experienced better quality of recovery. The spouserelated factors, namely uncertainty and depressive state, were associated with lower quality of recovery. Factors associated with greater quality of recovery among the patients were spouses with a history of employment in social services or health care, and nurses explaining matters concerning the care and treatment for the spouses.ConclusionPatients and their spouses had high knowledge expectations that were not fulfilled during the hospital stay. Patients’ emotional state and their access to knowledge were important for their fulfilment of knowledge expectations. Patients’ and spouses’ emotional state also played an important role in determining the patients’ quality of recovery, and greater satisfaction with care among the patients was associated with better quality of recovery.These results emphasise the need to detect patients and their spouses in need of support in their preparation and recovery process. It is therefore important to assess patients’ and spouses’ personal knowledge expectations, and adapt to their emotional state while fulfilling them.The content of patient education should be personalised in future care, and informal caregivers should be seriously taken into account during the period of early recovery. The results of this thesis can be used in the development and testing of person-centred educational interventions for patients undergoing elective hip or knee replacements.
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| 3. |
- Johansson Stark, Åsa, 1959-, et al.
(författare)
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Fulfilment of knowledge expectations and emotional state among people undergoing hip replacement : A multi-national survey
- 2014
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Ingår i: International Journal of Nursing Studies. - : Elsevier. - 0020-7489 .- 1873-491X. ; 51:11, s. 1491-1499
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND:Patient education in connection with hip replacement is intended to prepare patients for surgery, discharge and postoperative recovery. Patients experience symptoms and emotions due to disease or upcoming surgery which can affect how their knowledge expectations are fulfilled.OBJECTIVES:To describe the differences between received and expected knowledge in patients undergoing elective hip replacement in three Nordic countries, and to analyse how these differences are related to patients' characteristics, preoperative symptoms and emotions.DESIGN:A descriptive, prospective survey with two data collection points; before admission and at hospital discharge after surgery.SETTINGS:Two Finnish, three Icelandic and two Swedish hospitals.PARTICIPANTS:The population consisted of patients on a waiting list for hip replacement. Of the consecutively included patients, 320 answered questionnaires both before admission and at discharge and were included in the study. The mean age of the patients was 64 years, and 55% were women.METHODS:Structured questionnaires were used; the knowledge expectations of hospital patients scale and self-reported scales for symptoms and emotions before admission and received knowledge of hospital patients scale at discharge. Fulfilment of knowledge expectation was assessed by calculating the difference between received and expected knowledge with a paired sample t-test. A multiple stepwise regression model was used to explain the variance of fulfilled knowledge expectations.RESULTS:Patients expected more knowledge than they received (p<0.001) and 77% of them had unfulfilled knowledge expectations. Patients with a higher level of education were more likely to have unfulfilled knowledge expectations. A higher level of education was also related to a greater difference between received and expected knowledge. The difference was more correlated with patients' emotions than their symptoms. A depressive state was the major predictor of the variance in the difference between received and expected knowledge.CONCLUSIONS:In order to better support patients by education it is necessary to assess their emotional state, educational level and knowledge expectations before surgery.
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| 4. |
- Johansson Stark, Åsa, 1959-, et al.
(författare)
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Fulfilment of patients’ knowledge expectations in connection with hip or knee replacement – a Nordic perspective
- 2014
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Objective: To describe and compare the differences between received and expected knowledge in patients undergoing elective hip or knee replacement in three Nordic countries, and to analyse if these differences are related to patients’ characteristics.Method: A descriptive, prospective and comparative survey of patients with osteoarthritis treated at two Finnish, three Icelandic and two Swedish hospitals (n=612). Patients answered questionnaires about their knowledge expectations (KEhp) before surgery and about received knowledge (RKhp) at discharge. These two parallel instruments include: bio-physiological, functional, experiential, ethical, social and financial dimensions of knowledge.Results: Among the 29% Finnish, 34% Icelandic and 37% Swedish patients (hip: 53%, knee: 47%) were 54% females and the mean age was 65 years. Patients` knowledge expectations were higher, mean: 3.6 (±SD 0.5), than their perception of received knowledge 3.0 (0.7). The difference between expected and received knowledge was larger in Sweden -0.9(0.8) compared with Finland -0.4(0.8) and Iceland -0.5(0.7) (p<0.001) but not statistically different between patients having hip or knee replacement. Patients perceived having received most bio-physiological -0.3(0.6) and functional -0.3(0.6) knowledge but least financial -1.2(1.2) knowledge. A relationship was found between the difference of expected and received knowledge and whether the hospital stay was as expected. For patients undergoing hip replacement this difference was also related to the level of education, for knee replacement patients if they had their first arthroplasty and employment in social or health care.Conclusions: Patients expect multidimensional knowledge during hospital stay which was inadequately met. Assessing patients’ knowledge needs could improve patient education.
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| 5. |
- Johansson Stark, Åsa, 1959-, et al.
(författare)
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Spouse-related factors associated with Quality of Recovery of patients after hip or knee replacement : a Nordic perspective
- 2016
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Ingår i: International Journal of Orthopaedic and Trauma Nursing. - : Elsevier. - 1878-1241 .- 1878-1292. ; 23, s. 32-46
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Tidskriftsartikel (refereegranskat)abstract
- Background: Today’s shorter hospital stays means that patients may need support from informal caregivers during their recovery period. The responsibility for providing this support shifts from the health care staff to their family members fairly early in the recovery process. Spousal caregivers are considered to be primary caregivers as their relationship with the patient is more interdependent than other family members or caregivers.Objectives: The aim was to describe spouse-related factors that were associated with patients’ quality of recovery on discharge from hospital after elective hip or knee replacement.Design: The design was prospective, descriptive and comparative with two measurements; before arthroplasty and on discharge.Settings: Two Finnish, three Icelandic and two Swedish university or community hospitals.Participants: The sample consisted of spouses and patients. The inclusion criteria were: age ≥ 18 years, able to complete the questionnaires, and able to understand Finnish/Icelandic/Swedish. The patients were asked to identify one family member. Spouses were those defining themselves as; wife, husband or cohabiting partner. Out of 463 spouses, 306 (66%) were included. The mean age of the included spouses was 64 years, and 54% of them were females.Methods: Self-reported instruments on; expected and received knowledge, access to knowledge, emotional state and quality of recovery were used.Results: If the spouses were or had been employed in the social services or healthcare their partner had greater quality of recovery (p=0.006). Spouses experiencing negative emotions had partners who experienced lower quality of recovery (p<0.001). Spouses who experienced that nurses had enough time and explained matters concerning their family members’ care and treatment had partners who experienced greater quality of recovery (p=0.011, 0.044).Conclusions: Spouses’ emotional state played an important role in the patients’ quality of recovery, with uncertainty and depressive state as the main predictors. The importance of nurses explaining matters sufficiently to spouses was emphasized, while spouses’ fulfilment of knowledge expectations was not associated with patients’ recovery.
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| 6. |
- Johansson Stark, Åsa, 1959-, et al.
(författare)
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The quality of recovery on discharge from hospital, a comparison between patients undergoing hip and knee replacement : a European study
- 2016
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Ingår i: Journal of Clinical Nursing. - : Wiley-Blackwell Publishing Inc.. - 0962-1067 .- 1365-2702. ; 25:17-18, s. 2489-2501
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Tidskriftsartikel (refereegranskat)abstract
- Aims and objectives. To describe and compare the quality of recovery (QoR) on discharge from hospital between patients undergoing elective hip or knee replacement. The study will also attempt to identify any predicting factors.Background. Arthroplasty is commonly used for an increasing population of patients with osteoarthritis, and the recovery process starts directly after surgery. Today’s shorter hospital stay may be a challenge for the patients during the early period of recovery. It is therefore important to identify factors associated with QoR at discharge from hospital.Design. A descriptive, comparative study including 12 hospitals in five European countries; Cyprus, Finland, Greece, Iceland and Sweden.Methods. Consecutively included patients responded on: Health-Related Quality of Life, and emotions before surgery and at hospital discharge; Quality of Recovery, Patient Satisfaction and fulfilment of knowledge expectations. Related factors and associations were analysed separately for each kind of arthroplasty. In total 865 patients were included (hip n=413, knee n=452).Results. In the dimension of pain, patients undergoing hip replacement had significantly better QoR compared to those undergoing knee replacement. Both patient groups experienced negative emotions before surgery that were related to poorer QoR. Fulfilment of knowledge expectations has a limited effect on QoR. Greater satisfaction with care predicted better QoR.Conclusions. Negative preoperative emotions were related to poorer QoR. For both kinds of arthroplasty, greater satisfaction with care was associated with better QoR.Relevance to clinical practice. The result emphasises the need to detect patients in need of support in their preparation and recovery process, taking into account the perspective of their emotional state.
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| 7. |
- Stark, Margareta
(författare)
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Isolation and characterization of lipid-associated and neurosecretory polypeptides
- 2000
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Lipid-interacting proteins play important roles in all living organisms. This thesis focuses on isolation and characterization of an enzyme in the triacylglycerol biosynthesis (phosphatidic acid phosphatase, PAP), hydrophobic polypeptides in bile, and polypeptides in cerebrospinal fluid. These fields constitute methodological challenges and mean development of suitable tools in between lipid and protein biochemistry. Two methods used to measure PAP activity were compared. It was established that the discrepancy between the methods was mainly due to different acyl chains of the substrate. In purification of PAP from the yeast Saccharomyces cerevisiae, an apparent molecular weight of 35 and/or 40 kDa (determined by SDS-PAGE) and approximately 67 kDa (determined by size exclusion chromatography) was obtained. The discrepancy in molecular size indicates that PAP forms a multimeric structure. The results suggest a smaller subunit size than previously deduced. A method to determine protein content in extremely lipid-rich samples (90-98% lipids), where the protein content is low (1-5%), was developed. By derivatization of hydrolysed samples to their phenylisothiocarbamyl forms, and subsequent separation by reversed-phase HPLC, the amino acid content was determined. In addition, phosphatidylethanolamine and phosphatidylserine could be detected together with the amino acid constituents. A method to isolate polypeptides from lipid-rich material was evaluated. Separation by cromatography of chloroform/methanol extracts of lipid-rich tissues as spinal cord, lung and bile on Lipidex-5000 in the solvent system methanol/ethylene chloride, the polypeptides were well separated from the majority of the lipids. Several hydrophobic polypeptides in human gallbladder bile were identified, as ATP-synthase lipid-binding protein 9, a fragment of monocyte differentiation antigen CD14, and a fragment of mac25/insulin-like growth factor-binding protein 7, all not previously identified in bile. Several novel proteolytic fragments of neuroendocrine proteins were identified in human cerebrospinal fluid. Proteolytically processed fragments of chromogranin A, chromogranin B, neuroendocrine protein 7B2, proenkephalin, neuroendocrine specific protin VGF, osteopontin, testican and IGF-II E-peptide were characterized, several of them not previously reported.
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