| 1. |
- Repapi, Emmanouela, et al.
(författare)
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Genome-wide association study identifies five loci associated with lung function.
- 2010
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Ingår i: Nature genetics. - : Springer Science and Business Media LLC. - 1546-1718 .- 1061-4036. ; 42:1, s. 36-44
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Tidskriftsartikel (refereegranskat)abstract
- Pulmonary function measures are heritable traits that predict morbidity and mortality and define chronic obstructive pulmonary disease (COPD). We tested genome-wide association with forced expiratory volume in 1 s (FEV(1)) and the ratio of FEV(1) to forced vital capacity (FVC) in the SpiroMeta consortium (n = 20,288 individuals of European ancestry). We conducted a meta-analysis of top signals with data from direct genotyping (n < or = 32,184 additional individuals) and in silico summary association data from the CHARGE Consortium (n = 21,209) and the Health 2000 survey (n < or = 883). We confirmed the reported locus at 4q31 and identified associations with FEV(1) or FEV(1)/FVC and common variants at five additional loci: 2q35 in TNS1 (P = 1.11 x 10(-12)), 4q24 in GSTCD (2.18 x 10(-23)), 5q33 in HTR4 (P = 4.29 x 10(-9)), 6p21 in AGER (P = 3.07 x 10(-15)) and 15q23 in THSD4 (P = 7.24 x 10(-15)). mRNA analyses showed expression of TNS1, GSTCD, AGER, HTR4 and THSD4 in human lung tissue. These associations offer mechanistic insight into pulmonary function regulation and indicate potential targets for interventions to alleviate respiratory disease.
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| 2. |
- Ahlstedt, Carina, 1969-
(författare)
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Registered nurses' work motivation and intention to stay at the workplace
- 2024
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- There is currently a shortage of registered nurses (RNs) and high turnover of RNs, both nationally and internationally. Work motivation is an important part of a healthy work environment and something we need to know more about from an RN perspective.The overarching aim of this thesis was to enhance our understanding of the organisational and social workplace factors that contribute to an attractive environment for RNs, by exploring factors associated with work motivation. Four research questions were posed. (i) What factors create the conditions for motivation in RNs’ daily work? (ii) What role does social support in the workplace play in RNs’ work motivation? (iii) What role does the opportunity to work with relevant tasks play in RNs’ work motivation? (iv) Are there differences between healthcare settings regarding RNs’ social support, illegitimate tasks, and associations with work motivation? Four empirical studies were performed to answer these questions. Two were qualitative studies based on an ethnographic approach and two were quantitative cross-sectional studies based on a stratified national sample of RNs. The results of the qualitative studies indicate that crucial factors for RNs' work motivation include a friendly and permissive atmosphere in daily work. Visible progress and receiving feedback from the work itself also positively contributed to motivation. Additionally, RNs' opportunities to learn and support each other through ongoing communication during daily work tended to have a positive impact on work motivation. Effective collaboration between physicians and RNs with mutual respect, understanding of each other's competencies, and creating an environment where RNs could seek clarification were also central to work motivation. The quantitative studies revealed that the opportunity for social support from the immediate manager or co-workers was significant for dimensions related to RNs’ work motivation and the willingness to stay in the workplace. The associations differed in strength between healthcare settings. Furthermore, the results indicated that a factor in RNs' work motivation was the ability to work with tasks perceived as relevant, not illegitimate. However, the results highlighted that a significant portion of RNs performed illegitimate tasks, and that illegitimate tasks were more prevalent for RNs in home healthcare than those in primary care and hospitals. This is something to consider as more complex care is being conducted outside of hospitals. The thesis adds new knowledge that can be useful to the development of attractive workplaces, which could contribute to more RNs choosing to remain in their position for a longer period.
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| 3. |
- Arking, D. E., et al.
(författare)
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Genetic association study of QT interval highlights role for calcium signaling pathways in myocardial repolarization
- 2014
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Ingår i: Nature Genetics. - : Nature Publishing Group. - 1061-4036 .- 1546-1718. ; 46:8, s. 826-836
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Tidskriftsartikel (refereegranskat)abstract
- The QT interval, an electrocardiographic measure reflecting myocardial repolarization, is a heritable trait. QT prolongation is a risk factor for ventricular arrhythmias and sudden cardiac death (SCD) and could indicate the presence of the potentially lethal mendelian long-QT syndrome (LQTS). Using a genome-wide association and replication study in up to 100,000 individuals, we identified 35 common variant loci associated with QT interval that collectively explain ∼ 8-10% of QT-interval variation and highlight the importance of calcium regulation in myocardial repolarization. Rare variant analysis of 6 new QT interval-associated loci in 298 unrelated probands with LQTS identified coding variants not found in controls but of uncertain causality and therefore requiring validation. Several newly identified loci encode proteins that physically interact with other recognized repolarization proteins. Our integration of common variant association, expression and orthogonal protein-protein interaction screens provides new insights into cardiac electrophysiology and identifies new candidate genes for ventricular arrhythmias, LQTS and SCD. © 2014 Nature America, Inc.
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| 4. |
- Bergström, Helena, et al.
(författare)
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Factors influencing the implementation of a school-based parental support programme to promote health-related behaviours--interviews with teachers and parents.
- 2015
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Ingår i: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 15
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The 'Healthy School Start' programme was developed to promote healthy dietary habits and physical activity, targeting parents of 6-year-old children in pre-school class. Knowledge of barriers and facilitators of implementation is crucial before introducing this kind of programme on a larger scale. The aim of this study was to explore the views of teachers and parents regarding factors influencing the implementation of a school-based parental support programme to promote physical activity and healthy diet.METHODS: An inductive qualitative method was used to explore the experiences and views of teachers and parents involved in the programme. A group discussion was held with three teachers, and semi-structured interviews were conducted with 14 parents. Data were analysed using qualitative content analysis.RESULTS: Clear communication on roles and responsibilities was identified as an overarching theme, emphasising the importance of clear information and well-functioning cooperation between project management, schools and parents when implementing the programme in a school setting. Five categories at a manifest level described aspects influencing the implementation: 1) 'The programme' underlining the importance of flexibility and feed-back; 2) 'the school' referring to management and work routines; 3) 'family conditions', implying various life situations; 4) 'group dynamics' dealing with attitudes among children and parents; and 5) 'the surrounding community' including accessibility and attitudes within society.CONCLUSIONS: When implementing a parental support programme in a school setting it is important to facilitate communication and clearly define the division of responsibilities between project management, schools and parents. This emphasises the need for managerial support, and a professional prevention support system.
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| 5. |
- Bergström, Helena, et al.
(författare)
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Managing Implementation of a Parental Support Programme for Obesity Prevention in the School Context : The Importance of Creating Commitment in an Overburdened Work Situation, a Qualitative Study.
- 2020
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Ingår i: Journal of Primary Prevention. - : Springer. - 0278-095X .- 1573-6547. ; 41:3, s. 191-209
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Tidskriftsartikel (refereegranskat)abstract
- Health-related behaviours in children can be influenced by parental support programmes. The aim of this study was to explore barriers to and facilitators for the implementation of a parental support programme to promote physical activity and healthy dietary habits in a school context. We explored the views and experiences of 17 coordinating school nurses, non-coordinating school nurses, and school principals. We based the interview guide on the Consolidated Framework for Implementation Research. We held four focus group discussions with coordinating and non-coordinating school nurses, and conducted three individual interviews with school principals. We analysed data inductively using qualitative content analysis. We identified "Creating commitment in an overburdened work situation" as an overarching theme, emphasising the high workload in schools and the importance of creating commitment, by giving support to and including staff in the implementation process. We also identified barriers to and facilitators of implementation within four categories: (1) community and organisational factors, (2) a matter of priority, (3) implementation support, and (4) implementation process. When implementing a parental support programme to promote physical activity and healthy dietary habits for 5- to 7-year-old children in the school context, it is important to create commitment among school staff and school nurses. The implementation can be facilitated by political support and additional funding, external guidance, use of pre-existing resources, integration of the programme into school routines, a clearly structured manual, and appointment of a multidisciplinary team. The results of this study should provide useful guidance for the implementation of similar health promotion interventions in the school context.
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| 6. |
- Bjersand, Kathrine, et al.
(författare)
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Ex vivo assessment of cancer drug sensitivity in epithelial ovarian cancer and its association with histopathological type, treatment history and clinical outcome
- 2022
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Ingår i: International Journal of Oncology. - : Spandidos Publications. - 1019-6439 .- 1791-2423. ; 61:4
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Tidskriftsartikel (refereegranskat)abstract
- Epithelial ovarian cancer (EOC) is divided into type I and type II based on histopathological features. Type I is clinically more indolent, but also less sensitive to chemotherapy, compared with type II. The basis for this difference is not fully clarified. The present study investigated the pattern of drug activity in type I and type II EOC for standard cytotoxic drugs and recently introduced tyrosine kinase inhibitors (TKIs), and assessed the association with treatment history and clinical outcome. Isolated EOC tumor cells obtained at surgery were investigated for their sensitivity to seven standard cytotoxic drugs and nine TKIs using a short-term fluorescent microculture cytotoxicity assay (FMCA). Drug activity was compared with respect to EOC subtype, preoperative chemotherapy, cross-resistance and association with progression-free survival (PFS). Out of 128 EOC samples, 120 samples, including 21 type I and 99 type II, were successfully analyzed using FMCA. Patients with EOC type I had a significantly longer PFS time than patients with EOC type II (P=0.01). In line with clinical experience, EOC type I samples were generally more resistant than type II samples to both standard cytotoxic drugs and the TKIs, reaching statistical significance for cisplatin (P=0.03) and dasatinib (P=0.002). A similar pattern was noted in samples from patients treated with chemotherapy prior to surgery compared with treatment-naive samples, reaching statistical significance for fluorouracil, irinotecan, dasatinib and nintedanib (all P<0.05). PFS time gradually shortened with increasing degree of drug resistance. Cross-resistance between drugs was in most cases statistically significant yet moderate in degree (r<0.5). The clinically observed relative drug resistance of EOC type I, as well as in patients previously treated, is at least partly due to mechanisms in the tumor cells. These mechanisms seemingly also encompass kinase inhibitors. Ex vivo assessment of drug activity is suggested to have a role in the optimization of drug therapy in EOC.
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| 7. |
- Bobjer, Johannes, et al.
(författare)
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Location of retroperitoneal lymph node metastases in upper tract urothelial carcinoma : results from a prospective lymph node mapping study
- 2023
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Ingår i: European Urology Open Science. - : Elsevier. - 2666-1691 .- 2666-1683. ; 57, s. 37-44
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Tidskriftsartikel (refereegranskat)abstract
- Background: There is limited information on the distribution of retroperitoneal lymph node metastases (LNMs) in upper tract urothelial carcinoma (UTUC).Objective: To investigate the location of LNMs in UTUC of the renal pelvis or proximal ureter and short-term complications after radical nephroureterectomy (RNU) with lymph node dissection (LND).Design, setting, and participants: This was a prospective Nordic multicenter study (four university hospitals, two county hospitals). Patients with clinically suspected locally advanced UTUC (stage >T1) and/or clinical lymph node–positive (cN+) disease were invited to participate. Participants underwent RNU and fractionated retroperitoneal LND using predefined side-specific templates.Outcome measurements and statistical analysis: The location of LNMs in the LND specimen and retroperitoneal lymph node recurrences during follow-up was recorded. Postoperative complications within 90 d of surgery were ascertained from patient charts. Descriptive statistics were used.Results and limitations: LNMs were present in the LND specimen in 23/100 patients, and nine of 100 patients experienced a retroperitoneal recurrence. Distribution per side revealed LNMs in the LND specimen in 11/38 (29%) patients with right-sided tumors, for whom the anatomically larger, right-sided template was used, in comparison to 12/62 (19%) patients with left-sided tumors, for whom a more limited template was used. High-grade complications (Clavien grade ≥3) within 90 d of surgery were registered for 13/100 patients. The study is limited in size and not powered to assess survival estimates.Conclusions: The suggested templates that we prospectively applied for right-sided and left-sided LND in patients with advanced UTUC included the majority of LNMs. High-grade complications directly related to the LND part of the surgery were limited.Patient summary: This study describes the location of lymph node metastases in patients with cancer in the upper urinary tract who underwent surgery to remove the affected kidney and ureter. The results show that most metastases occur within the template maps for lymph node surgery that we investigated, and that this surgery can be performed with few severe complications.
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| 8. |
- Brändstedt, Johan, et al.
(författare)
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Urosymphyseal fistula after pelvic radiotherapy in a tertial referral centre : a rare entity with significant comorbidity requiring multidisciplinary management
- 2023
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Ingår i: Scandinavian journal of urology. - : Medical Journals Sweden AB. - 2168-1805 .- 2168-1813. ; 58, s. 4-10
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To report population-based clinical presentation and outcomes in patients with urosymphyseal fistula (USF) after pelvic radiotherapy (RT).Patients and methods: A retrospective chart review was performed in 33 consecutive patients diagnosed with suspicion of USF in a tertial referral center from 2014–2022 to ascertain information about diagnostic delay, clinical presentation, precipitating causes, treatments received and outcomes during the median 22 months follow-up. Out of 33 consecutive patients with suspicion of USF, one female with vesicovaginal fistula, one patient developing RT-associated bladder angiosarcoma, four patients with short follow-up (<3 months), and three patients that during chart review not were considered to have a USF were excluded.Results: In all, 24 males with a median age of 77 years were diagnosed with USF. Local pain was the predominating symptom in 17/24 (71%) patients. Endourologic manipulations preceded the diagnosis of USF in 16 patients. Five patients had a diagnostic delay of more than 3 months. At diagnosis, 20/24 patients had radiological signs of osteomyelitis, and five had a concomitant rectourethral fistula. Due to comorbidity, five patients were not amenable to any other interventions than urinary catheter or suprapubic tube in conjunction with long-term antibiotics, of which three died from infections related to the USF. Out of the remaining 19 patients receiving some form of urinary diversion, five had recurrent osteomyelitis, of which four did not undergo cystectomy in conjunction with surgery for the USF.Conclusions: Urethral endourologic interventions in patients previously subjected to pelvic RT should be performed cautiously.
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| 9. |
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| 10. |
- Dahgam, Santosh, et al.
(författare)
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Haplotypes of the inducible nitric oxide synthase gene are strongly associated with exhaled nitric oxide levels in adults: a population-based study
- 2014
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Ingår i: Journal of Medical Genetics. - : BMJ. - 0022-2593 .- 1468-6244. ; 51:7, s. 449-454
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Tidskriftsartikel (refereegranskat)abstract
- Background Previous genetic association studies have reported evidence for association of single-nucleotide polymorphisms (SNPs) in the NOS2 gene, encoding inducible nitric oxide synthase (iNOS), to variation in levels of fractional exhaled nitric oxide (FENO) in children and adults. In this study, we evaluated 10 SNPs in the region of chromosome 17 from 26.07Mb to 26.13Mb to further understand the contribution of NOS2 to variation in levels of FENO. Methods In a cohort of 5912 adults 25-75years of age, we investigated the relationship between NOS2 haplotypes and FENO, and effect modification by asthma. Results Seven common (frequency 5%) haplotypes (H1-H7) were inferred from all possible haplotype combinations. One haplotype (H3) was significantly associated with lower levels of FENO: -5.8% (95% CI -9.8 to -1.7; p=0.006) compared with the most common baseline haplotype H1. Two haplotypes (H5 and H6) were significantly associated with higher levels of FENO: +10.7% (95% CI 5.0 to 16.7; p=0.0002) and +14.9% (95% CI 10.6 to 19.3; p=7.8x10(-13)), respectively. The effect of haplotype H3 was mainly seen in subjects with asthma (-21.6% (95% CI -33.5 to -5.9)) and was not significant in subjects without asthma (-4.2% (95% CI -8.4 to 0.2)). The p value for interaction between H3 and asthma status was 0.004. Conclusions Our findings suggest that several common haplotypes in the NOS2 gene contribute to variation in FENO in adults. We also saw some evidence of effect modification by asthma status on haplotype H3.
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| 11. |
- Dahgam, Santosh, et al.
(författare)
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Single nucleotide polymorphisms in the NOS2 and NOS3 genes are associated with exhaled nitric oxide
- 2012
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Ingår i: Journal of Medical Genetics. - : BMJ. - 0022-2593 .- 1468-6244. ; 49:3, s. 200-205
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Tidskriftsartikel (refereegranskat)abstract
- Background Polymorphisms in nitric oxide synthase genes (NOS1, NOS2, and NOS3) have been suggested to have a major impact on fraction of exhaled nitric oxide (FENO), a biomarker of airway inflammation. However, the genetic contribution of NOS polymorphisms to FENO is not fully understood. The aim of this study was to investigate comprehensively the association between single nucleotide polymorphisms (SNPs) in all three NOS genes and FENO in an adult population, and to assess whether such associations are modified by asthma or atopy. Method In 1737 adults from a Swedish general population sample, FENO was measured and genetic variation in the NOS genes was assessed using 49 SNPs. The genetic effect of NOS polymorphisms on FENO, asthma, and atopy was estimated using multiple regression methods. Results In a multi-SNP model based on stepwise regression analysis, two SNPs in NOS2 and one in NOS3 showed independent associations with levels of FENO. For NOS2 SNP rs9901734, subjects had 5.3% (95% CI 1.0% to 9.7%) higher levels of FENO per G allele, and for rs3729508, subjects with CC or CT genotypes had 9.4% (95% CI 3.1% to 15.2%) higher levels compared with TT. For NOS3 SNP rs7830, subjects with GT or TT had 5.6% (95% CI 0.4% to 11.1%) higher levels than GG; the genetic effect of this SNP was stronger in asthmatics (21.9%, 95% CI 4.6% to 42.0%). Conclusion These results suggest that NOS2 is the major NOS gene determining variability in exhaled nitric oxide in the healthy adult population, while NOS3 may play a more important role in asthmatic adults.
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| 12. |
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| 13. |
- Elinder, Liselotte Schäfer, et al.
(författare)
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A Healthy School Start Plus for prevention of childhood overweight and obesity in disadvantaged areas through parental support in the school setting - study protocol for a parallel group cluster randomised trial.
- 2018
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Ingår i: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 18:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Systematic reviews conclude that interventions to prevent overweight and obesity in children obtain stronger effects when parents are involved. Parenting practices and parent-child interactions shape children's health-related behaviours. The Healthy School Start Plus intervention aims to promote healthy dietary habits and physical activity and prevent obesity in children through parental support in disadvantaged areas with increased health needs, delivered by teachers and school nurses. This protocol describes the design, outcome and process evaluation of the study.METHODS: Effectiveness of the intervention is compared to standard care within school health services. The 6-month programme, based on Social Cognitive Theory, consists of four components: 1) Health information to parents regarding the child; 2) Motivational Interviewing with the parents by the school nurse concerning the child; 3) classroom activities for the children by teachers; and 4) a web-based self-test of type-2 diabetes risk by parents. Effects will be studied in a cluster randomised trial including 17 schools and 352 six-year old children. The primary outcome is dietary intake of indicator foods, and secondary outcomes are physical activity, sedentary behaviour and BMI. Outcomes will be measured at baseline, at 6 months directly after the intervention, and at follow-up 18 months post baseline. Statistical analysis will be by mixed-effect regression analysis according to intention to treat and per protocol. Mediation analysis will be performed with parental self-efficacy and parenting practices. Quantitative and qualitative methods will be used to study implementation in terms of dose, fidelity, feasibility and acceptability. The hypothesis is that the programme will be more effective than standard care and feasible to perform in the school context.DISCUSSION: The programme is in line with the cumulated evidence regarding the prevention of childhood obesity: That schools should be a focal point of prevention efforts, interventions should involve multiple components, and include the home environment. If effective, it will fill a knowledge gap concerning evidence-based health promotion practice within school health services to prevent obesity, and in the long term reduce social inequalities in health.TRIAL REGISTRATION: The trial was retrospectively registered on January 4, 2018 and available online at ClinicalTrials.gov : No. NCT03390725 .
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| 14. |
- Etminan Malek, Mahnoush, et al.
(författare)
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Relationships between Physical Activity Parenting Practices and Children's Activity Measured by Accelerometry with Children's Activity Style as a Moderator : A Cross Sectional Study
- 2022
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Ingår i: Children. - : MDPI AG. - 2227-9067. ; 9:2
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Tidskriftsartikel (refereegranskat)abstract
- The objective was to examine the associations between physical activity parenting practices (PAPP) and children’s levels of moderate-to-vigorous physical activity (MVPA), and time spent sedentary (SED) during non-school time in weekdays and weekends when children’s activity style was taken into account. Study participants were 88 children (mean age 6.3 (SD 0.3) years); 51.0% girls) and their parents who took part in A Healthy School Start Plus in Sweden. The independent variables included PAPPs Structure, Neglect/control, and Autonomy promotion and children’s activity style as moderator, assessed through validated parent questionnaires. Dependent variables were the MVPA and SED in minutes, measured by accelerometry. Structural equation modeling was used to examine the associations between PAPPs and children’s MVPA and SED with children’s activity style as a moderator. No significant associations between the PAPPs Structure, Neglect/control, and Autonomy promotion and measures of physical activity were found (p > 0.13). The moderating role of activity style improved the model fit and the final model had a reasonable fit to the data. Our results suggest that in future studies, with the aim to explore the relationship between PAPP and children’s physical activity, the activity style of the children should be included as a moderator.
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| 15. |
- Everhov, Åsa H, et al.
(författare)
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Serum Androgen Levels and Sexual Function Before and One Year After Treatment of Uterine Cervical Cancer: A Pilot Study.
- 2016
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Ingår i: The journal of sexual medicine. - : Oxford University Press (OUP). - 1743-6109 .- 1743-6095. ; 13:3, s. 413-24
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Tidskriftsartikel (refereegranskat)abstract
- Radiotherapy or radical hysterectomy with salpingo-oophorectomy (SOE) as treatment for uterine cervical cancer causes estrogen deprivation in premenopausal women. The effects on androgen production have rarely been examined but could be relevant for survivors of cervical cancer because insufficiency has been associated with low sexual function.
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| 16. |
- Forsman, Åsa, 1972-, et al.
(författare)
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Utvärdering av alkolås efter rattfylleri : Sammanfattande slutrapport
- 2018
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- I Sverige finns sedan 1 januari 2012 ett permanent system för alkolås efter rattfylleri som innebär att förare som gjort sig skyldiga till rattfylleribrott med avseende på alkohol kan beviljas ett körkort med villkor om alkolås istället för att få körkortet helt återkallat. Transportstyrelsen ansvarar för systemet.Systemet med alkolås efter rattfylleri har utvärderats i tre olika delstudier: en registerstudie, en enkätstudie och en intervjustudie. I den här slutrapporten redovisas en sammanfattning av resultaten från alla tre delstudier. Syftet med utvärderingen var dels att beräkna hur stor andel som deltar i systemet, men också att öka förståelsen om varför man väljer eller inte väljer alkolås efter rattfylleri och att studera individernas upplevelse av systemet. Resultaten från studierna visar bland annat att:Cirka 30 procent av alla som fick körkortet återkallat på grund av alkoholrattfylleri ansökte om och beviljades alkolås.Både deltagare och icke deltagare i alkolåsprogrammet upplevde en förbättrad hälsa när det gått ett tag efter rattfyllerihändelsen och de rapporterade också en minskad alkoholkonsumtion.Det största hindret för att öka deltagandet i systemet med alkolås efter rattfylleri är kostnaden, men det finns även andra orsaker som bidrar till att man inte ansöker.Många deltagare upplevde brister i informationen från Transportstyrelsen.Totalt 31 procent av deltagarna med alkolås i två år har fått diagnosen alkoholberoende eller alkoholmissbruk.
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| 17. |
- Forward, Sonja, 1956-, et al.
(författare)
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Motorcyklister – utbildning, erfarenhet, syn på risk och olycksinblandning
- 2022
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Det övergripande syftet med denna studie var att bidra till att förbättra trafiksäkerheten för förare av tvåhjulig motorcykel. Ett annat syfte var att undersöka orsaken till varför olyckor inträffar och motorcyklisters syn på risker i trafiken. I studien ingick fyra delstudier: registerstudie, enkätstudie och två intervjustudier. Både registerstudien och enkätstudien jämfördes med en grupp som skadats i trafiken med en kontrollgrupp. Resultaten från registerstudien visade att cirka 80 procent av de skadade förarna hade en giltig behörighet. Jämfört med kontrollgruppen hade skadegruppen något fler underkända kunskapsprov. Enkätstudien visade att de vanligaste olyckorna var singelolyckor och att cirka en femtedel av de skadade var helt eller delvis vållande till olyckan. Enligt intervjustudien med drabbade motorcyklister som varit vållande till olyckan berodde det på bristande uppmärksamhet och att bilförarens beteende misstolkades. Resultatet från regressionsanalysen visade att 55 procent av de variabler som ingår i Theory of Planned Behaviour förklarade deras avsikt att överträda hastighetsbestämmelser vilket innebär att detta beteende kan kopplas till medvetna felhandlingar. En annan slutsats är att olycksinblandning inte alltid ökar deras riskmedvetenhet. Frågor baserade på T-Locus of Control visade att den troligaste orsaken till en olycka, enligt motorcyklisterna, är att andra fordonsförares brister i sin körning snarare än det egna beteendet. Detta gällde oavsett om man var vållande till olyckan eller inte vilket i sin tur minskar motivationen att förändra sitt eget beteende. Slutsatsen är att utbildning inte kan kopplas till olycksinblandning, däremot gick det att fastslå att hastighetsöverträdelser kan kopplas till medvetna felhandlingar. Det sistnämnda styrker behovet av en rad olika utbildningsinsatser. Samtidigt är det viktigt att betona att utbildningen måste hålla hög kvalitet och att den är elevcentrerad, det vill säga utgår ifrån elevens tidigare erfarenheter samtidigt som den utmanar redan etablerade föreställningar. Studien avslutas med en rad rekommendationer för att öka motorcyklisters trafiksäkerhet.
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| 18. |
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| 19. |
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| 20. |
- Isaksson, Johan, et al.
(författare)
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Cortisol levels in children with Attention-Deficit/Hyperactivity Disorder
- 2012
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Ingår i: Journal of Psychiatric Research. - : Elsevier BV. - 0022-3956 .- 1879-1379. ; 46:11, s. 1398-1405
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Tidskriftsartikel (refereegranskat)abstract
- Regulation of the Hypothalamus-Pituitary-Adrenal axis (HPA-axis) and its end product cortisol differs among persons with certain psychiatric disorders when compared with controls. Some reports concern Attention-Deficit/Hyperactivity Disorder (ADHD) but findings are inconclusive. In this study we collected four saliva samples during a regular weekday in children, 6-17 years old, with ADHD (n = 201) and non-affected comparisons (n = 221). Saliva cortisol was measured with radioimmunoassay technique. Clinical data were collected for diagnostic information. Subtypes and severity of symptoms were determined using parental rating scales. Children with ADHD had lower saliva cortisol levels than comparisons at waking up Median = 9.1 versus 12.7 nmol/L (p < .001), 30 min later Median = 15.8 versus 20.1 nmol/L (p < .001) and before going to bed Median = 0.8 versus 1.0 nmol/L (p = .015). No difference was found for the afternoon sample. When the study group was split into three different age groups similar results were found only for children above 10 years of age. Subtype of ADHD or co-occurring symptoms did not affect the cortisol levels. Degree of severity of ADHD symptoms was not associated with cortisol levels in the study group, other than a weak negative correlation between the afternoon sample and hyperactivity symptoms. The low cortisol levels in children with ADHD may indicate a dysregulation of the HPA-axis, for instance a down-regulation or a phase delay of the diurnal curve. The low levels may be related to the under-arousal possibly underlying several of the core symptoms of ADHD.
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| 21. |
- Jonsson, Ann-Sofie, 1983-, et al.
(författare)
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Experiencing hospitality through people, places and artefacts within an institutional setting : A qualitative interview study with eleven in patients across three hospital wards in Sweden
- 2020
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Ingår i: Nordic Association for Food Studies Workshop 2020. - : Örebro University. - 9789187789434 - 9789187789441 ; , s. 23-23
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Konferensbidrag (refereegranskat)abstract
- Eating and sharing meals are essential parts of everyday life and expressed through tradition and culture. This everyday expression of who we are is argued to be taken away from us during hospitalization. Few studies have qualitatively explored hospitalized older patients experiences with their mealtimes. This is a perspective that could increase the understanding of how to provide enhanced dining experiences during time of illness for this malnutrition prune age group. The study objective was therefore to explore older patients’ (> 65 years) mealtime experiences during hospital stay with an emphasis towards the social interactions taking place before, during and after their meals. Eleven semi structured interviews were conducted and analysed through the lens of hospitality and the dramaturgical theory outlined by Goffman. The preliminary results indicate that the patients experience hospitality through materiality (e.g. the menu), commensality (with fellow patients and staff) an d individuality (the possibility to make own meal choices) but also inhospitality through conformity (not expressing their wishes or conforming to the situation) and locality (e.g. being lonely in ther oom). The patients are seen to reinforce the role of the non-complaining patient as well as not being a burden. The understanding of these kinds of role making and role taking by the patients is important to recognize within healthcare to be able to ensure that the mealtime and the meal service is provided with a person- centered approach together with the recognition that hospitality can bring fourth the practical doings in how to perform during meal service.
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| 22. |
- Jonsson, Ann-Sofie, 1983-, et al.
(författare)
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Hospitality and mealtime approaches in hospitals – perspectives from nursing- and meal-staff
- 2020
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Ingår i: The INC 2020. ; , s. 98-99
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Konferensbidrag (refereegranskat)abstract
- In order to understand the provision of meals to older patients in hospitals, the notion of hospitality is interesting. Previous research has found that even if adequate nutrition is provided the food served to the patients is not always consumed (Agarwal et al. 2013). Therefore, it is essential to also highlight aspects related to how and where the meals areserved, as well as the interaction between the staff and the patients.The overall aim of this study was to explore how nursing staff and meal-hosts approached the mealtime for older patients and what aspects impacted on how the meals were served to the patients.Method: Twenty mealtimes was observed across four wards within two hospitals in Sweden that had nursing staff serving meals on wards with a dayroom (2 wards) and meal-host serving meals on the wards with a dining room (2 wards). The objectives of the observations was to observe how the staff served the meals to the patients with as special focus on the hospitality approaches provided and the overall dining area. The Five Aspect Meal Model (Gustafsson, Öström, Johansson & Mossberg, 2006; Edwards & Gustafsson, 2008) and the notion of hospitality (Lashley, 2000; Telfer, 2000) serves as main frameworks. Moreover, Goffman’s dramaturgical theory (Goffman, 2014) is used to understand the scenery observed during the mealtimes.Preliminary findings: Two overall themes were identified in the initial analyses, 1) atmosphere in the dining area; 2) and serving style and hospitality approaches.The overall atmosphere differed between the two dining areas which impacted on how the patients were approached during mealtimes. The observations disclosed several encounters were the atmosphere in the dining area in the wards with meal-hosts serving were perceived as a regular restaurant with patients approached and asked what they would like to eat and drink in relation to the menu that was available. It was also observed in several occasions that the meal-host sat down next to the patients and helped the patients to choose a dish from the menu, asking if they were satisfied with the meal or if they needed anything else. The meal-host constant presence in the dining room contributed to a positive atmosphere as well as opportunities for the patients to get direct assistance. In the wards with nursing staff serving the food in the dayroom the patients were not as frequently out for lunch or dinner and several observations disclosed that no patients were taken to dine outside the own room. However, when the patients were out the hospitality approaches differed. Most often the patients were nicely talked and attended to in the moment of providing the meal tray and when the tray was taken away. However, the time between service and closing of the meal the patients was most often left unattended for. The atmosphere was most often sensed as “heavy” and silent. It was observed that the nursing staff not always thought of turning the lights on in the dayroom contributing to a less positive atmosphere. The staff was observed to just passing by the dayroom without visiting the dayroom to ask if the meal was of satisfaction or overall seeing the patients.The serving style and hospitality approaches differed in some aspects between meal-hosts and nursing staff at the observed wards. The nursing staff was observed on all wards, including the wards with meal-host serving the meals, to be more hands-on and talking closer with the patients, which also disclosed different caring roles during mealtimes. If patients wanted anything else, a hand was often seen to be touched upon the patient or confirmed the wish by talking near and close to the patient. The meal-host was observed to both display a near service style with taking orders by sitting next to the patient or squatting to be on the same level as the patient, and, in some occasions, take orders as in restaurants with the help of a note pad standing next to the table.Conclusion: The preliminary findings of this study indicate that a constant presence of a meal-host or nursing staff would be beneficial for both the overall atmosphere in the dining area as well as for patients getting timely assistance. However, further analyses are needed to fully understand and report the findings of this study.
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| 23. |
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| 24. |
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| 25. |
- Jonsson, Ann-Sofie, et al.
(författare)
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Older patients' perspectives on mealtimes in hospitals : a scoping review of qualitative studies
- 2021
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Ingår i: Scandinavian Journal of Caring Sciences. - : John Wiley & Sons. - 0283-9318 .- 1471-6712. ; 35:2, s. 390-404
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Tidskriftsartikel (refereegranskat)abstract
- The increasing age of populations throughout the world means that healthcare services are faced with new challenges, not least regarding the provision of food during hospital stay. There is a lack of knowledge of how hospital mealtimes are experienced by older patients, and so the aim of this article was to review current knowledge regarding mealtimes in hospitals from the perspectives of older patients. A literature search was performed using seven databases: PubMed, Web of Science, Scopus, Sociological Abstracts, SweMed+, ASSIA and CINAHL with no limits regarding publication date. The inclusion criteria were peer-reviewed articles in English or Swedish that used qualitative methods to examine older patients' (>65 years) mealtime experiences. The Five Aspect Meal Model (FAMM) served as a framework for understanding the complexity behind a mealtime experience. Qualitative content analysis was used as a guide when analysing the material. The search produced 415 studies, 14 of which were included in the review. The findings generated three main themes for understanding how older patients experience mealtimes while in hospital: (1) the food and the food service, (2) mealtime assistance and commensality during mealtimes and (3) the importance of retaining one's independence. The review also clearly indicated a shortage of studies that solely focus on older patients' experiences of their mealtime. More research is therefore needed to be fully able to understand the complex task of providing meals in hospitals.
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