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1.	Ahlberg, Mona, 1966- (författare) Being cared for in an Intensive Care Unit – family functioning and support 2022 Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract When COVID-19 came as an uninvited guest into our everyday lives, nursing in intensive care was affected and thus the studies contain data from both before and during the COVID-19 pandemic.Before the pandemic, most intensive care units, which care for patients with critical illness in a technical setting, allowed family members to visit the patient 24 hours a day. The intensive care unit is a stressful and frightening environment for both the patient and their family. They can be affected both mentally and physically, showing symptoms such as difficulty sleeping, stress and depression. The intensive cared patient often does not remember anything from the time they were cared for in the intensive care unit, and the family needs to explain and recount this unconscious time. During the pandemic, this changed, with restrictions and limited opportunities to visit the hospital and patient due to virus outbreaks. Family members received information about the patient's medical condition by phone from a physician. The overall aim of this thesis was to explore and conceptualise the family functioning of families with a family member treated in the intensive care unit. There was also an intention to describe and evaluate how an intervention affects the family and individual family members in families where a family member received intensive care.In these studies, qualitative, quantitative, as well as mixed methods were utilised. Participants were adult intensive cared patients from seven intensive care clinics, and their families. The results examined between families are based on the patient and family characteristics. The results from study I show that families who have experienced COVID-19 and with a family member who was cared for in an intensive care unit, have existential thoughts. Study II shows no major impact on family function between families, but the answers differ within the families who experienced intensive care. In study III, concerning families experiencing intensive care and attending family health conversations, there was an awareness of family function. The conversations brought the family closer together, through improved understanding of each other. In study IV family functioning, hope and sense of coherence were com-pared among the participants in two intervention groups: Family health conversations and support group conversations. Family functioning and hope were higher in the group that participated in the family health conversations and comprehensibility, meaningfulness and vitality were higher among the participants in the support group conversation. By exploring how family function affects the individual family member and the family as a unit during critical illness and intensive care, new ways of working can be strengthened in the care of patients and their families.
2.	Alves Dias, Joana, et al. (författare) A high quality diet is associated with reduced systemic inflammation in middle-aged individuals. 2015 Ingår i: Atherosclerosis. - : Elsevier BV. - 1879-1484 .- 0021-9150. ; 238:1, s. 38-44 Tidskriftsartikel (refereegranskat)abstract To examine if overall diet quality is associated with cellular and soluble biomarkers of systemic inflammation in middle-aged individuals.
3.	Alves Dias, Joana, et al. (författare) Low-grade inflammation, oxidative stress and risk of invasive post-menopausal breast cancer - A nested case-control study from the Malmö diet and cancer cohort 2016 Ingår i: PLoS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 11:7 Tidskriftsartikel (refereegranskat)abstract Objective: Although cancer promotes inflammation, the role of inflammation in tumor-genesis is less well established. The aim was to examine if low-grade inflammation is related to post-menopausal breast cancer risk, and if obesity modifies this association. Methods; In the Malmo Diet and Cancer cohort, a nested case-control study was defined among 8,513 women free of cancer and aged 55.73 years at baseline (1991.96); 459 were diagnosed with invasive breast cancer during follow-up (until December 31st, 2010). In laboratory analyses of blood from 446 cases, and 885 controls (matched on age and date of blood sampling) we examined systemic inflammation markers: oxidized (ox)-LDL, interleukin (IL)- 1β, IL-6, IL-8, tumor necrosis factor (TNF)-α, white blood cells, lymphocytes and neutrophils. Odds ratios (OR) and 95% confidence intervals (CI) for breast cancer risk was calculated using multivariable conditional logistic regression. Results: Inverse associations with breast cancer were seen in fully-adjusted models, for 2nd and 3rd tertiles of ox-LDL, OR (95% CI): 0.65 (0.47.0.90), 0.63 (0.45.0.89) respectively, p-trend = 0.01; and for the 3rd tertile of TNF-α, 0.65 (0.43.0.99), p-trend = 0.04. In contrast, those in the highest IL-1β category had higher risk, 1.71 (1.05.2.79), p-trend = 0.01. Obesity did not modify associations between inflammation biomarkers and breast cancer. Conclusion; Our study does not suggest that low-grade inflammation increase the risk of post-menopausal breast cancer.
4.	Alves Dias, Joana, et al. (författare) Plasma variation and reproducibility of oxidized LDL-cholesterol and low-grade inflammation biomarkers among participants of the Malmö Diet and Cancer cohort 2016 Ingår i: Biomarkers. - 1354-750X. ; 21:6, s. 562-571 Tidskriftsartikel (refereegranskat)abstract Context: Large epidemiological studies often collect non-fasting samples, although the reliability of biomarkers may be uncertain. Objective: To explore the reliability and reproducibility of a single measurement of selected biomarkers in a sub-sample of the Malmö Diet and Cancer cohort. Methods: We estimated single- and average-measures intraclass correlation coefficients (ICC) for oxidized (ox)-LDL, interleukin (IL)-1β, IL-6, IL-8 and TNF-α. Results: Single-measures ICC in non-fasting samples of ox-LDL, IL-1β, IL-6, IL-8 and TNF-α were the following: 0.85, 0.71, 0.61, 0.78 and 0.66 for men, and 0.67, 0.81, 0.87, 0.69 and 0.81 for women. Biomarkers at non-fasting and fasting samples were highly correlated (all r > 0.80). Conclusions: The observed ICC suggest that most of the examined biomarkers (non-fasting blood) would allow meaningful analysis in epidemiological studies.
5.	Amini, Rose-Marie, et al. (författare) Relapsed Hodgkin's lymphoma : immunostaining patterns in relation to survival 2002 Ingår i: Leukemia and Lymphoma. - : Informa UK Limited. - 1042-8194 .- 1029-2403. ; 43, s. 1253- Tidskriftsartikel (refereegranskat)abstract Patients with relapsing Hodgkin's lymphoma (HL) have a rather poor prognosis and mechanisms that lead to resistance to therapy are poorly understood. Our aims were to investigate the immunohistochemical staining patterns of Rb (retinoblastoma protein) and the p53 tumour suppressor protein in HL at initial presentation and at relapse in order to elucidate a possible role in disease progression and resistance to therapy. Further to evaluate the presence and prognostic importance of Epstein-Barr virus (EBV) and anaplastic lymphoma kinase (ALK). Eighty-one cases of relapsing HL were reexamined histopathologically and immunostained for the expression of p53, Rb, ALK and CD30. EBV was detected with LMP-1 stainings and in situ hybridisation for EBER. Clinical data were extracted from the Swedish National Health Care Programme for HL. Median follow-up time was six years (range 0-12) from the date of relapse. The majority of cases were positive for p53 and Rb both at presentation and at relapse, though to a different extent. Both an increase and a decrease in the proportion of stained tumour cells were observed. None of our cases was ALK-positive and 44% were EBV-positive. No specific staining pattern was directly correlated to survival. In 12 patients a switch in HL subtype from diagnosis to relapse was observed and the five-year Hodgkin-specific survival (HLS) was statistically significantly inferior, 37 vs 81% (p = 0.002), in those patients. We found a significant relation between the expression of p53 and EBV at diagnosis and relapse, indicating a clonal relationship. We were unable to find any specific staining pattern of p53 or Rb, affecting survival.
6.	André-Petersson, Lena, et al. (författare) Adaptive behavior in stressful situations and stroke incidence in hypertensive men: results from prospective cohort study "men born in 1914" in Malmo, Sweden 2001 Ingår i: Stroke: a journal of cerebral circulation. - 1524-4628. ; 32:8, s. 1712-1717 Tidskriftsartikel (refereegranskat)abstract BACKGROUND AND PURPOSE: Although hypertension is a major risk factor for stroke, many hypertensive persons remain healthy. The aim of the present study was to analyze whether adaptation in a stressful situation was associated with the incidence of stroke in hypertensive men. METHODS: Two hundred thirty-eight hypertensive men were followed from baseline in 1982/1983 until first stroke, death, or December 31, 1996. Adaptation to stress was studied with the serial Color-Word Test. In the Regression dimension, 4 patterns of adaptation could be distinguished according to mastering of the test. Successful mastering of the test was shown in stabilized patterns, increasing difficulty in cumulative patterns, fluctuating difficulty in dissociative patterns, and fluctuating difficulty that increased during testing in cumulative-dissociative patterns. The patterns were compared regarding stroke incidence. RESULTS: Forty-three men experienced a stroke during follow-up. Stroke rates per 1000 person-years were 12.6 for men with stabilized patterns, 14.3 for men with cumulative patterns, 16.2 for men with dissociative patterns, and 31.2 for men with cumulative-dissociative patterns. Multivariate analysis, adjusted for relevant cerebrovascular risk factors, showed that the cumulative-dissociative pattern of the Regression dimension was associated with an increased risk of stroke during follow-up (relative risk 3.00, 95% CI 1.32 to 6.81). CONCLUSIONS: The specific behavior pattern, characterized by the greatest difficulties in managing the test, was associated with incidence of stroke in hypertensive men. One interpretation is that hypertensive men who chronically fail to find successful strategies in stressful situations are vulnerable to the damaging effects of stress and thereby at an increased risk of a future stroke.
7.	André-Petersson, Lena, et al. (författare) Prognostic significance of ventricular arrhythmia modified by ability to adapt to stressful situations 2004 Ingår i: European Journal of Cardiovascular Prevention & Rehabilitation. - 1741-8267 .- 1741-8275. ; 11:1, s. 25-32 Tidskriftsartikel (refereegranskat)
8.	Avby, Gunilla, 1965-, et al. (författare) Shaping leadership development systems to the work context 2022 Konferensbidrag (refereegranskat)abstract The paper seeks to identify patterns of leadership development in different organization contexts with the aim of contributing to improved understanding of how the context shapes the leadership development system (LDS).Design/methodology/approach: This study is based on the initial phase of a 4-year collaborative research project on LDSs. Data was collected in the five collaborative partner organizations and based on four data sources: 1) company visits; 2) internal documentation; 3) external information (websites); and 4) company presentations at an on-line workshop.Findings: The results show a strong focus on individual leader development, and at least partly, confirms the under-use of developmental assignments and relationships as shown in previous studies. All organizations outsource leadership development to different degrees. However, leadership development is not only structured through different methods, it is also dependent on the organization context in the form of leader forums and meetings. An identified pattern is that the smaller organizations are more dependent on external resources, and the larger organizations tailor company-wide programs for their unique needs together with external consultants. Furthermore, the LDS is believed to be an effective change agent in the adaptive process of transforming.Originality: This study contributes to the research on leadership development by advancing the current understanding of how leadership development interacts with the context of the organization.Practical implications: This study highlights the need for leaders and HR professionals to acknowledge contextual issues when choosing practices used for developing the leadership in the organization.
9.	Bergmo-Prvulovic, Ingela, 1970-, et al. (författare) Exploring Social Representations of Leadership Development : Designing for Work-Integrated Learning 2022 Konferensbidrag (refereegranskat)
10.	Bergmo-Prvulovic, Ingela, 1970-, et al. (författare) Exploring Social Representations of Leadership Development : Designing for Work-Integrated Learning 2022 Ingår i: International Conference on Work Integrated Learning. - Trollhättan : University West. - 9789189325302 ; , s. 83-86 Konferensbidrag (refereegranskat)abstract This paper explored social representations of leadership and leadership development shaping an organizations leadership development system (LDS). This study is based on the initial phase of a 4-year collaborative research project on LDSs, adopting an interactive research approach to co-produce knowledge through joint meetings and learning workshops (Ellström et al., 2020). The research project involves researchers from different disciplines, and five organizations operating in different business domains. The participating organizations vary in terms of size, strategies, markets, processes, products, and ways of organizing, but they all share a common interest in how to develop sustainable approaches to leadership development. An LDS encompasses all the metho ds and practices in an organization that contribute to developing and producing effective leaders (McCauley et al 2010). The importance of understanding the characteristics of the context the LDS is embedded in has been highlighted in a previous study (Avby et al., 2022), and serve as a point-of-reference in this study. However, less is known of what underlying assumptions an LDS is based upon. This study paid attention to the underlying values, ideas, and perspectives on leadership and leadership development that shape an organizations’ ways of thinking, communicating, and acting in the LDS. We suggest that the potential to develop a more deliberate practice of leadership development was enhanced by exploring and articulating the tacit knowledge and assumpt ions that an LDS rests upon.Aim The aim of this study was to explore how socially and contextually shaped assumptions on leadership and leadership development can be visualized and practically applied to develop the leadership in the organization. The question addressed was how the awareness of underlying assumptions can support the methods and practices applied, and in what way the disclosing of underlying ideas, values and practices may foster work -integrated learning?Design and methods From a social representation theory approach (Moscovici, 2001, Jovchelovitch, 2007, Markova, 2003, BergmoPrvulovic, 2015), underlying assumptions of leadership and leadership development were explored. In the collaborative project an initial mapping of the participating organizations’ LDSs has been co nducted, based on different sources of data. The results of this mapping have been presented through a metaphorical analysis (Avby et al., 2022), in which the participating organizations are described with certain metaphors of their LDS. This study paid specific attention to the organization entitled The Self-Managing Team, and added to the initial stage of mapping LDSs by exploring the underlying assumptions that underpins the expressions and formulations on leadership and leadership development found in the organization’s documents, websites, formulations in meetings and strategies. The exploration of social representations of LDSs was based upon the free association method (Abric, 1995), further developed, and used in studies exploring social representations of similar abstract and complex phenomena, such as career (Bergmo-Prvulovic, 2013: 2015). The method consists of questions, words and series of words given to the respondents who spontaneously write down their immediate associations towards a specific concept and complex phenomenon with a gradual deepening of questions related to specific words, series of words. In this study, a digital enquiry was created in Esmaker. The enquiry was designed to ask for respondents spontaneous, immediate thoughts on words, and series of words related to leadership and leadership development. The gradually deepening of questions, were designed by paying attention to the five dimensions of representations suggested by Jovchelovitch (2007), by exploring who are concerned, why and for what leadership is needed, what is the content 84 of leadership, when it works and doesn’t work, when and how it occurs as well who is responsible, whose engagement and what conditions are needed. This study was based on 19 respondents’ answers a ll member in the Self-Managing Team. They were selected by the organization, as identified having important roles and functions in the company’s LDS. A facilitator in the organization introduced an online enquiry with 12 questions, given one by one to the respondents, providing 1-2 minutes for each. The respondents wrote down their associations to each question, some background data, and questions about leadership identity. The analytical procedure was made according to qualitative content analysis method as the basic procedure of qualitatively exploring social representations (Bergmo-Prvulovic, 2013; 2015). Expressions were numbered with a certain code for each respondent related to each answered question, thereafter each textual units were condensed, meaning units were coded and grouped into constitutive elements that builds up preliminary and primary themes generating a web of social representations of LDS for the group of respondents.Preliminary results The results disclosed a web of underlying social representations shaping the LDS in The Self-Managing Team. The social representations shape a basic, contextually characterized system of values, ideas, and practices, on which the company at present form their LDS. Given the collaborative design of the project, the results were fed back to the organization to validate the analytical procedure, as well as to support the designing for work -integrated learning and further knowledge use in the organization. The results revealed the respondents’ assumptions on leadership, leadership development, and self-leadership. These assumptions are clearly anchored in the organization’s aim to build in self-management, as a collective way of working with leadership. However, the existing knowledge base encloses both commonalities and contradictions that needs to be further highlighted to create a sustainable LDS. Results showed both stable representations, that occur repeatedly throughout the material, and dynamic social rep resentations, that express a negotiating character between different views, or as being antinomies of thoughts. By identifying and raising awareness of ambiguities deriving from the results, a base of designing for reflective work-integrated learning was provided. A joint learning process to discuss how the results could be utilized as a tool for work-integrated learning was initiated. Some challenges were recognized, and the organization especially addressed the need to work with a second step of workplace reflection. A first learning cycle was initiated to be continuously developed by involving the employees in the process. In all, the contribution of the study explains the basis of leadership development practice, which unnoticed might create ambiguity in service delivery. The mapping of social representations of an LDS can be utilized as a tool for a more deliberate leadership development practice and highlight possibilities and challenges that need to be addressed for integrating methods and practices in everyday work.
11.	Brun Sundblad, Gunilla M, et al. (författare) Prevalence and co-occurrence of self-rated pain and perceived health in school-children : Age and gender differences. 2007 Ingår i: European Journal of Pain. - : Wiley. - 1090-3801 .- 1532-2149. ; 11:2, s. 171-80 Tidskriftsartikel (refereegranskat)abstract In this nationwide study, 1975 students from grades 3, 6, and 9 (ages 9, 12, and 15 at the onset of the year), were recruited from randomly selected schools, which represented different geographical areas throughout Sweden. The main aim of the study was to assess the prevalence of self-reported pain (headache, abdominal, and musculoskeletal pain) and perceived health (problems sleeping and/or if they often felt tired, lonely and sad). A second aim was to study the co-occurrence among different pain and health variables. The students, (n = 1908 distributed by grade 3: 255 girls and 305 boys, grade 6: 347 girls and 352 boys, grade 9: 329 girls and 320 boys) answered retrospectively (three months) a specially designed questionnaire. Fifty percent (50%) of the students reported that they had experienced pain, either as headache, abdominal pain or musculoskeletal pain, within the recall period. Gender differences were especially noticeable for headaches, where twice as many girls (17%, n = 159) than boys (8%, n = 80) reported that they suffered such pain at least once a week or more often. Co-occurrence among the variables was moderate (0.3-0.5). For the total of the seven variables, the perception of pain and health complaints decreased with age for boys from grades 3 to 9, while multiple complaints increased for girls.
12.	Brun Sundblad, Gunilla, et al. (författare) Studenter tar plats i SIH-projektet 2013 Ingår i: Svensk Idrottsforskning. - 1103-4629. ; 22:1, s. 20-24 Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract I drygt tio år har SIH-projektet kartlagt ungas upplevda hälsa, fysiska status och aktivitetsgrad, och dessutom skolämnet idrott och hälsa. Studenter vid GIH har medverkat i projektet och bidragit med forskningsdata. I artikeln presenteras aktuella resultat och hur projektet har integrerats i studenternas utbildning samt vetenskapliga skolning.
13.	Cederblad, Lena, et al. (författare) Cancer of the parotid gland; long-term follow-up : A single centre experience on recurrence and survival 2009 Ingår i: Acta Oncologica. - : Informa UK Limited. - 0284-186X .- 1651-226X. ; 48:4, s. 549-555 Tidskriftsartikel (refereegranskat)abstract BACKGROUND: The aim of the study was to investigate the results of treatment of malignant parotid gland tumours at a single centre during a 56 year period, focusing on tumour control and survival. PATIENTS AND METHODS: At Uppsala University Hospital, Sweden, 144 patients (73 male and 71 female) with parotid cancer were treated between 1948 and 2004. The mean and median ages were 62 and 65 years, respectively (range 16-89 years). Surgery was the primary treatment in 113 (78%) patients followed by radiotherapy in 81. Postoperative radiotherapy in doses of 64-66 Gy, where the intention was curative and delivered with either split course or not, was administered to a majority of patients after 1970. The split-course mode was practised between 1970 and 1989. The median follow-up time was 8.3 years for patients still alive. There were 57 (40%) relapses, of which 40 were local recurrences with 26 inside the treatment volume. RESULTS: The overall 5-year survival was 53%. The majority of tumour-related deaths appeared in the first 3-5 years after diagnosis. Age, co-morbidity, the presence of lymph node metastases, adenoid cystic carcinoma and extent of disease were important for outcome; gender, however, was not. We found no difference in the survival between patients following split course therapy versus continuous fractionation. No difference could be seen in the survival of patients treated in the 1970s versus the 1990s. CONCLUSIONS: Age, nodal engagement, a higher T-stage, adenoid cystic carcinoma histopathology, facial palsy and intercurrent disease worsen the outcome of patients, whereas gender does not. Treatment principles at our hospital have been surgery followed by radiotherapy since the early 1970s even though a split course technique was practised during a part of this period. Survival has not improved markedly. Thus, there is scope for improvement for this group of patients.
14.	Cederblad, Lena, 1959-, et al. (författare) Cancer of the parotid gland; long-term follow-up. A single centre experience on recurrence and survival 2009 Ingår i: Acta Oncologica. - 0284-186X .- 1651-226X. Tidskriftsartikel (refereegranskat)
15.	Engström, Anders, et al. (författare) The Importance of Representing Mixed-Phase Clouds for Simulating Distinctive Atmospheric States in the Arctic 2014 Ingår i: Journal of Climate. - 0894-8755 .- 1520-0442. ; 27:1, s. 265-272 Tidskriftsartikel (refereegranskat)abstract Observations from the Surface Heat Budget of the Arctic Ocean experiment (SHEBA) suggest that the Arctic Basin is characterized by two distinctly different preferred atmospheric states during wintertime. These states appear as two peaks in the frequency distribution of surface downwelling longwave radiation (LWD), representing radiatively clear and opaque conditions. Here, the authors have investigated the occurrence and representation of these states in the widely used ECMWF Interim Re-Analysis (ERA-Interim) dataset. An interannually recurring bimodal distribution of LWD values is not a clearly observable feature in the reanalysis data. However, large differences in the simulated liquid water content of clouds in ERA-Interim compared to observations are identified and these are linked to the lack of a radiatively opaque peak in the reanalysis. Using a single-column model, dynamically controlled by data from ERA-Interim, the authors show that, by tuning the glaciation speed of supercooled liquid clouds, it is possible to reach a very good agreement between the model and observations from the SHEBA campaign in terms of LWD. The results suggest that the presence of two preferred Arctic states, as observed during SHEBA, is a recurring feature of the Arctic climate system during winter [December–March (DJFM)]. The mean increase in LWD during the Arctic winter compared to ERA-Interim is 15 W m−2. This has a substantial bearing on climate model evaluation in the Arctic as it indicates the importance of representing Arctic states in climate models and reanalysis data and that doing so could have a significant impact on winter ice thickness and surface temperatures in the Arctic.
16.	Engström, Birgitta, 1941-, et al. (författare) Sjuksköterska med uppdrag att leda 2009. - 2 [omarb.] i boken angivet som 2:1 Bok (övrigt vetenskapligt/konstnärligt)
17.	Engström, Maria, et al. (författare) Nursing students' perceptions of using the Clinical Education Assessment tool AssCE and their overall perceptions of the clinical learning environment : a cross-sectional correlational study 2017 Ingår i: Nurse Education Today. - : Elsevier BV. - 0260-6917 .- 1532-2793. ; 51, s. 63-67 Tidskriftsartikel (refereegranskat)abstract BackgroundClinical education is a vital part of nursing students' learning; the importance of assessment tools and feedback in stimulating student learning has been stressed, but this needs to be studied in more detail.ObjectivesTo examine relationships between nursing students' perceptions of using an Assessment tool in Clinical Education (AssCE) during their mid-course discussion and final assessment, the content discussed during these meetings between the student, preceptor and nurse teacher and the students' overall perception of the clinical learning environment.DesignA cross-sectional, correlational design was used.Setting and ParticipantsA convenience sample of 110 nursing students from one Norwegian university college with two campuses.MethodsData were collected with self-developed questionnaires and analysed using logistic regression with SPSS and the PROCESS macro for mediation analysis.ResultsThere was a positive relationship between nursing students' perceptions of using the assessment tool AssCE and their overall perception of the clinical learning environment. This relationship was, in turn, mediated by the content discussed during the formative mid-course discussion and summative final assessment.ConclusionsOur conclusion is that the assessment tool AssCE supported students' clinical learning and that this relationship, in turn, was mediated by the degree to which the conversation during the assessment meeting focused on the student's knowledge, skills and professional judgement.
18.	Engström, Maria, et al. (författare) Staff assessment of structural empowerment and ability to work according to evidence-based practice in mental health care 2015 Ingår i: Journal of Nursing Management. - : Hindawi Limited. - 0966-0429 .- 1365-2834. ; 23:6, s. 765-774 Tidskriftsartikel (refereegranskat)abstract Aim: To study associations between staff members' self-rated structural empowerment in mental health care, organisational type, and the ability and willingness to work according to evidence-based practice.Method: Questionnaire data were collected from 253 mental health staff members.Result: Multivariate logistic regressions analyses revealed that participants who scored higher on opportunity (OR 2.5) and were employed by the county council (OR 1.9) vs. the municipality were more likely to report high evidence-based practice ability. A generalised estimating equation taking into account unknown correlations within units found opportunity and resources to be significant predictors of evidence-based practice ability. Regarding evidence-based willingness, increased odds were found for higher scores of opportunity (OR 2.2) and being employed by the county council (OR 2.9). The generalised estimating equation also found resources to be a significant predictor of evidence-based willingness. In both organisations, the values for empowerment were moderate.Conclusion: Structural conditions such as access to opportunities and resources are important for creating supporting structures for practice to be evidence-based. Implications for nursing management: Our results emphasise the managers' essential role in creating empowering structures, and especially access to opportunities and resources, for their staff to carry out evidence-based practice.
19.	Engström, Maria, et al. (författare) What relationships can be found between nurses' working life and turnover? - A mixed-methods approach 2022 Ingår i: Journal of Nursing Management. - : Wiley. - 0966-0429 .- 1365-2834. ; 30:1, s. 288-297 Tidskriftsartikel (refereegranskat)abstract AIM: to describe why registered nurses decide to leave their work and to investigate relationships between registered nurses' working life and turnover (leaving the unit versus the profession).BACKGROUND: Much research has explored nurses' intention to leave, while less research has looked at turnover and especially leaving the profession.METHODS: Data were collected using questionnaires and interviews.RESULTS: The three most common reasons for both groups (leaving the profession, n=40; leaving unit but not profession, n=256) were high workload, low salary and applied for and got a new job. Multivariate logistic regression analysis revealed statistically significant relationships between turnover and empowering structures, such as access to resources and informal power as well as the factor learning in thriving.CONCLUSIONS: Structural empowerment, such as good access to resources and informal power, is important to keeping nurses in the profession, while learning seems to increase the risk of leaving the profession when variables such as vitality, resources, informal power and age are held constant.IMPLICATIONS FOR NURSING MANAGEMENT: To counteract nurses leaving the profession, managers must provide nurses with good access to resources, informal power, such as networks within and outside the organization, and focus on nurses' vitality.
20.	Engström, Åsa, et al. (författare) People's experiences of being mechanically ventilated in an ICU : a qualitative study 2013 Ingår i: Intensive & Critical Care Nursing. - : Elsevier BV. - 0964-3397 .- 1532-4036. ; 29:2, s. 88-95 Tidskriftsartikel (refereegranskat)abstract In previous studies people receiving mechanical ventilation treatment have described experiencing distress over their inability to speak and feelings such as anxiety. More research is needed to improve their experience in the intensive care unit and promote recovery. The aim of this study was to describe the intensive care unit experiences of people undergoing mechanical ventilation.MethodQualitative, personal interviews were conducted during 2011 with eight people who were mechanically ventilated in an intensive care unit in the northern part of Sweden. Interview transcripts were analysed using qualitative content analysis.FindingsTwo themes emerged, with four and three categories, respectively. Being dependent for survival on other people and technical medical equipment created a sense of being vulnerable in an anxious situation and a feeling of uncertainty about one's own capacity to breathe. Having lines and tubes in one's body was stressful. Being given a diary and follow-up visit to the intensive care unit after the stay were important tools for filling in the missing time, but there was also one participant who did not want to remember his stay in the intensive care unit.ConclusionTo be dependent on other people and technical medical equipment for survival creates a sense of being delivered into the hands of others, as the people being mechanically ventilated could not trust their body to function.
21.	Holmgren, Daniel, 1945, et al. (författare) Transcutaneous blood gas monitoring during salbutamol inhalations in young children with acute asthmatic symptoms. 1992 Ingår i: Pediatric pulmonology. - 8755-6863. ; 14:2, s. 75-9 Tidskriftsartikel (refereegranskat)abstract The effect of salbutamol inhalations on transcutaneous blood gases was investigated in 23 children (aged 11 months-2.5 years) with asthmatic symptoms. After one salbutamol inhalation there was a mean increase in transcutaneous PO2 (tcPO2) of 0.5 kPa (P less than 0.01); after a second dose given 30 minutes later, the mean increase was 1.2 kPa (P less than 0.001). The increase in tcPO2 after only one dose of salbutamol was significantly correlated to age (P less than 0.01). No such correlation was observed after a second dose. The overall increase in tcPO2 after two salbutamol inhalations showed a negative correlation to the duration of the current symptomatic period (P less than 0.05). We conclude that salbutamol inhalations have beneficial effects in young children with acute asthmatic symptoms, even below the age of 18 months, provided that an adequate dose reaches the lung and preferably at an early stage of obstruction.
22.	Häggqvist, Bo, 1962-, et al. (författare) Medin : an integral fragment of aortic smooth muscle cell-produced lactadherin forms the most common form of human amyloid. 1999 Ingår i: Proceedings of the National Academy of Sciences of the United States of America. - 0027-8424 .- 1091-6490. ; 96, s. 8669-8674 Tidskriftsartikel (refereegranskat)
23.	Ingvarsson, Johan, et al. (författare) Detection of pancreatic cancer using antibody microarray-based serum protein profiling 2008 Ingår i: Proteomics. - : Wiley. - 1615-9861 .- 1615-9853. ; 8:11, s. 2211-2219 Tidskriftsartikel (refereegranskat)abstract The driving force behind oncoproteomics is to identify protein signatures that are associated with a particular malignancy. Here, we have used a recombinant scFv antibody microarray in an attempt to classify sera derived from pancreatic adenocarcinoma patients versus healthy subjects. Based on analysis of nonfractionated, directly labeled, whole human serum proteomes we have identified a protein signature based on 19 nonredundant analytes, that discriminates between cancer patients and healthy subjects. Furthermore, a potential protein signature, consisting of 21 protein analytes, could be defined that was shown to be associated with cancer patients having a life expectancy of <12 months. Taken together, the data suggest that antibody microarray analysis of complex proteomes will be a useful tool to define disease associated protein signatures.
24.	Ingvarsson, Johan, et al. (författare) Recombinant antibdy microarray based oncoproteomics detects cancer and defines a predictor of survival for pancreatic carcinoma 2007 Ingår i: Molecular & Cellular Proteomics. - 1535-9484. ; , s. 311-311 Konferensbidrag (refereegranskat)
25.	Jarnulf, Therese, et al. (författare) District nurses experiences of precepting district nurse students at the postgraduate level 2019 Ingår i: Nurse Education in Practice. - : Elsevier BV. - 1471-5953 .- 1873-5223. ; 37, s. 75-80 Tidskriftsartikel (refereegranskat)abstract District nurses are preceptors of district nurse students at the postgraduate level. These district nurse students are already registered nurses who have graduated and are now studying to become district nurses; this training is at the postgraduate level. As preceptors at the postgraduate level, district nurses play an important role in helping these students to achieve the learning outcomes of the clinical practice part of their education. However, there is a lack of studies on precepting at this level. Thus, the aim was to describe district nurses' experiences of precepting district nurse students at the postgraduate level. The study was descriptive in design and used a qualitative approach. Purposive sampling was used and nine district nurses from seven primary health care units in Sweden were interviewed. Data were analysed using qualitative content analysis. An overall theme ”Fluctuating between transferring knowledge and striving for reflective learning” and two subthemes emerged. The preceptors’ views on precepting and performance varied depending on the situation. The conclusions is that given the current learning outcomes for clinical practice education at the postgraduate level, district nurses need to bemore influenced by preception focused on reflective learning.
26.	Johan, Katarzyna, et al. (författare) Acceleration of amyloid protein A amyloidosis by amyloid-like synthetic fibrils 1998 Ingår i: Proceedings of the National Academy of Sciences of the United States of America. - 0027-8424 .- 1091-6490. ; 95:5, s. 2558-2563 Tidskriftsartikel (refereegranskat)abstract Amyloid protein A (AA) amyloidosis is a consequence of some long-standing inflammatory conditions, and subsequently, an N-terminal fragment of the acute phase protein serum AA forms β-sheet fibrils that are deposited in different tissues. It is unknown why only some individuals develop AA amyloidosis. In the mouse model, AA amyloidosis develops after ≈25 days of inflammatory challenge. This lag phase can be shortened dramatically by administration of a small amount of amyloid extract containing an as yet undefined amyloid-enhancing factor. In the present study, we show that preformed amyloid-like fibrils made from short synthetic peptides corresponding to parts of several different amyloid fibril proteins exert amyloidogenic enhancing activity when given i.v. to mice at the induction of inflammation. We followed i.v. administered, radiolabeled, heterologous, synthetic fibrils to the lung and to the perifollicular area in the spleen and found that new AA–amyloid fibrils developed on these preformed fibrils. Our findings thus show that preformed, synthetic, amyloid-like fibrils have an in vivo nidus activity and that amyloid-enhancing activity may occur, at least in part, through this mechanism. Our findings also show that fibrils of a heterologous chemical nature exert amyloid-enhancing activity.
27.	Johansson, Gunilla, et al. (författare) Experiences of a nature-based intervention program in a northern natural setting: A longitudinal case study of two women with stress-related illness 2023 Ingår i: International Journal of Qualitative Studies on Health and Well-being. - : Taylor & Francis. - 1748-2623 .- 1748-2631. ; 18:1 Tidskriftsartikel (refereegranskat)abstract PurposeThis study explored the experiences of people with stress-related illness participating in a nature-based intervention programme in a northern natural setting.MethodsA longitudinal case study was conducted with two women participating in a nature-based intervention programme on a farm. Data were collected by semi-structured interviews, diaries, rating scales, and self-assessment. Qualitative data were analysed by qualitative content analysis and quantitative data are presented descriptively.ResultsThe theme of finding a source for recovery and well-being permeates all categories. The participants perceived the farm and nature to be a calming refuge; they learned to be in the present and could manage the tasks. In togetherness with each other and the facilitator on the farm they felt understood and confident, experienced joy, and found opportunities for change. They gained knowledge and positive memories and found new approaches in life. Self-assessment questionnaires indicated improvements of functioning in everyday life and reduced stress-related exhaustion at the end of the NBI programme.ConclusionsNature-based interventions lasting for a relatively short period seem to promote health and may be a complement to other treatments of stress-related illness. Further research is needed with a larger number of participants and in various natural settings.PurposeThis study explored the experiences of people with stress-related illness participating in a nature-based intervention programme in a northern natural setting.
28.	Johansson, Gunilla, et al. (författare) Nature-based interventions to promote health for people with stress-related illness: An integrative review 2022 Ingår i: Scandinavian Journal of Caring Sciences. - : John Wiley & Sons. - 0283-9318 .- 1471-6712. ; 36:4, s. 910-925 Forskningsöversikt (refereegranskat)abstract BackgroundStress-related illness is increasing and is a common cause of sick leave. Spending time in nature have a positive effect on health and well-being for instance by reducing stress. Specific programmes with nature-based interventions (NBI) with the intention to involve people in activities in a supportive natural environment have been developed for people with stress-related illness.AimTo identify and summarise scientific studies of NBIs to promote health for people with stress-related illness.MethodThe design used in this study is integrative literature review. Scientific studies focusing on any type of NBI for people with stress-related illness were sought in Cinahl, PubMed, PsycInfo, AMED and Scopus. In total, 25 studies using both qualitative and quantitative designs were included in the review.ResultThe reviewed studies focused on garden or forest interventions. In the majority of the studies, NBIs were performed in groups, including individual activities, and the length of programmes varied. Interventions in natural environments have unique qualities for individualised, meaningful activities and interactions with others in a non-demanding atmosphere. NBIs offer restoration that reduces stress, improves health and well-being and strengthen self-efficacy and work ability. Connectedness with nature support existential reflections and people with stress-related illness can achieve balance in everyday life.ConclusionIn conclusion, NBIs may have advantages to promote health for people with stress-related illness and should therefore be considered as an alternative to those affected. Further research from different perspectives, including nursing, is needed to understand the possibilities of NBIs and how they can be integrated into practice.
29.	Johansson, Gunilla (författare) Nature-based interventions to promote health in people with stress-related illness 2024 Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract Stress-related illness is increasing and is a common cause of sick leave in Sweden. Spending time in nature reduces stress and promotes health and well-being. Consequently, nature-based interventions (NBI) for people with stress-related illness have been developed, implemented and studied in southern Scandinavia. However, such interventions are uncommon in the Circumpolar North with a different climate which affect conditions for outdoor activities. The overall aim of this doctoral thesis was to explore NBIs to promote health in people with stress-related illness from the perspectives of previous research, people with stress-related illness, healthcare professionals and entrepreneurs offering NBIs with a specific focus on northern natural conditions.The thesis includes four studies. An integrative literature review (I) identified and summarised scientific studies of NBIs for people with stress-related illness. Studies using both qualitative and quantitative designs were included. Study II explored key stakeholders’ perceptions of the value of NBIs in promoting health in people with stress-related illness. Semi-structured interviews were conducted with people with stress-related illness experience, healthcare professionals, and entrepreneurs offering NBI and data were analysed through qualitative content analysis. In study III people with stress-related illness experiences of participating in an NBI program in a northern natural setting were explored. A longitudinal case study design was used, and data were collected through repeated semi-structured interviews, diary entries and self-assessment questionnaires. Qualitative content analysis was used to analyse interviews and reflections from diaries and data from self-assessing questionnaires were presented descriptively. Study IV explored people with stress-related illness experiences of nature prescription. Data were collected through interviews with open-ended questions and analysed with a phenomenological-hermeneutic method.Findings show that natural environments offer unique qualities for individualised, meaningful activities and interactions with others in a non-demanding atmosphere. In NBI people with stress-related illness find a source for recovery, joy, and well-being. Spending time in nature is perceived as calming and facilitates being in the present. NBIs improve health and strengthen self-efficacy and work ability. Time in nature provides new perspectives, supports existential reflections, and empowers people with stress-related illness to find opportunities for change to achieve balance in everyday life. NBIs can be helpful for people with stress-related illness to overcome barriers to going out in nature or to find their way back to nature. In conclusion, NBIs seem to be beneficial in promoting health in people with stress-related illness. Different stakeholders have similar perceptions of the value of NBIs, indicating that it could be a valuable complement to health care. NBIs in a northern natural setting seems to have similar health promoting qualities as those seen in studies of NBIs in other natural settings.
30.	Johansson, Gunilla, et al. (författare) Stakeholders’ perceptions of value of nature-based interventions in promoting health in people with stress-related illness: a qualitative study 2024 Ingår i: International Journal of Circumpolar Health. - : Taylor & Francis. - 1239-9736 .- 2242-3982. ; 83:1 Tidskriftsartikel (refereegranskat)abstract Stress-related illness is a common and increasing cause for sick leave in Sweden. Spending time in nature reduces stress and promotes health and well-being. Accordingly, nature-based interventions (NBI) for people with stress-related illness have been developed and implemented in southern Scandinavia; however, such interventions are uncommon in the Circumpolar North. Previous studies have examined the effects and experiences of participating in NBI, but research about different stakeholders’ perspectives on NBI is lacking. The aim of this study was to explore different key stakeholders’ perceptions of the value of NBI in promoting health in people with stress-related illness. Data were collected through semi-structured interviews with 11 persons with stress-related illness experience, 14 healthcare professionals, and 11 entrepreneurs offering NBI. Qualitative content analysis resulted in four categories: Providing opportunity for recovery, Offering new perspectives and opportunity for reflection, Empowering balance and control in life, and Enabling one to overcome barriers. Although the study was conducted in a region where NBI is not widely implemented, the different stakeholders expressed similar perceptions of the value of NBI, indicating that NBI may be a valuable complement to health care which reaches people with stress-related illness needs and promotes their health.
31.	Johansson, Gunilla, et al. (författare) The meaning of nature prescription for people with stress-related illness Annan publikation (övrigt vetenskapligt/konstnärligt)
32.	Kerstis, Birgitta, 1963- (författare) Depressive Symptoms among Mothers and Fathers in Early Parenthood 2015 Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract Aims: The overall aims were to study depressive symptoms among mothers and fathers in early parenthood and how depressive symptoms are related to dyadic consensus (DCS), sense of coherence (SOC), perceiving of the child temperament, separation within the couple and bonding to the infant.Methods: Study I-III was based on the BiT-study, a longitudinal project where 393 couples answered 3 questionnaires including instruments measuring DCS at one week after childbirth, depressive symptoms at 3 months and parental stress at 18 months after childbirth. Study IV was based on the UPPSAT-study, a population based cohort project, where 727 couples answered questionnaires measuring depressive symptoms at 6 weeks and 6 months after childbirth, and impaired bonding at 6 months after childbirth.Results: In the BiT-study, 17.7% of the mothers and 8.7% of the fathers scored depressive symptoms at 3 months after childbirth, using the Edinburgh Postnatal Depression Scale (EPDS) cut-off of ≥10. There was an association between depressive symptoms and less consensus (DCS), and the parents partly differed regarding which areas of their relationship they perceived that they disagreed about. Parents with depressive symptoms had a poorer SOC and perceived their child as more difficult than parents without depressive symptoms. Among the couples, 20% were separated 6-8 years after childbirth. Separation was associated with less dyadic consensus, more depressive symptoms and parental stress. In the UPPSAT-study, 15.3% of the mothers and 5.1% of the fathers scored depressive symptoms 6 weeks after childbirth, using the EPDS cut-off of ≥10. Further, there was an association between impaired bonding at 6 months and the parents’ depressive symptoms, as well as experience of deteriorated relationship with the spouse.Conclusions and clinical implications: Health professionals need the knowledge that depressive symptoms are common in both mother and fathers in early parenthood. It is also important to understand how depressive symptoms are associated to dyadic consensus, SOC, separation and impaired bonding in order to optimize conditions for the whole family. This knowledge is also important for the public, so those who are pregnant and new parents as well as the society are aware that there might be problems in early parenthood as depressive symptoms.
33.	Kjellström, Sofia, 1970-, et al. (författare) Workshop: Systems of leadership development: how to transcend linear conceptualizations 2023 Konferensbidrag (refereegranskat)abstract The focus of this workshop is to employ a more systematic approach to leadership development and design a maturity model that is supported by validated and practical applicable theories, methods and practices to fit the organization’s needs and resources.
34.	Kornfält Isberg, Helena, et al. (författare) Different antibiotic regimes in men diagnosed with lower urinary tract infection - a retrospective register-based study 2020 Ingår i: Scandinavian Journal of Primary Health Care. - : Informa UK Limited. - 0281-3432 .- 1502-7724. ; 38:3, s. 291-299 Tidskriftsartikel (refereegranskat)abstract Objective To compare the proportion of therapy failure, recurrence and complications within 30 days after consultation between men diagnosed with lower urinary tract infection (UTI) treated with narrow-spectrum antibiotics (nitrofurantoin or pivmecillinam) and broad-spectrum antibiotics (fluoroquinolones or trimethoprim or trimethoprim/sulfamethoxazole). Design A retrospective cohort study based on data derived from electronic medical records between January 2012 and December 2015. Setting Primary health care and hospital care in five different counties in Sweden. Patients:A total of 16,555 men aged between 18 and 79 years diagnosed with lower UTI. Main outcome measures Treatment with narrow-spectrum antibiotics was compared with broad-spectrum antibiotics regarding therapy failure, recurrence and complications within 30 days. Results The median age of included men was 65 IQR (51-72) years. Narrow-spectrum antibiotics were prescribed in 8457 (40%) and broad-spectrum antibiotics in 12,667 (60%) cases, respectively. Therapy failure was registered in 192 (0.9%), recurrence in 1277 (6%) and complications in 121 (0.6%) cases. Therapy failure and recurrence were more common in patients treated with narrow-spectrum antibiotics and trimethoprim (p < 0.001), but no such difference could be detected regarding complications. Conclusion There was no difference in incidence of complications within 30 days between men treated with narrow- or broad-spectrum antibiotics. Patients prescribed broad-spectrum antibiotics had lower odds of reconsultation because of therapy failure and recurrence. From current data, treatment with narrow-spectrum antibiotics seems to be an optimal choice regarding preventing complications when treating men with lower UTI.
35.	Larsson, Annika, et al. (författare) Unwinding fibril formation of medin, the peptide of the most common form of human amyloid. 2007 Ingår i: Biochemical and Biophysical Research Communications - BBRC. - : Elsevier BV. - 0006-291X .- 1090-2104. ; 361:4, s. 822-828 Tidskriftsartikel (refereegranskat)abstract Medin amyloid affects the medial layer of the thoracic aorta of most people above 50 years of age. The consequences of this amyloid are not completely known but the deposits may contribute to diseases such as thoracic aortic aneurysm and dissection or to the general diminished elasticity of blood vessels seen in elderly people. We show that the 50-amino acid residue peptide medin forms amyloid-like fibrils in vitro. With the use of Congo red staining, Thioflavin T fluorescence, electron microscopy, and a solid-phase binding assay on different synthetic peptides, we identified the last 18-19 amino acid residues to constitute the amyloid-promoting region of medin. We also demonstrate that the two C-terminal phenylalanines, previously suggested to be of importance for amyloid formation, are not required for medin amyloid formation.
36.	Larsson, Gunilla, et al. (författare) Breastfeeding and breast changes among women with eating disorder problems : Cause for Satisfaction or Concern? 2009 Konferensbidrag (övrigt vetenskapligt/konstnärligt)
37.	Löfmark, Anna, 1941-, et al. (författare) Lecturers' reflection on the three-part assessment discussions with students and preceptors during clinical practice education : A repeated group discussion study 2019 Ingår i: Nurse Education in Practice. - : Elsevier BV. - 1471-5953 .- 1873-5223. ; 36, s. 1-6 Tidskriftsartikel (refereegranskat)abstract Assessment of students' learning and achievement requires active involvement of participating students, preceptors and lecturers. The lecturers have overall responsibility for both the content of the assessment and students' learning. The aim of the present study was to investigate lecturers' reflections on the mid-course discussion and final assessment that are part of nursing students' clinical practice education. The design was descriptive and had a qualitative approach. Repeated group discussions were undertaken with 14 lecturers at two university campuses in Norway. Five categories were identified: preparing for the three-part discussion, creating a collaborative atmosphere, facilitating student learning, verifying student learning, using the assessment tool to create the assessment discussion; one theme emerged: ‘being able to see and justify students’ learning processes'. Lecturers' reflections on both assessment discussions and students' learning proceeded from a clear pedagogical viewpoint.
38.	Ma, Zhi, et al. (författare) Altered immunoreactivity of islet amyloid polypeptide (IAPP) may reflect major modifications of the IAPP molecule in amyloidogenesis 1997 Ingår i: Diabetologia. - : Springer Science and Business Media LLC. - 0012-186X .- 1432-0428. ; 40:7, s. 793-801 Tidskriftsartikel (refereegranskat)abstract We have developed a mouse monoclonal antibody against rat/mouse islet amyloid polypeptide (IAPP). The antibody recognises an epitope in the N-terminal part of the molecule, which is conserved between different species. The antibody immunohistochemically labelled beta cells in normal islets of most different mammalian species including man and in one avian species. Previous immunohistochemical studies of human pancreatic tissue from individuals with non-insulin-dependent diabetes mellitus (NIDDM) have revealed a paradoxical and unexplained lack of IAPP immunoreactivity in beta cells close to amyloid in spite of the presence of IAPP mRNA. In contrast to these findings we show that the newly developed monoclonal IAPP antibody strongly labels such beta cells while islet amyloid deposits which are labelled by polyclonal antisera do not bind the monoclonal antibody. These findings with the polyclonal antisera and the monoclonal antibody indicate that IAPP undergoes one or several structural changes during the amyloidogenesis. Knowledge of these structural changes that may include abnormal folding or chemical modification of IAPP is probably important for the understanding of the amyloidogenesis and the pathogenesis of the islet lesion in NIDDM.
39.	Ma, Zhi, et al. (författare) Enhanced in vitro production of amyloid-like fibrils from mutant (S20G) islet amyloid polypeptide 2001 Ingår i: Amyloid. - : Informa UK Limited. - 1350-6129 .- 1744-2818. ; 8, s. 242- Tidskriftsartikel (refereegranskat)abstract Islet amyloid polypeptide (IAPP, “amylin”) is the amyloid-fibril-forming polypeptide in the islets of Langerhans associated with type 2 diabetes mellitus. A missense mutation in the IAPP gene associated with early-onset type 2 diabetes has been identified in the Japanese population. This mutation results in a glycine for serine substitution at position 20 of the mature IAPP molecule. Whether or not formation of islet amyloid with resulting destruction of islet tissue is the cause of this diabetes is yet not known. The present in vitro study was performed in order to investigate any influence of the amino acid substitution on the fibril formation capacity. Synthetic full-length wild type (lAPPwt) and mutant (IAPPS20G) as well as corresponding truncated peptides (position 18-29) were dissolved in dimethylsulfoxide (DMSO) or in 10% acetic acid at a concentration of 10 mg/mL and their fibril forming capacity was checked by Congo red staining, electron microscopy, a Congo red affinity assay and Thioflavine T fluorometric assay. It was found that full-length and truncated IAPPS20G both formed more amyloid-like fibrils and did this faster compared to IAPPwt. The fibril morphology differed slightly between the preparations. Conclusion: The amino acid substitution (S20G) is situated close to the region of the IAPP molecule implicated in the IAPP fibrillogenesis. The significantly increased formation of amyloid-like fibrils by IAPPS20G is highly interesting and may be associated with an increased islet amyloid formation in vivo and of fundamental importance in the pathogenesis of this specific form of diabetes.
40.	Markstad, Hanna, et al. (författare) High Levels of Soluble Lectinlike Oxidized Low-Density Lipoprotein Receptor-1 Are Associated With Carotid Plaque Inflammation and Increased Risk of Ischemic Stroke 2019 Ingår i: Journal of the American Heart Association. - 2047-9980. ; 8:4 Tidskriftsartikel (refereegranskat)abstract Background When the lectinlike oxidized low-density lipoprotein (ox LDL) receptor-1 ( LOX -1), a scavenger receptor for ox LDL , binds ox LDL , processes leading to endothelial dysfunction and inflammation are promoted. We aimed to study release mechanisms of LOX -1 and how circulating levels of soluble LOX -1 ( sLOX -1) relate to plaque inflammation and future risk for ischemic stroke. Methods and Results Endothelial cells and leukocytes were used to study release of sLOX -1. Plasma levels of sLOX -1 were determined in 4703 participants in the Malmö Diet and Cancer cohort. Incidence of ischemic stroke was monitored. For 202 patients undergoing carotid endarterectomy, levels of sLOX -1 were analyzed in plasma and plaque homogenates and related to plaque inflammation factors. Endothelial cells released sLOX -1 when exposed to ox LDL . A total of 257 subjects experienced stroke during a mean follow-up of 16.5 years. Subjects in the highest tertile of sLOX -1 had a stroke hazard ratio of 1.75 (95% CI, 1.28-2.39) compared with those in the lowest tertile after adjusting for age and sex. The patients undergoing carotid endarterectomy had a significant association between plasma sLOX -1 and the plaque content of sLOX -1 ( r=0.209, P=0.004). Plaques with high levels of sLOX -1 had more ox LDL , proinflammatory cytokines, and matrix metalloproteinases. Conclusions Our findings demonstrate that ox LDL induces the release of sLOX -1 from endothelial cells and that circulating levels of sLOX -1 correlate with carotid plaque inflammation and risk for ischemic stroke. These observations provide clinical support to experimental studies implicating LOX -1 in atherosclerosis and its possible role as target for cardiovascular intervention.
41.	Mårtensson, Gunilla, 1957-, et al. (författare) Mental health nursing staff's attitudes towards mental illness : an analysis of related factors 2014 Ingår i: Journal of Psychiatric and Mental Health Nursing. - : Wiley. - 1351-0126 .- 1365-2850. ; 21:9, s. 782-788 Tidskriftsartikel (refereegranskat)abstract Employer/workplaces have an impact on mental health nursing staff's general attitudes towards persons with mental illness. Staff have more positive attitudes if their knowledge about mental illness is less stigmatized and currently have or have once had a close friend with mental problem. More favourable attitudes among staff towards persons with mental illness could be developed and transmitted in the subculture at work places.ABSTRACT: There is growing awareness that mental illness is surrounded by negative attitudes and stigmas. The aim of the present study was to investigate factors associated with mental health nursing staff's attitudes towards persons with mental illness. Data were collected from 256 mental health nursing staff employed by one county council and 10 municipalities. The findings show that staff have more positive attitudes towards persons with mental illness if their knowledge about mental illness is less stigmatized, their work places are in the county council, and they currently have or have once had a close friend with mental health problems. The multiple regression model explained 16% of the variance; stigma-related knowledge and employer had significant Beta-coefficients. To account for unknown correlations in data, a linear generalized estimating equation was performed. In this model, stigma-related knowledge and employer remained significant, but a new significant factor also emerged: personal contact, i.e. currently having or having once had a close friend with mental health problems. This indicates correlations at unit level in the county council and in the municipalities. The conclusion is that more favourable attitudes among staff towards persons with mental illness could be developed and transmitted in the subculture at work places.
42.	Mårtensson, Gunilla, et al. (författare) What are the structural conditions of importance to preceptors' performance? 2013 Ingår i: Nurse Education Today. - : Elsevier BV. - 0260-6917 .- 1532-2793. ; 33:5, s. 444-449 Tidskriftsartikel (refereegranskat)abstract Background: Preceptors play a critical role in the process of developing nursing students' knowledge, skills and ability to make independent and critical judgments, however relatively little is known about what aspects are associated with nurses' performance as preceptors. Objectives: To investigate structural conditions and professional aspects of potential importance to nurses' perceptions of their performance as preceptors, and to evaluate the validity and reliability of a questionnaire measuring nurses' perceptions of being a preceptor. Methods: The study had a correlational design. Total population sampling (N = 1720) in a county council district in central Sweden was used to screen for nurses with recent preceptor experience, 933 nurses responded (response rate 54%), of those 323 nurses fulfilled the inclusion criteria. The present findings are based on data from 243 of these subjects. Data were collected with a questionnaire and analyzed using multiple regressions analyses, exploratory factor analyses and reliability coefficients. Results: The results show that aspects such as receiving feedback on the function as a preceptor, being able to plan and prepare the clinical education period, receiving support from unit managers and having specific supervision education explain 31% of nurses' overall view of their performance as preceptors. However, structural conditions and professional experiences could not explain preceptors' use of reflection and critical thinking when acting as preceptors. These findings are discussed within the framework of Kanter's structural theory of power in organizations. Further, the psychometric evaluation showed that the questionnaire is a valid and reliable instrument for measuring nurses' structural conditions for and perceptions of their performance as preceptors. Conclusions: Structural conditions such as feedback and support seemed to strengthen nurses' general view of their performance as preceptors but did not seem to facilitate nurses' work toward the aim of higher education and helping nursing students develop critical thinking.
43.	Nyman-Carlsson, Erika, 1982-, et al. (författare) Individual cognitive behavioral therapy and combined family/individual therapy for young adults with Anorexia nervosa : A randomized controlled trial 2020 Ingår i: Psychotherapy Research. - : Routledge. - 1050-3307 .- 1468-4381. ; 30:8, s. 1011-1025 Tidskriftsartikel (refereegranskat)abstract OBJECTIVE: In this study, we evaluate the efficacy of outpatient individual cognitive behavioral therapy for young adults (CBT-YA) and combined family/individual therapy for young adults (FT-YA) for anorexia nervosa (AN).METHOD: Participants (aged 17-24 years) with AN in Sweden were recruited and assigned to 18 months of CBT-YA or FT-YA. Treatment efficacy was assessed primarily using BMI, presence of diagnosis, and degree of eating-related psychopathology at post-treatment and follow-up. Secondary outcomes included depression and general psychological psychopathology. The trial was registered at http://www.isrctn.com/, ISRCTN (25181390).RESULTS: Seventy-eight participants were randomized, and seventy-four of them received allocated treatment and provided complete data. Clinical outcomes from within groups resulted in significant improvements for both groups. BMI increased from baseline (CBT-YA 16.49; FT-YA 16.54) to post-treatment (CBT-YA 19.61; FT-YA 19.33) with high effect sizes. The rate of weight restoration was 64.9% in the CBT-YA group and 83.8% in the FT-YA group. The rate of recovery was 76% in both groups at post-treatment, and at follow-up, 89% and 81% had recovered in the CBT-YA and FT-YA groups respectively.CONCLUSIONS: Outpatient CBT-YA and FT-YA appear to be of benefit to young adults with AN in terms of weight restoration and reduced eating disorder and general psychopathology.
44.	Paulson-Karlsson, Gunilla, et al. (författare) A pilot study of a family-based treatment for adolescent anorexia nervosa: 18- and 36-month follow-ups. 2009 Ingår i: Eating disorders. - : Informa UK Limited. - 1532-530X .- 1064-0266. ; 17:1, s. 72-88 Tidskriftsartikel (refereegranskat)abstract The current study evaluated the outcome of family-based treatment for female adolescents with anorexia nervosa (N = 32), at the Anorexia-Bulimia Outpatient Unit in Göteborg, Sweden. Patients/parents were assessed pre-treatment, at 18- and 36-month follow-ups concerning eating disorder symptoms, general psychopathology, family climate and BMI. At the 36-month follow-up, 75% of the patients were in full remission with reduction in eating disorder symptoms and internalizing problems and they experienced a less distant and chaotic atmosphere in their families. These results show that family-based treatment appears to be effective in adolescent anorexia nervosa patients regarding areas examined in this study.
45.	Paulson-Karlsson, Gunilla, 1950- (författare) Anorexia nervosa : treatment expectations, outcome and satisfaction 2012 Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract Anorexia nervosa is a serious mental disorder with high mortality. It has the lowest prevalence compared with other eating-disorder diagnoses and the onset is related to adolescence, with a majority of female patients. The focus of this thesis is anorexia nervosa and the aim is to study adolescent and adult patients' comprehension and the course of treatment in order to make a contribution to the clinical work relating to these patients. The areas that were studied are expectations of treatment, outcome, predictors of outcome and satisfaction with treatment. Four research papers are included; three originate from work at a specialist eating-disorder unit at Queen Silvia Children's Hospital, Göteborg, Sweden and one from a multicentre study comprising 15 specialised eating-disorder units in Sweden.Paper I has a qualitative design, where participants, 18-25 years of age, were interviewed about their expectations while on the waiting list at a specialist eating-disorder unit. Three main categories of expectations emerged: "Treatment content," "Treatment professionals" and "Treatment focus." The participants expected to receive the appropriate therapy in a collaborative therapeutic relationship and to recover. Paper II evaluated the outcome of a family-based treatment for adolescent patients, 13-18 years old, and their parents. The results indicate that the treatment that is offered appears to be effective, as 78% of the patients were in full remission with less distance and a less chaotic family climate at the 36-month follow-up. Paper III examined the importance of motivation to change eating behaviour, treatment expectationsand experiences, ED symptomatology, self-image and treatment alliance for predicting weight increase in adult patients, 18-46 years of age. Patients' motivation to change eating habits, social relations, self-image, body image and duration of illness were found to predict weight increase both in both the short term (six months) and the long term (36 months). PaperIV studied adolescent patients' and their parents' satisfaction with a family-based treatment a tan 18-month follow-up. The majority of patients (73%) and parents (83%) stated that their expectations had been fulfilled and individual sessions for patients and parents respectively were of great help. Family-based treatment with a combination of individual and family sessions corresponds well to patients' and parents' treatment expectations.Young adult patients' expectations before treatment are multifaceted and should be taken into account in the therapeutic relationship. From the start of treatment, issues relating to patients' motivation, self-image, body image and social relationships should be continuously addressed in order to establish positive collaboration and a weight increase. Anorexia nervosa treatment for adolescents and their parents should be family-based and include family sessions as well as individual sessions for patients and parents. In addition, prevention programmes with the emphasis on early detection should be a prioritised area.
46.	Paulson-Karlsson, Gunilla, et al. (författare) Anorexia nervosa : 18- and 36-months follow-up 2007 Konferensbidrag (refereegranskat)
47.	Paulson-Karlsson, Gunilla, et al. (författare) Anorexia nervosa : treatment satisfaction 2006 Ingår i: Journal of Family Therapy. - Oxford, United Kingdom : Blackwell. - 0163-4445 .- 1467-6427. ; 28:3, s. 293-306 Tidskriftsartikel (refereegranskat)abstract Patient satisfaction plays a central role in treatment alliance and outcome. Investigating patient expectations and experiences of treatment sheds light on its importance. This study examines adolescent anorexia nervosa patients and their parents' satisfaction with family-based treatment. Patients and parents answered a questionnaire at the eighteen-month follow-up focusing on expectations and experiences of treatment, therapists, aims of treatment and accomplishment. The results show that 73 per cent of the patients and 83 per cent of the parents felt that their pre-treatment expectations had been fulfilled. The majority agreed that individual patient sessions and parental sessions were of great help, while the patients valued family therapy sessions as being less helpful than did parents. In overall terms, parents were more pleased with the therapists than were the patients. These data suggest that family-based treatment with individual sessions for patients, in parallel with parental sessions combined with family sessions, corresponds well to patients' and parents' treatment expectations.
48.	Pålsson, Ylva, 1971- (författare) A pathway into the profession : The use, feasibility and outcomes of a peer learning intervention for nursing students and newly graduated nurses 2020 Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract The overall aim of present thesis was to study the use, feasibility and outcomes of a peer learning intervention for nursing students and new graduates, including studies using a quasi-experimental (Study I and III), descriptive (Study II) and mixed-methods (Study IV) design. Data were collected using questionnaires, observations, checklists for intervention fidelity, individual interviews and group interviews. When studying peer learning outcomes among nursing students, peer learning seems to have a significant interaction effect on self-efficacy, based on a comparison of changes over time between the intervention (n=42) and comparison (n=28) groups. Studying each group separately over time, significant improvements were found in the intervention group on thirteen of the twenty variables, whereas the comparison group improved on four (Study I). Observations of how nursing students (n=16) used peer learning revealed that the student pairs collaborated to different extents and in different ways. All students were observed practicing several competencies together (Study II). Testing the peer learning model in new graduates’ workplace introduction (n=10) revealed that new graduates’ descriptions of peer learning were consistent with the theoretical description (Study III). Feasibility was tested in relation to compliance and acceptability, and lessons were learned. In Study IV, fidelity to the intervention was generally good. When first-line managers (n=8) described their perception of using the peer learning intervention with new graduates, predominantly positive outcomes were expressed. When examining the effect of peer learning in workplace introduction for newly graduated nurses (n=35), it was difficult to draw any conclusions due to recruitment problems (Study IV). The conclusions is that peer learning is a useful model for nursing students’ that seems to improve self-efficacy more than traditional supervision does. The model gives nursing students opportunities to practice several competencies on each other, and these competencies, e.g., leadership and organizational skills are useful in their future profession. The students practice teaching and supervision skills on each other, which seems to be a natural part of the peer relationship. Peer learning in the context of new graduates’ workplace introduction describes in a way consistent with the theoretical description of peer learning outcomes thus, also here it seems as a useful model. When developing and testing new interventions such as peer learning, it is important to do so systematically to minimize problems when conducting an evaluation, where the MRC framework can be useful. First-line managers generally expressed a positive attitude toward the peer learning model.
49.	Pålsson, Ylva, Adjunkt, 1971-, et al. (författare) A peer learning intervention in workplace introduction - managers’ and new graduates’ perspectives 2022 Ingår i: BMC Nursing. - : BMC. - 1472-6955. ; 21 Tidskriftsartikel (refereegranskat)abstract BackgroundEvaluation of a complex intervention are often described as being diminished by difficulties regarding acceptability, compliance, delivery of the intervention, recruitment and retention. Research of peer learning for nursing students have found several positive benefits while studies of peer learning for newly graduated nurses are lacking. This study aimed (1) to investigate the study process in terms of (a) first-line managers’ perspectives on the intervention study, the difficulties they face and how they handle these and (b) new graduates’ fidelity to the intervention and (2) to examine the effect of the peer learning intervention in workplace introduction for newly graduated nurses.MethodsA mixed-methods approach using semi-structured interviews with eight managers, repeated checklist for fidelity and questionnaires conducted with 35 new graduates from June 2015 and January 2018, whereof 21 in the intervention group. The peer learning intervention’s central elements included pairs of new graduates starting their workplace introduction at the same time, working the same shift and sharing responsibility for a group of patients for 3 weeks. The intervention also included 3 months of regular peer reflection.ResultsManagers offered mostly positive descriptions of using peer learning during workplace introduction. The intervention fidelity was generally good. Because of recruitment problems and thereby small sample size, it was difficult to draw conclusions about peer learning effects and, thus, the study hypothesis could either be accepted or rejected. Thereby, the study should be regarded as a pilot.ConclusionsThe present study found positive experiences of, from managers, and fidelity to the peer learning intervention; regarding the experimental design, there were lessons learned.Trial registrationBefore starting data collection, a trial registration was registered at (Trial ID ISRCTN14737280).
50.	Pålsson, Ylva, et al. (författare) A peer learning intervention targeting newly graduated nurses : A feasibility study with a descriptive design based on the Medical Research Council framework 2018 Ingår i: Journal of Advanced Nursing. - : John Wiley & Sons. - 0309-2402 .- 1365-2648. ; 74:5, s. 1127-1138 Tidskriftsartikel (refereegranskat)abstract Aims: The aim of this study was to describe the feasibility of a peer learning intervention targeting newly graduated nurses. Feasibility was tested concerning consistency of the theoretical description of peer learning with empirical findings in a new context, compliance and acceptability, as well as usability of a questionnaire measuring the intended future outcome variables.Background: Newly graduated nurses who meet, socialize and share experiences have described supporting each other's ability to cope with stress. Peer learning involves individuals in a similar situation learning from and with each other through interaction. When implementing new interventions, feasibility studies are used to minimize problems in future evaluation studies.Design: Quasi‐experimental design with an intervention group, followed over time using descriptive methods. The study was based on the Medical Research Council framework.Methods: Repeated semi‐structured interviews, a checklist for fidelity and a questionnaire were conducted with 10 newly graduated nurses from January to March 2015. The intervention's main component included pairs of newly graduated nurses working the same shift and having joint responsibility for a group of patients for a period of 3 weeks. The intervention also included 3 months of regular reflection by the pair.Findings: Using deductive analysis, the peer learning intervention was found to be consistent with the theoretical description. Due to the compliance and acceptability, there were lessons learnt. The tested questionnaire was found to be useful.Conclusions: This peer learning intervention seems to be feasible in this context. This study will serve as the basis for a future full‐scale evaluation study.

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