| 1. |
- Axelsson, Karin, 1969-
(författare)
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Entrepreneurship in a School Setting : Introducing a Business Concept in a Public Context
- 2017
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Entrepreneurship has during the last decades gained an immense interest in academia, politics and practice. It is argued from politics that more entrepreneurs are necessary for the economic development. In addition, nowadays entrepreneurship is also perceived as a solution to social and societal challenges. This drives a need for entrepreneurial people everywhere in society who can cope with the inconstant and uncertain world of today. As a consequence, there are around the world numerous educational initiatives trying to inspire and fuel an entrepreneurial mind-set. Here, educations of all kind become relevant contexts since they provide an opportunity to affect children, youth’s and adult’s interest and attitudes towards entrepreneurship, and as such give a possibility to reach a vast number of people.Sweden is no exception, and in 2009 the Swedish Government launched a ‘Strategy for entrepreneurship in the field of education’ in which entrepreneurship is said to run like a common thread throughout education. The main focus is that self-employment is to become as natural as being an employee. As such the Government took an active stand for implementing entrepreneurship in the school setting on a broad front, from preschool to adult education.This development can be seen as part of New Public Management; a development where concepts from the private sector are lent and transferred to the public sector. Thus, when introducing entrepreneurship in the Swedish educational system, this at the same time means introducing a traditional business concept in a public setting. Therefore, the overall aim of this thesis is to increase knowledge of and insights on how a business concept – entrepreneurship – is operationalised and constructed in a public setting.When placing entrepreneurship in new societal contexts other questions arise and complexity intensifies. In this qualitative research, the empirical context in focus are schools. It investigates how entrepreneurship is constructed among teachers in their work. But also how this business concept is included in a non-business setting by studying how the entrepreneurship strategy is operationalised in educational practice.As such the thesis and its findings contribute to the scientific discussions on societal entrepreneurship and entrepreneurship education, as well as on strategy and strategising in a public context. The research also aspire to serve inspiration, insights and food for thoughts on discussions and reflections on entrepreneurship within the school practice. This compilation thesis include five papers. To be able to fulfil the aim this research use a broad theoretical base and multiple qualitative research methods. The combination of methods include semi-structured interviews, in-depth interview using the stimulated recall method, focus group interviews, participative meetings, observations, document studies, digital questionnaires, written inquiries, analysing texts and critical incidents questionnaires.
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| 2. |
- Berglund, Gunilla, et al.
(författare)
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"Between Men" : A psychosocial rehabilitation programme for men with prostate cancer
- 2007
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Ingår i: Acta Oncologica. - : Informa UK Limited. - 0284-186X .- 1651-226X. ; 46:1, s. 83-89
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to evaluate the effect of psychosocial rehabilitation on newly diagnosed prostate cancer patients. The “Between Men” programme consisted of seven weekly sessions of physical training (Phys) alone, information (Info) alone or physical training plus information (PhysInfo). After diagnoses, patients (n =211) were consecutively included, stratified and randomised to one of four groups: Phys, Info, PhysInfo or standard care control (C). A nurse specialised in urology, an urologist and a physiotherapist performed the interventions. Patients were followed up during one year with mailed standardised questionnaires. It could not be assumed that the “Between Men” programme had any effect on patients’ anxiety and depression (HADS). Health-related quality of life (HRQOL) was associated with stage of disease but not with psychosocial intervention. Thus, Physical Function (PF), Role Function (RF) and Fatigue (FA) were inferior among patients with, than without, metastases of prostate cancer both at baseline and at the 12-month follow-up. This randomized study did not demonstrate any significant effect of psychosocial rehabilitation among prostate cancer patients. Considering the low rate (1/2), of included/eligible patients a less complicated design (intervention versus control) would have been preferred in order to increase power.
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| 3. |
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| 4. |
- Berglund, Karin, et al.
(författare)
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Practicing ’intellectus’ in rural entrepreneurship
- 2019
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Konferensbidrag (refereegranskat)abstract
- In this paper we turn to recent philosophical investigations to analyse stories from entrepreneurial women in rural areas. They describe a variety of social activities they are engaged in to develop their companies, products and services, but also the local community, and society. These engagements are often described in passing, and not directly connected to the company according to conventional goal-oriented logic. Rather, they are seen as taken for granted– they are just done, and someone needs to do them. They concern care for others – for the children in the community, the elderly, the infrastructure, the sustainability of the industry etc. They are neither described as sacrifice, nor as benevolence, as is often emphasized in social entrepreneurship stories. Rather, these engagements signal something else. We argue that they illustrate a reflective practice of entrepreneurship, normally suppressed by an economic logic and described as play, passion and creativity in the sociologically inspired entrepreneurship literature.To better understand the role of reflexive practices in rural entrepreneurship, we turn to philosopher Jonna Bornemark who describes how humans in modern societies have become ‘prisoners’ of the measurable economic rationality (‘ratio’). With inspiration from the pre-renaissance philosopher, Nicholas Cusanus (1401-1464), she describes how the calculating ‘ratio’ has taken precedence over ‘intellectus’. Economic rationality (ratio) describes how we turn to rules of abstractions and generalization. Bornemark’s argument is that too much of ratio makes us loose contact with ourselves, others and the specific situation in a way that disables us to develop judgment. Instead we rely on external parameters to objectively guide our action. Practices built on intellectus, on the contrary, emphasize the subjective, emotional, temporary and our ability to ‘not know’, but to learn to cope with insecurity, instability, anxiety and find ways to act in such terrains. Bornemark’s point is that ratio and intellectus practices are interdependent – both are needed. But, in modern societies intellectus has been suppressed, overlooked and seen as state of lack of better knowledge.But, what if intellectus is a practice that is nurtured in rural contexts? A practice that not only makes it possible for rural areas to survive and thrive, but which we can learn from in the contemporary calls to change global society in a more thoughtful direction. By analyzing stories from 35 women pursuing different businesses and social activities, we set eyes at the question of if, and how, intellectus is practiced by rural entrepreneurial women.
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| 5. |
- Dijken, Jan W.V. van, 1947-, et al.
(författare)
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Samarbete breddar forskning : Oral Biomaterialgruppen, Umeå
- 2008
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Ingår i: Tandläkartidningen. - : Sveriges Tandläkarförbund. ; 100:5, s. 74-79
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Tidskriftsartikel (populärvet., debatt m.m.)abstract
- Vid institutionen för odontologi vid Umeå Universitet finns en lång tradition av biomaterialforskning. För drygt två år sedan samlades större delen av den forskningen i ett vetenskapligt nätverk. Här beskrivs ett axplock av det breda forskningsarbetet.
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| 6. |
- Fröbom, Robin, et al.
(författare)
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Phase I trial evaluating safety and efficacy of intratumorally administered inflammatory allogeneic dendritic cells (ilixadencel) in advanced gastrointestinal stromal tumors
- 2020
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Ingår i: Cancer Immunology and Immunotherapy. - : Springer Science and Business Media LLC. - 0340-7004 .- 1432-0851. ; 69:11, s. 2393-2401
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundThe majority of patients with advanced gastrointestinal stromal tumor (GIST) develop resistance to imatinib, and subsequent treatments have limited efficacy. Ilixadencel (allogeneic inflammatory dendritic cells) is a cell-based immune primer injected intratumorally that previously has been clinically investigated in metastatic renal cell carcinoma and hepatocellular carcinoma.MethodsThe trial was a single arm phase I trial assessing safety and efficacy of ilixadencel in subjects with progressing advanced/metastatic GIST despite ongoing treatment with second or later lines of tyrosine kinase inhibitors (TKI). Three patients were progressing while on sunitinib (second line), one on regorafenib (third line), and two on pazopanib (fourth line). TKI treatment was maintained throughout, while two intratumoral injections of ilixadencel (10 × 106 viable and HLA-DR expressing cells per dose) were administered.ResultsNo severe adverse events were found to be related to ilixadencel administration. Four patients showed continued tumor progression at 3 months per RECIST 1.1 and Choi criteria. One patient (on third line regorafenib) had stable disease for 9 months and another patient (on second line sunitinib) had stable disease at end of study (12 months) as per RECIST 1.1. These two patients developed a partial response as per Choi criteria with a duration of 3 and 6 months, respectively. The median progression-free survival (PFS) was 4.0 months.ConclusionIlixadencel treatment presented an acceptable safety profile among advanced GIST patients who developed resistance to TKI. Encouraging radiological tumor responses were detected in 33% of treated patients, supporting further investigation.
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| 7. |
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| 8. |
- Hjerpe, Karin, et al.
(författare)
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Utsläpp av växthusgaser från torvmark
- 2014
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Dikad torvmark i Sverige avgav sammanlagt drygt 11,4 miljoner ton koldioxidekvivalenter år 2012, enligt den senaste klimatrapporteringen. Denna mängd kan jämföras med de totala svenska utsläppen av växthusgaser, som beräknades uppgå till 57,6 miljoner ton koldioxidekvivalenter samma år. En åtgärd som skulle kunna minska utsläppen av växthusgaser från dikad torvmark är att återställa marken till våtmark, vilket minskar avgången av koldioxid och lustgas från marken. Samtidigt ökar avgången av metan, men minskningen av koldioxid- och lustgasutsläppen är större, vilket innebär att utsläppen av växthusgaser från marken totalt sett minskar. Om de ekonomiska resurserna för att återställa dikad torvmark till våtmark är begränsade bör man i första hand återställa dikade torvmarker som är stora källor för växthusgaser till våtmark. Studier av växthusgasutsläpp från dikade torvmarker som används för skogsproduktion visar att näringsrika och väldränerade marker är större källor för växthusgaser än näringsfattigare, fuktigare marker. Vi bedömer därför att det ur ett klimatperspektiv är viktigast att återställa dikad skogsmark med en kol:kväve-kvot under 25 som är frisk-fuktig eller torrare. Dikad torvmark som används för naturbete avger mindre växthusgaser än åkermark på dikad torvmark och därför är det viktigare att återställa åkermark till våtmark. Avgången av växthusgaser varierar mycket mellan olika åkrar på dikad torvmark. Det är dock inte möjligt att identifiera åkrar på dikad torvmark som är stora källor för växthusgaser utifrån markfuktighet eller kol:kväve-kvot, och inte heller utifrån några andra faktorer som är enkla att mäta. Detta beror sannolikt på att åkermarken generellt är så pass väldränerad och näringsrik att varken syreeller kvävetillgången är begränsande för avgången av koldioxid och lustgas. I ett längre tidsperspektiv kommer dikad torvmark att avge koldioxid och lustgas så länge det finns ett syresatt torvlager. Därför bedömer vi att det är viktigast att återställa dikad åkermark med tjockt torvlager till våtmark. Därtill bör mark som inte längre aktivt brukas prioriteras framför mark som fortfarande är i bruk. Utsläppen av växthusgaser verkar inte automatiskt minska när brukandet upphör och även om marken sannolikt kommer att försumpas på sikt, vilket innebär att utsläppen av växthusgaser minskar, kan det ta väldigt lång tid. Dessutom borde kostnaderna för att återställa marken till våtmark i genomsnitt bli lägre om marken inte längre används. Hur mycket avgången av växthusgaser minskar när dikad torvmark återställs till våtmark beror inte bara på hur stor avgången av växthusgaser från den dikade marken var utan också på hur stor avgången från den anlagda våtmarken blir. Utsläppen från våtmarken påverkas av hur den anläggs och sköts. För att våtmarken ska avge så lite växthusgaser som möjligt bör grundvattennivån höjas så mycket att förhållandena före dikningen återskapas. Om våtmarken anläggs på mark som använts för jordbruksproduktion bör dessutom vegetationen tas bort före återställandet. Anläggning av våtmarker kan också ge andra nyttor – våtmarkerna kan bland annat gynna biologisk mångfald och minska näringsläckaget till våra sjöar och vattendrag. När en våtmark ska anläggas och skötas behöver man ta hänsyn till alla dessa aspekter så att våtmarken ger så stor nytta som möjligt.
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| 9. |
- Nordin, Karin, et al.
(författare)
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Predicting anxiety and depression among cancer patients : a clinical model.
- 2001
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Ingår i: European Journal of Cancer. - : Elsevier BV. - 0959-8049 .- 1879-0852. ; 37:3, s. 376-384
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to investigate the possibility of predicting anxiety and depression 6 months after the cancer diagnosis on the basis of measures of anxiety, depression (Hospital Anxiety and Depression, HAD scale), subjective distress (Impact of Event, IES scale) and some aspects of social support in connection with the diagnosis. A further purpose was to attempt identification of individual patients at risk of prolonged psychological distress, and to develop an easily applicable clinical tool for such detection. A consecutive population-based series of 522 newly diagnosed patients with breast, colorectal, gastric and prostate cancer were interviewed in connection with the diagnosis and 6 months later. Anxiety and depression close to the diagnosis explained 39% of the variance in anxiety and depression 6 months later. Patients scoring as doubtful cases/cases for HAD anxiety and/or depression were more than 11 times more likely than non-cases to score as doubtful cases/cases at 6 months. Addition:ll risk factors were having an advanced disease and nobody in addition to the family to rely on in case of difficulties. Levels of anxiety and depression at diagnosis predict a similar status 6 months later. The results also indicate that the HAD scale in combination with a single question about social support may be a suitable screening tool for clinical use.
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| 10. |
- Sorgenfrei, Simon, Docent, et al.
(författare)
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Mångreligiositet och sekularitet i svenskt polisväsende, vård, skola och offentlig förvaltning : en forskningsöversikt
- 2021
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Under de senaste decennierna har Sverige genomgått stora demografiska och politiska förändringar. Tillsammans har dessa inneburit att Sverige idag samtidigt är ett av Europas mest sekulariserade och mest mångreligiösa länder. Den snabba demografiska förändring Sverige har genomgått har ställt många inför nya, stora och i vissa fall skyndsamma kunskapsbehov samtidigt är forskningen om situationen delvis eftersatt. I denna rapport identifieras hur den nya situationen relaterar till det lagstadgade uppdrag som svenskt polisväsende, vård, skola och offentlig förvaltning har. Den forskning som gjorts inom dessa områden sammanfattas och de viktigaste forskningsbehoven identifieras.
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| 11. |
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| 12. |
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| 13. |
- Ahl, Helene, 1958-, et al.
(författare)
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Can governments support both women and entrepreneurship?
- 2014
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Ingår i: Diana International Research Conference 2014.
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Konferensbidrag (refereegranskat)abstract
- Feminism in Sweden as well as in the other Scandinavian countries was largely formulated as state feminism. The women’s movement has cooperated with feminists in the state, resulting in societies that count as the most gender equal in the world. The Scandinavian countries are consistently ranked in the top position on international gender equality indices. The state has provided a large publicly financed welfare sector that both employs many women, and makes it possible to combine work and family through family friendly policies. The last decade has seen a political change influenced by neoliberal thought, in which politicians hand over welfare state responsibilities to the market, and instead encourage entrepreneurship, not least among women. The Swedish government has since 20 years back programs and policies to promote women’s entrepreneurship. The Swedish state has during the same period shrunk the public sector and privatized many operations in services and care, which traditionally employ many women. Instead, women are encouraged to start businesses in former public sectors. Empirical studies suggest however, that all of the increase of women’s entrepreneurship in these sectors is within low-paid, micro service businesses, typically child minding.Traditional state feminism has also changed character. Instead of public regulations, market solutions are advocated. In this paper we ask how to theorize this change from a feminist theory perspective; we ask what the implications for feminist action are, and we ask what consequences for women’s position in society are. We use research literature and policy texts as our empirical material and conduct a critical literature analysis. We conclude that the entrepreneurship discourse challenges, and possibly weakens state feminism and feminist action as we have known it in the Scandinavian countries, but may also offer new forms of feminist resistance, on market terms.
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| 14. |
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| 15. |
- Ahl, Helene, 1958-, et al.
(författare)
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Entrepreneurship for equality?
- 2013
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Ingår i: The International Helix conference 2013, Linköping, Sweden, June.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)
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| 16. |
- Ahl, Helene, 1958-, et al.
(författare)
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Entrepreneurship in rural areas : The role of women?
- 2017
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Ingår i: Paper presented at: 31st RENT Conference, Lund, 16-17 NOV 2017. - : European Institute for Advanced Studies in Management. ; , s. 1-20
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Konferensbidrag (refereegranskat)
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| 17. |
- Ahl, Helene, 1958-, et al.
(författare)
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From feminism to FemInc.ism : On the uneasy relationship between feminism, entrepreneurship and the Nordic welfare state
- 2016
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Ingår i: The International Entrepreneurship and Management Journal. - : Springer Science and Business Media LLC. - 1554-7191 .- 1555-1938. ; 12:2, s. 369-392
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Tidskriftsartikel (refereegranskat)abstract
- Feminism in the Nordic countries was primarily formulated in terms of ‘state feminism’. The women’s movement cooperated with feminist government officials and politicians, resulting in societies that can be considered to be the most gender-equal societies in the world. Historically, the state provided for a large publicly-financed welfare sector which made it possible for many women to combine work and family through the state’s implementation of family-friendly policies, while simultaneously providing employment opportunities for many women. However, since the financial crisis of the 1990s, there has been a political change influenced by neo-liberal thought, in which politicians have handed over the welfare state’s responsibilities to the market, and, instead, the politicians have encouraged entrepreneurship, not least among women. Further to this development, there has been a change in emphasis from entrepreneurship (understood as starting and running a business) to entrepreneurialism which, in addition to a belief in the efficacy of market forces, also contains a social dimension where individuals are supposed to be flexible and exercise choice. In this article, we ask whether this entails a change in the feminist project in the Nordic countries, and if so, what the likely consequences are for this project, both in practice and in research. In order to answer this question, we reviewed existing Nordic research on women’s entrepreneurship and examined how this body of work conceptualizes entrepreneurship, gender, the state, and equality. We also considered whether any trends could be identified. We relate our findings to recent changes in government policy and conclude that the current discourse on entrepreneurship challenges, and possibly weakens, state feminism, but we also conclude that this discourse may also provide space for new forms of feminist action, in market terms. We coin the term FemInc.ism to denote feminist action through enterprise and we discuss a number of important challenges that research on this phenomenon is faced with.
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| 18. |
- Ahl, Helene, 1958-, et al.
(författare)
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Is institutional support for women’s entrepreneurship feminist?
- 2014
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Ingår i: Gender, Work & Organization. - : John Wiley & Sons. ; , s. 142-142
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Konferensbidrag (refereegranskat)abstract
- Feminism in Sweden as well as in the other Scandinavian countries was largely formulated as state feminism. The women's movement has cooperated with feminists in the state, resulting in societies that count as the most gender equal in the world. The Scandinavian countries are consistently ranked in the top position on international gender equality indices. The state has provided a large publicly financed welfare sector that both employs many women, and makes it possible to combine work and family through family friendly policies. The last decade has seen a politica l change influenced by neoliberal thought, in which politicians hand over welfare state responsibilities to the market, and instead encourage entrepreneurship, not least among women. The Swedish government has since 20 years back programs and policies to promote women's entrepreneurship. The Swedish state has during the same period shrunk the pub lic sector and privatized many operations in services and care, which traditionally employ many women. Instead, women are encouraged to start businesses in former public sectors. Empirica l studies suggest however, that all of the increase of women 's entrepreneurs hip in these sectors is within low-paid, micro service businesses, typically child minding.Traditional state feminism has also changed character. Instead of public regulations, market solutions are advocated. In this paper we ask how to theorize this change from a feminist theory perspective; we ask what the implications for feminist action are, and we ask what consequences for women's position in society are. We use research literature and policy texts as our empirical material and conduct a critical literature analysis. We conclude that the entrepreneurship discourse challenges, and possibly weakens state feminism and feminist action as we have known it in the Scandinavian countries, but may also offer new forms of feminist resistance, on market terms.
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| 19. |
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| 20. |
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| 21. |
- Ahl, Helene, et al.
(författare)
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Will business ownership support gender equality?
- 2012
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Konferensbidrag (refereegranskat)abstract
- Current Swedish as well as international policy advocates an increase inwomen’s business ownership. The reasons center around economic growth:women start businesses at a lower rate than men, and are therefore seen asan untapped resource in stagnant economies. Busienss ownership is advo-cated as a viable alternative to unemployment. Women’s business owner-ship is further seen as instrumental in the neo-liberal transformation of thepublic sector, with privatization of former public commitments in educa-tion and care. In developing countries the arguments center around pov-erty alleviation – help to self-help is advocated. Feminist arguments suchas equal distribution of power and influence among men and women arelargely absent, and a discussion of the allocation of unpaid, domestic workbetween men and women is also absent. The discussion on entrepreneur-ship and the discussion on feminism seem to live side by side, with littleexchange between them. Neither feminist theory, nor extant entrepreneur-ship theory adequately account for feminist agency and activism within aglobalized market economy, in which discourses of entrepreneurship, in-novation and economic growth take precedence. Doing so would implychallenges of and developments of concepts like enterprise, gender, growth,competition, agency, feminist activism and gender equality. In this paperwe seek to bridge and combine feminist and entrepreneurship theories innew ways. We suggest a feminist theoretical understanding of current dis-courses, practices and policies regarding entrepreneurship and women’sentrepreneurship.
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| 22. |
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| 23. |
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| 24. |
- Ahl, Helene, 1958-, et al.
(författare)
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Women's contributions to rural development : implications for entrepreneurship policy
- 2023
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Ingår i: International Journal of Entrepreneurial Behaviour & Research. - : Emerald Group Publishing Limited. - 1355-2554 .- 1758-6534.
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Tidskriftsartikel (refereegranskat)abstract
- PurposePolicy for women's entrepreneurship is designed to promote economic growth, not least in depleted rural areas, but very little is known about the contributions of rural women entrepreneurs, their needs or how the existing policy is received by them. Using a theoretical framework developed by Korsgaard et al. (2015), the authors analyse how rural women entrepreneurs contribute to rural development and discuss the implications for entrepreneurship policy. This paper aims to focus on the aforementioned objectives.Design/methodology/approachThe authors interviewed 32 women entrepreneurs in rural Sweden representing the variety of businesses in which rural Swedish women are engaged. The authors analysed their contributions to rural development by analysing their motives, strategies and outcomes using Korsgaard et al.'s framework of "entrepreneurship in the rural" and "rural entrepreneurship" as a heuristic, interpretative device.FindingsIrrespective of industry, the respondents were deeply embedded in family and local social structures. Their contributions were substantial, multidimensional and indispensable for rural viability, but the policy tended to bypass most women-owned businesses. Support in terms of business training, counselling and financing are important, but programmes especially for women tend to miss the mark, and so does rural development policy. More important for rural women entrepreneurs in Sweden is the provision of good public services, including for example, schools and social care, that make rural life possible.Research limitations/implicationsTheoretically, the findings question the individualist and a-contextual focus of much entrepreneurship research, as well as the taken-for-granted work-family divide. How gender and how the public and the private are configured varies greatly between contexts and needs contextual assessment. Moreover, the results call for theorising place as an entrepreneurial actor.Practical implicationsBased on the findings, the authors advise future policymakers to gender mainstream entrepreneurship policy and to integrate entrepreneurship and rural development policy with family and welfare state policy.Originality/valueThe paper highlights how rural women respond to policy, and the results are contextualised, making it possible to compare them to other contexts. The authors widen the discussion on contributions beyond economic growth, and the authors show that policy for public and commercial services and infrastructure is indeed also policy for entrepreneurship.
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| 25. |
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| 26. |
- Ahlén Bergman, Emma, et al.
(författare)
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Increased CD4+ T cell lineage commitment determined by CpG methylation correlates with better prognosis in urinary bladder cancer patients
- 2018
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Ingår i: Clinical Epigenetics. - : BMC. - 1868-7083 .- 1868-7075. ; 10
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Urinary bladder cancer is a common malignancy worldwide. Environmental factors and chronic inflammation are correlated with the disease risk. Diagnosis is performed by transurethral resection of the bladder, and patients with muscle invasive disease preferably proceed to radical cystectomy, with or without neoadjuvant chemotherapy. The anti-tumour immune responses, known to be initiated in the tumour and draining lymph nodes, may play a major role in future treatment strategies. Thus, increasing the knowledge of tumour-associated immunological processes is important. Activated CD4+ T cells differentiate into four main separate lineages: Th1, Th2, Th17 and Treg, and they are recognized by their effector molecules IFN-γ, IL-13, IL-17A, and the transcription factor Foxp3, respectively. We have previously demonstrated signature CpG sites predictive for lineage commitment of these four major CD4+ T cell lineages. Here, we investigate the lineage commitment specifically in tumour, lymph nodes and blood and relate them to the disease stage and response to neoadjuvant chemotherapy.RESULTS: Blood, tumour and regional lymph nodes were obtained from patients at time of transurethral resection of the bladder and at radical cystectomy. Tumour-infiltrating CD4+ lymphocytes were significantly hypomethylated in all four investigated lineage loci compared to CD4+ lymphocytes in lymph nodes and blood (lymph nodes vs tumour-infiltrating lymphocytes: IFNG -4229 bp p < 0.0001, IL13 -11 bp p < 0.05, IL17A -122 bp p < 0.01 and FOXP3 -77 bp p > 0.05). Examination of individual lymph nodes displayed different methylation signatures, suggesting possible correlation with future survival. More advanced post-cystectomy tumour stages correlated significantly with increased methylation at the IFNG -4229 bp locus. Patients with complete response to neoadjuvant chemotherapy displayed significant hypomethylation in CD4+ T cells for all four investigated loci, most prominently in IFNG p < 0.0001. Neoadjuvant chemotherapy seemed to result in a relocation of Th1-committed CD4+ T cells from blood, presumably to the tumour, indicated by shifts in the methylation patterns, whereas no such shifts were seen for lineages corresponding to IL13, IL17A and FOXP3.CONCLUSION: Increased lineage commitment in CD4+ T cells, as determined by demethylation in predictive CpG sites, is associated with lower post-cystectomy tumour stage, complete response to neoadjuvant chemotherapy and overall better outcome, suggesting epigenetic profiling of CD4+ T cell lineages as a useful readout for clinical staging.
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| 27. |
- Ahrné, Karin, et al.
(författare)
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Tillstånd och trender för arter och deras livsmiljöer – rödlistade arter i Sverige 2015
- 2015
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- 2015 års upplaga av den svenska rödlistan är den fjärde i ordningen. Den är baserad på IUCN:s rödlistningskriterier och revideras vart femte år. I rödlistan bedöms risken som enskilda arter av djur, växter och svampar löper att försvinna från Sverige. Bedömningen utförs av ArtDatabankens medarbetare i samverkan med över 100 externa experter, indelade i 14 expertkommittéer för olika organismgrupper. Under arbetet med 2015 års rödlista har tillstånd och trender bedömts för 21 600 arter och 1 318 lägre taxa (apomiktiska arter, underarter och varieteter), sammanlagt ca 22 900 taxa. Av de bedömda arterna klassificerades 2 029 som hotade (kategorierna CR, EN och VU) och 4 273 som rödlistade (inkluderar även kategorierna NT, RE och DD). Förhållandet mellan antalet rödlistade och antalet bedömda arter ar 19,8 %, vilket är ungefär samma värde som 2010 och 2005. I denna rapport jämförs antalet och andelen rödlistade arter mellan olika organismgrupper, biotoper, substrat och påverkansfaktorer. Texten ar indelad i en allmän del och åtta kapitel inriktade på olika landskapstyper. Landskapstyperna utgör en grov indelning av landets miljöer enligt följande kategorier: Skog, Jordbrukslandskap, Urbana miljöer, Fjäll, Våtmarker, Sötvatten, Havsstränder och Havsmiljöer. Skogen och jordbrukslandskapet är de artrikaste landskapstyperna med 1 800 respektive 1 400 arter som har en stark anknytning dit, och ytterligare flera hundra arter som förekommer där mer sporadiskt. De faktorer som påverkar flest rödlistade arter i Sverige är skogsavverkning och igenväxning, som båda utgör ett hot mot vardera ca 30 % av de rödlistade arterna. Avverkning minskar arealen av skog där naturliga strukturer och naturlig dynamik upprätthålls, och den orsakar därmed förlust av livsmiljöer. Igenväxning orsakas av ett antal faktorer, bland annat upphörande hävd (bete och slåtter), gödsling, trädplantering och brist på naturliga störningsregimer som t.ex. regelbundna översvämningar kring vattendrag och sjöar. Andra viktiga påverkansfaktorer är fiske, torrläggning av våtmarker, tillbakagång hos värdarter (främst alm och ask som drabbats av invasiva svampsjukdomar), klimatförändringar och konkurrens från invasiva arter. IUCN:s rödlisteindex beräknas för ett urval av de bedömda organismgrupperna. Rödlisteindex visar att skillnaderna mellan rödlistorna från 2000, 2005, 2010 och 2015 är små. Ett par undantag finns dock. Groddjur och stora däggdjur har fått en något förbättrad situation sedan 2000. Totalt förefaller det ändå som att trycket mot Sveriges artstock har förblivit relativt konstant under de senaste 15 åren.
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| 28. |
- Al-Behadili, Ali, et al.
(författare)
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A two-nuclease pathway involving RNase H1 is required for primer removal at human mitochondrial OriL
- 2018
-
Ingår i: Nucleic acids research. - : Oxford University Press (OUP). - 0305-1048 .- 1362-4962. ; 46:18, s. 9471-9483
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Tidskriftsartikel (refereegranskat)abstract
- The role of Ribonuclease H1 (RNase H1) during primer removal and ligation at the mitochondrial origin of light-strand DNA synthesis (OriL) is a key, yet poorly understood, step in mitochondrial DNA maintenance. Here, we reconstitute the replication cycle of L-strand synthesis in vitro using recombinant mitochondrial proteins and model OriL substrates. The process begins with initiation of DNA replication at OriL and ends with primer removal and ligation. We find that RNase H1 partially removes the primer, leaving behind the last one to three ribonucleotides. These 5'-end ribonucleotides disturb ligation, a conclusion which is supported by analysis of RNase H1-deficient patient cells. A second nuclease is therefore required to remove the last ribonucleotides and we demonstrate that Flap endonuclease 1 (FEN1) can execute this function in vitro. Removal of RNA primers at OriL thus depends on a two-nuclease model, which in addition to RNase H1 requires FEN1 or a FEN1-like activity. These findings define the role of RNase H1 at OriL and help to explain the pathogenic consequences of disease causing mutations in RNase H1.
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| 29. |
- Alborn, Sven-Eric, 1952, et al.
(författare)
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Välja väg: Utredning, stöd och behandling vid alkohol- och narkotikaproblem
- 2023
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Bok (övrigt vetenskapligt/konstnärligt)abstract
- Alkohol- och narkotikaproblem är vanligt förekommande i vårt samhälle. Både de personer som har ett beroende och deras anhöriga drabbas, vilket är viktigt att beakta när samhället erbjuder vård, stöd och behandling. Välja väg är en kliniskt orienterad bok med omfattande forskningsbas som beskriver ett bra utredningsförfarande och grunderna för en kvalitativt god behandling och relevanta stödinsatser, oavsett metod och verksamhetsform. I fördjupande kapitel tar författarna upp bland annat motivation, psykiatrisk samsjuklighet, ungdomar, vård utan samtycke och individanpassning. Boken vänder sig till personal inom verksamheter som arbetar med personer som har alkohol- och narkotikaproblem och med samsjuklighet, samt till studenter som utbildar sig till exempelvis socionomer, psykologer, sjuksköterskor och beteendevetare.
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| 30. |
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| 31. |
- Alikhani, Nyosha, et al.
(författare)
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Targeting Capacity and Conservation of PreP Homologues Localization in Mitochondria of Different Species
- 2011
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Ingår i: Journal of Molecular Biology. - : Elsevier BV. - 0022-2836 .- 1089-8638. ; 410:3, s. 400-410
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Tidskriftsartikel (refereegranskat)abstract
- Mitochondrial presequences and other unstructured peptides are degraded inside mitochondria by presequence proteases (PrePs) identified in Arabidopsis thaliana (AtPreP), humans (hPreP), and yeast (Cym1/Mop112). The presequences of A. thaliana and human PreP are predicted to consist of 85 and 29 amino acids, respectively, whereas the Saccharomyces cerevisiae Cym1/Mop112 presequence contains only 7 residues. These differences may explain the reported targeting of homologous proteins to different mitochondrial subcompartments. Here we have investigated the targeting capacity of the PreP homologues' presequences. We have produced fusion constructs containing N-terminal portions of AtPreP(1-125), hPreP(1-69), and Cym1(1-40) coupled to green fluorescent protein (GFP) and studied their import into isolated plant, mammalian, and yeast mitochondria, followed by mitochondrial subfractionation. Whereas the AtPreP presequence has the capacity to target GFP into the mitochondrial matrix of all three species, the hPreP presequence only targets GFP to the matrix of mammalian and yeast mitochondria. The Cym1/Mop112 presequence has an overall much weaker targeting capacity and only ensures mitochondrial sorting in its host species yeast. Revisiting the submitochondrial localization of Cym1 revealed that endogenous Cym1/Mop112 is localized to the matrix space, as has been previously reported for the plant and human homologues. Moreover, complementation studies in yeast show that native AtPreP restores the growth phenotype of yeast cells lacking Cym1, demonstrating functional conservation.
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| 32. |
- Alkhaled-Studholme, Sophie, et al.
(författare)
-
And now I’m free’ : Women’s empowerment and emancipation through entrepreneurship in Saudi Arabia and Sweden
- 2018
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Ingår i: Entrepreneurship and Regional Development. - : Informa UK Limited. - 0898-5626 .- 1464-5114. ; 30:7-8, s. 877-900
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Tidskriftsartikel (refereegranskat)abstract
- Critical perspectives have called for the study of women’s entrepreneurship as a route to social change. This ‘social turn’ claims women are empowered and/or emancipated through entrepreneurship with limited problematisation of how these interchangeably used concepts operate. Using an institutional perspective in combination with a narrative approach, we investigate women entrepreneurs’ life stories on their ‘road to freedom’ where entrepreneurial activity enables them to ‘break free’ from particular gendered constraints. Through juxtaposing women’s narratives in the contexts of Saudi Arabia and Sweden, the relationship between empowerment and emancipation is disentangled and (re)conceptualised. The findings distinguish between empowerment narrated as individual practices to achieve freedom for the self within institutional structures and emancipation as narrated as a wish to challenge and change structures of power and reach collative freedom. The yearning for collective emancipation propels women’s stories of entrepreneurship by raising expectations for entrepreneurship as a vehicle for institutional change. Such stories may fascinate and inspire others to engage in entrepreneurial endeavours to become empowered, but whether they reach emancipation remains an empirical question to be answered. The performative dimension of entrepreneurial narratives is, however, their ability to turn emancipation into an (un)reachable object of desire, with a quest for even more individual empowerment and entrepreneurial activity, at the same time excluding other forms of human conduct as conducive for change.
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| 33. |
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| 34. |
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| 35. |
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| 36. |
- Almroth, Melody, 1989-, et al.
(författare)
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The role of working conditions in educational differences in all-cause and ischemic heart disease mortality among Swedish men
- 2024
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Ingår i: Scandinavian Journal of Work, Environment and Health. - 0355-3140 .- 1795-990X. ; 50:4, s. 300-309
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Tidskriftsartikel (refereegranskat)abstract
- Objectives This study aims to investigate the extent to which low job control and heavy physical workload in middle age explain educational differences in all-cause and ischemic heart disease (IHD) mortality while accounting for important confounding factors.Methods The study is based on a register-linked cohort of men who were conscripted into the Swedish military at around the age of 18 in 1969/1970 and were alive and registered in Sweden in 2005 (N=46 565). Cox proportional hazards regression models were built to estimate educational differences in all-cause and IHD mortality and the extent to which this was explained by physical workload and job control around age 55 by calculating the reduction in hazard ratio (HR) after adjustments. Indicators of health, health behavior, and other factors measured during conscription were accounted for.Results We found a clear educational gradient for all-cause and IHD mortality (HR 2.07 and 2.47, respectively, for the lowest compared to the highest education level). A substantial part was explained by the differential distribution of the confounding factors. However, work-related factors, especially high physical workload, also played important explanatory roles.Conclusion Even after accounting for earlier life factors, low job control and especially high physical workload seem to be important mechanistic factors in explaining educational inequalities in all-cause and IHD mortality. It is therefore important to find ways to reduce physical workload and increase job control in order to decrease inequalities in mortality.
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| 37. |
- Amisten, Stefan, et al.
(författare)
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Increased risk of acute myocardial infarction and elevated levels of C-reactive protein in carriersof the Thr-87 variant of the ATP receptor P2Y11.
- 2007
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Ingår i: European Heart Journal. - : Oxford University Press (OUP). - 1522-9645 .- 0195-668X. ; 28:1, s. 13-18
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Tidskriftsartikel (refereegranskat)abstract
- Aims Extracellular ATP acting on the P2Y(11) receptor regulates inflammatory cells. We hypothesized that polymorphisms in the receptor could influence the risk of acute myocardial infarction (AMI). Methods and results In the Malmo diet and cancer AMI case-control study (n = 3732) the P2Y(11) gene Thr-87 polymorphism was present in 19.8% of the controls and 22.9% in AMI patients (OR 1.21; P = 0.03). Stronger associations were found in patients with family history (FH) of AMI, 1.32; early-onset (EO) AMI, 1.43; or EO AMI combined with FH, 1.50; supporting a genetic mechanism. The Thr-87 homozygotes had an even greater risk of AMI, 1.94 (P = 0.04); and 2.48 in the EO AMI subgroup, suggesting a genetic dosage effect. In the cardiovascular risk factor group (n = 6055), 21.3% carried the Thr-87 allele. C-reactive protein was elevated in Thr-87 carriers: 1.6 mg/L vs. 1.3 mg/L (P = 0.001). No difference was seen for blood pressure, lipids, body mass index, smoking, or diabetes mellitus. Conclusion The common Ala-87-Thr polymorphism of the P2Y(11) receptor is associated with AMI and increased levels of C-reactive protein. We hypothesize that an inflammatory mechanism might be involved. The P2Y(11) receptor is a promising new drug target in the prevention of AMI.
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| 38. |
- Andersson, Björn, 1985, et al.
(författare)
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Cross-contamination risks in sediment-based resurrection studies of phytoplankton
- 2022
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Ingår i: Limnology and Oceanography Letters. - : Wiley. - 2378-2242. ; 8:2, s. 376-84
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Tidskriftsartikel (refereegranskat)abstract
- Resurrection studies can answer some fundamental questions in aquatic ecology and evolutionary biology. For phytoplankton resting stages, longevity of thousands to millions of years has recently been reported. However, contamination during sediment sampling could distort these estimates, and this risk has not been systematically evaluated. Here we used 4.5 mu m diameter microspheres to quantify contamination while reviving the resting stages of seven abundant estuarine diatom and cyanobacterial taxa. We observed a sharp decline in resting stages abundance from 10(6) (g wet sediment)(-1) at the surface to < 0.8 (g wet sediment)(-1) at 12.5 cm depth. Added microspheres (similar to 4.5 x 10(7) cm(-2)) were translocated even deeper down the sediment and could well explain the vertical distributions and abundances of revived cells. Without this control, we could have claimed to have revived seven multi-decades to centennial-old taxa. Our findings suggest that improved contamination controls are needed for sediment core sampling of rare cells, microfossils, or DNA molecules.
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| 39. |
- Andersson, Björn, 1985, et al.
(författare)
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Differences in metal tolerance among strains, populations, and species of marine diatoms – Importance of exponential growth for quantification
- 2020
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Ingår i: Aquatic Toxicology. - : Elsevier BV. - 0166-445X .- 1879-1514. ; 226
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Tidskriftsartikel (refereegranskat)abstract
- © 2020 The Author(s) Strains of microalgae vary in traits between species and populations due to adaptation or stochastic processes. Traits of individual strains may also vary depending on the acclimatization state and external forces, such as abiotic stress. In this study we tested how metal tolerance differs among marine diatoms at three organizational levels: species, populations, and strains. At the species level we compared two pelagic Baltic Sea diatoms (Skeletonema marinoi and Thalassiosira baltica). We found that the between-species differences in tolerance (EC50) to the biologically active metals (Cu, Co, Ni, and Zn) was similar to that within-species. In contrast, the two species differed significantly in tolerance towards the non-essential metals, Ag (three-fold higher in T. baltica), Pb and Cd (two and three-fold higher in S. marinoi). At the population level, we found evidence that increased tolerance against Cu and Co (17 and 41 % higher EC50 on average, respectively) had evolved in a S. marinoi population subjected to historical mining activity. On a strain level we demonstrate how the growth phase of cultures (i.e., cellular densities above exponential growth) modulated dose-response relationships to Ag, Cd, Co, Cu, and Zn. Specifically, the EC50's were reduced by 10–60 % in non-exponentially growing S. marinoi (strain RO5AC), depending on metal. For the essential metals these differences were often larger than the average differences between the two species and populations. Consequently, without careful experimental design, interactions between nutrient limitation and metal stress may interfere with detection of small, but evolutionary and ecologically important, differences in tolerance between microalgae. To avoid such artifacts, we outline a semi-continuous cultivation approach that maintains, and empirically tests, that exponential growth is achieved. We argue that such an approach is essential to enable comparison of population or strain differences in tolerance using dose-response tests on cultures of microalgae.
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| 40. |
- Andersson, Björn, 1985, et al.
(författare)
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Intraspecific variation in metal tolerance modulate competition between two marine diatoms
- 2022
-
Ingår i: ISME Journal. - : Springer Science and Business Media LLC. - 1751-7362 .- 1751-7370. ; 16, s. 511-520
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Tidskriftsartikel (refereegranskat)abstract
- Despite widespread metal pollution of coastal ecosystems, little is known of its effect on marine phytoplankton. We designed a co-cultivation experiment to test if toxic dose–response relationships can be used to predict the competitive outcome of two species under metal stress. Specifically, we took into account intraspecific strain variation and selection. We used 72 h dose–response relationships to model how silver (Ag), cadmium (Cd), and copper (Cu) affect both intraspecific strain selection and competition between taxa in two marine diatoms (Skeletonema marinoi and Thalassiosira baltica). The models were validated against 10-day co-culture experiments, using four strains per species. In the control treatment, we could predict the outcome using strain-specific growth rates, suggesting low levels of competitive interactions between the species. Our models correctly predicted which species would gain a competitive advantage under toxic stress. However, the absolute inhibition levels were confounded by the development of chronic toxic stress, resulting in a higher long-term inhibition by Cd and Cu. We failed to detect species differences in average Cu tolerance, but the model accounting for strain selection accurately predicted a competitive advantage for T. baltica. Our findings demonstrate the importance of incorporating multiple strains when determining traits and when performing microbial competition experiments.
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| 41. |
- Andersson, Björn, et al.
(författare)
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Strain-specific metabarcoding reveals rapid evolution of copper tolerance in populations of the coastal diatom Skeletonema marinoi
- 2023
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Ingår i: Molecular Ecology. - 0962-1083 .- 1365-294X.
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Tidskriftsartikel (refereegranskat)abstract
- Phytoplankton have short generation times, flexible reproduction strategies, large population sizes and high standing genetic diversity, traits that should facilitate rapid evolution under directional selection. We quantified local adaptation of copper tolerance in a population of the diatom Skeletonema marinoi from a mining-exposed inlet in the Baltic Sea and in a non-exposed population 100 km away. We hypothesized that mining pollution has driven evolution of elevated copper tolerance in the impacted population of S. marinoi. Assays of 58 strains originating from sediment resting stages revealed no difference in the average tolerance to copper between the two populations. However, variation within populations was greater at the mining site, with three strains displaying hyper-tolerant phenotypes. In an artificial evolution experiment, we used a novel intraspecific metabarcoding locus to track selection and quantify fitness of all 58 strains during co-cultivation in one control and one toxic copper treatment. As expected, the hyper-tolerant strains enabled rapid evolution of copper tolerance in the mining-exposed population through selection on available strain diversity. Within 42 days, in each experimental replicate a single strain dominated (30%–99% abundance) but different strains dominated the different treatments. The reference population developed tolerance beyond expectations primarily due to slowly developing plastic response in one strain, suggesting that different modes of copper tolerance are present in the two populations. Our findings provide novel empirical evidence that standing genetic diversity of phytoplankton resting stage allows populations to evolve rapidly (20–50 generations) and flexibly on timescales relevant for seasonal bloom progressions.
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| 42. |
- Andersson, Susanne, et al.
(författare)
-
Introduction
- 2012
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Ingår i: Promoting innovation. - Stockholm : Vinnova. - 9789186517717 ; , s. 9-19
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Bokkapitel (refereegranskat)
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| 43. |
- Andersson, Susanne, et al.
(författare)
-
PART I: Policies for Innovation
- 2012
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Ingår i: Promoting Innovation. - Stockholm : Vinnova. - 9789186517717 ; , s. 21-24
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Bokkapitel (refereegranskat)
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| 44. |
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| 45. |
- Axelsson, Karin, PhD, 1969-, et al.
(författare)
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Improving Quality in Higher Education by using Living Lab Methods
- 2019
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Ingår i: The OpenLivingLab Days Conference 2019.. - Brussels, Belgium : enoll.org. - 9789082102796 ; , s. 394-406
-
Konferensbidrag (refereegranskat)abstract
- This conceptual paper presents a Living Lab model of how university, society and organisation may strengthen the co-creation capacity on regional and international level to improve quality in higher education. Our conclusions are that successful co-creation between universities and society/organizations is built on mutual contribution, knowledge sharing as well as engagement from all involved. Here, living lab methods can help improve quality. Further, from a university perspective, a challenge is to keep the engagement in the project from all involved, and to assure an equal status between stakeholders. This calls for a skill in how to conduct project in co-creation with several partners. A skill that has to be taught to students as well as to teachers and researchers.
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| 46. |
- Barrón Cuenca, Jessika, et al.
(författare)
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Pesticide exposure among Bolivian farmers : associations between worker protection and exposure biomarkers
- 2019
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Ingår i: Journal of Exposure Science and Environmental Epidemiology. - : Springer Science and Business Media LLC. - 1559-0631 .- 1559-064X.
-
Tidskriftsartikel (refereegranskat)abstract
- The use of pesticides has increased during the past decades, also increasing the risk of exposure to toxic pesticides that can cause detrimental health effects in the future. This is of special concern among farmers in low-to-middle-income countries that may lack proper training in the safe use of these chemicals. To assess the situation in Bolivia a cross-sectional study in three agricultural communities was performed (n = 297). Handling, use of personal protective equipment (PPE) and pesticide exposure were assessed by a questionnaire and measurements of urinary pesticide metabolites (UPMs). Results showed that methamidophos (65%) and paraquat (52%) were the most commonly used pesticides and that 75% of the farmers combined several pesticides while spraying. Notably, only 17% of the farmers used recommended PPEs while 84% reported to have experienced symptoms of acute pesticide poisoning after spraying. UPM measurements indicated high levels of exposure to chlorpyrifos, pyrethroids and 2,4D and that men generally were more highly exposed compared to women. Our study demonstrates that farmers who are better at following recommendations for pesticide handling and use of PPE had a significantly lower risk of having high UPM levels of most measured pesticides. Our results thus confirm the need of proper training of farmers in low-to-middle-income countries in proper protection and pesticide handling in order to reduce exposure levels and health problems.
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| 47. |
- Berglund, Anders, et al.
(författare)
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Dimensional change of a calcium aluminate cement for posterior restorations in aqueous and dry media.
- 2006
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Ingår i: Dental Materials. - : Elsevier BV. - 0109-5641 .- 1879-0097. ; 22:5, s. 470-476
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: A calcium aluminate cement has recently been developed, with claims of being an alternative to dental amalgam and resin composites in posterior cavities. However, its' mechanical properties are not well evaluated and the aim of the study was therefore, to evaluate its' dimensional stability over time. METHODS: The dimensional changes of the cement, Doxadent, and two composite resins, Esthet-X and InTen-S, were tested during 360 d. The specimens were stored at 37+/-1 degrees C either in 100% air humidity (dry) or immersed in distilled water (wet), except for the first 24h when all specimens were stored at 100% air humidity and 37+/-1 degrees C. RESULTS: During the first 24h, Doxadent decreased in volume with 0.04%, while InTen-S and Esthet-X decreased with 1.60 and 1.75%, respectively. From d 1-360, the dry Doxadent specimens increased in volume with 2.0% and in weight with 5.5%, while the corresponding increase for the wet specimens were 4.1 and 6.3%, respectively. The volume of both composites increased 0.8% or less in dry and wet conditions, while the increase in weight for InTen-S was 1.2% for the wet specimens and 0.6% for the dry. The corresponding figures for Esthet-X were 0.7 and 0.2%. SIGNIFICANCE: Doxadent was less dimensionally stable than the composites tested. Doxadent increased 2 times more in volume immersed in water than in 100% air humidity, while the increase in weight was almost similar. The clinical implications of the results found in the present study are uncertain. A material that continues to absorb water during prolonged periods and continues to react is questionable for clinical use.
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| 48. |
- Berglund, Annika, et al.
(författare)
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Factors facilitating or hampering nurses identification of stroke in emergency calls
- 2015
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Ingår i: Journal of Advanced Nursing. - : Wiley. - 0309-2402 .- 1365-2648. ; 71:11, s. 2609-2621
-
Tidskriftsartikel (refereegranskat)abstract
- Aims. To explore the factors that facilitate or hamper identification of stroke in emergency calls concerning patients with stroke who have fallen or been in a lying position.Background. Early identification of stroke in emergency calls is vital but can be complicated as the patients may be unable to express themselves and the callers generally are bystanders. In a previous study, we found presentation of fall or the patient being in a lying position to be the major problem in 66% of emergency calls concerning, but not dispatched as acute stroke.Design. A qualitative study using interpretive phenomenology.Methods. Analysis of transcribed emergency calls concerning 29 patients with stroke diagnoses at hospital discharge, in 2011 and presented with fall/lying position.Findings. Patients' ability to express themselves, callers' knowledge of the patient and of stroke, first call-takers' and nurses' authority, nurses' coaching and nurses' expertise skills facilitated or hindered the identification of stroke. Certain aspects are adjustable, but some are determined by the situation or on callers' and patients' abilities and thus difficult to change. Nurses' expertise skills were the only theme found to have a decisive effect of the identification of stroke on its own.Conclusion. To increase identification of stroke in emergency calls concerning stroke, the first call-takers' and nurses' action, competence and awareness of obstacles are crucial and if strengthened would likely increase the identification of stroke in emergency calls. In complicated cases, nurses' expertise skills seem essential for identification of stroke.
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| 49. |
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| 50. |
- Berglund, Annika, et al.
(författare)
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Identification of stroke during the emergency call : a descriptive study of callers' presentation of stroke
- 2015
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Ingår i: BMJ Open. - London, UK : BMJ Publishing Group Ltd. - 2044-6055. ; 5:4
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To evaluate symptoms presented by the caller during emergency calls regarding stroke, and to assess if symptoms in the Face-Arm-Speech-Time Test (FAST) are related to identification of stroke.SETTING: Emergency calls to the Emergency Medical Communication Center (EMCC) concerning patients discharged with stroke diagnosis in a large teaching hospital in Stockholm, Sweden, in January-June 2011.PARTICIPANTS: The emergency calls of 179 patients who arrived at hospital by ambulance, and who were discharged with a stroke diagnosis and consented to participate were included in the study.OUTCOME MEASURES: Frequencies of stroke symptoms presented and a comparison of symptoms presented in calls with dispatch code stroke or other dispatch code.RESULTS: Of the 179 emergency calls analysed, 64% were dispatched as 'Stroke'. FAST symptoms, that is, facial or arm weakness or speech disturbances, were presented in 64% of the calls and were spontaneously revealed in 90%. Speech disturbance was the most common problem (54%) in all calls, followed by fall/lying position (38%) and altered mental status (27%). For patients with dispatch codes other than stroke, the dominating problem presented was a fall or being in a lying position (66%), followed by speech disturbance (31%) and altered mental status (25%). Stroke-specific symptoms were more common in patients dispatched as stroke. FAST symptoms were reported in 80% of patients dispatched as stroke compared with 35% in those dispatched as something else.CONCLUSIONS: This study implicates that fall/lying position and altered mental status could be considered as possible symptoms of stroke during an emergency call. Checking for FAST symptoms in these patients might uncover stroke symptoms. Future studies are needed to evaluate if actively asking for FAST symptoms in emergency calls presenting falls or a lying position can improve the identification of stroke.TRIAL REGISTRATION NUMBER: Stroke2010/703-31/2.
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