| 1. |
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| 2. |
- Edberg, Anna-Karin, et al.
(författare)
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Psykisk ohälsa
- 2017
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Ingår i: Omvårdnad & äldre. - Lund : Studentlitteratur. - 9789144102795 ; , s. 433-455
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 3. |
- Sederholm Lawesson, Sofia, 1973-, et al.
(författare)
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Association Between History of Adverse Pregnancy Outcomes and Coronary Artery Disease Assessed by Coronary Computed Tomography Angiography.
- 2023
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Ingår i: JAMA. - : American Medical Association (AMA). - 1538-3598 .- 0098-7484. ; 329:5, s. 393-404
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Tidskriftsartikel (refereegranskat)abstract
- Adverse pregnancy outcomes are recognized risk enhancers for cardiovascular disease, but the prevalence of subclinical coronary atherosclerosis after these conditions is unknown.To assess associations between history of adverse pregnancy outcomes and coronary artery disease assessed by coronary computed tomography angiography screening.Cross-sectional study of a population-based cohort of women in Sweden (n=10528) with 1 or more deliveries in 1973 or later, ascertained via the Swedish National Medical Birth Register, who subsequently participated in the Swedish Cardiopulmonary Bioimage Study at age 50 to 65 (median, 57.3) years in 2013-2018. Delivery data were prospectively collected.Adverse pregnancy outcomes, including preeclampsia, gestational hypertension, preterm delivery, small-for-gestational-age infant, and gestational diabetes. The reference category included women with no history of these exposures.Coronary computed tomography angiography indexes, including any coronary atherosclerosis, significant stenosis, noncalcified plaque, segment involvement score of 4 or greater, and coronary artery calcium score greater than 100.A median 29.6 (IQR, 25.0-34.9) years after first registered delivery, 18.9% of women had a history of adverse pregnancy outcomes, with specific pregnancy histories ranging from 1.4% (gestational diabetes) to 9.5% (preterm delivery). The prevalence of any coronary atherosclerosis in women with a history of any adverse pregnancy outcome was 32.1% (95% CI, 30.0%-34.2%), which was significantly higher (prevalence difference, 3.8% [95% CI, 1.6%-6.1%]; prevalence ratio, 1.14 [95% CI, 1.06-1.22]) compared with reference women. History of gestational hypertension and preeclampsia were both significantly associated with higher and similar prevalence of all outcome indexes. For preeclampsia, the highest prevalence difference was observed for any coronary atherosclerosis (prevalence difference, 8.0% [95% CI, 3.7%-12.3%]; prevalence ratio, 1.28 [95% CI, 1.14-1.45]), and the highest prevalence ratio was observed for significant stenosis (prevalence difference, 3.1% [95% CI, 1.1%-5.1%]; prevalence ratio, 2.46 [95% CI, 1.65-3.67]). In adjusted models, odds ratios for preeclampsia ranged from 1.31 (95% CI, 1.07-1.61) for any coronary atherosclerosis to 2.21 (95% CI, 1.42-3.44) for significant stenosis. Similar associations were observed for history of preeclampsia or gestational hypertension among women with low predicted cardiovascular risk.Among Swedish women undergoing coronary computed tomography angiography screening, there was a statistically significant association between history of adverse pregnancy outcomes and image-identified coronary artery disease, including among women estimated to be at low cardiovascular disease risk. Further research is needed to understand the clinical importance of these associations.
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| 4. |
- Stockfelt, Marit, et al.
(författare)
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Activated low-density granulocytes in peripheral and intervillous blood and neutrophil inflammation in placentas from SLE pregnancies
- 2021
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Ingår i: Lupus Science and Medicine. - : BMJ. - 2053-8790. ; 8:1
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Tidskriftsartikel (refereegranskat)abstract
- Objective Women with SLE face an increased risk of adverse pregnancy outcomes compared with healthy women, but the underlying immunological mechanisms are unknown. Given the recognised association of neutrophil activation with SLE pathogenesis, we examined whether there is increased neutrophil activation and inflammation in blood and placenta in SLE relative to healthy pregnancy. Methods At delivery, peripheral blood, maternal-derived intervillous blood and placentas were collected from 12 SLE and 10 healthy control pregnancies. The proportion of low-density granulocytes (LDGs) and the activation status of LDG and normal-density granulocytes were examined with flow cytometry. The chemokines CXCL8 and CXCL1 were quantified with a cytometric bead-based assay and interferon alpha (IFNα) protein levels with a Simoa method. IFNα-stimulated maternal-derived decidual stromal cells were examined for CXCL8 gene expression with qPCR. A pathologist, blinded to the patient background, examined all placentas. Results Women with SLE had significantly higher proportions of LDG in peripheral blood compared with controls (p=0.02), and LDG in both peripheral and intervillous blood were more activated in SLE relative to healthy pregnancies (peripheral blood: p=0.002 and intervillous blood: p=0.05). There were higher levels of CXCL8 and CXCL1 in intervillous compared with peripheral blood in women with SLE (p=0.004 and p=<0.0001, respectively) but not in controls. In SLE pregnancy, IFNα was detectable in 6 out of 10 intervillous blood samples but only in one control. Stimulation with IFNα upregulated CXCL8 gene expression in decidual stromal cells from both SLE and healthy pregnancy. Histological chorioamnionitis was present in 6 out of 12 placentas from women with SLE and in 1 out of 10 controls. Conclusions In women with SLE, locally produced chemokines in the placenta are increased and may attract and activate neutrophils. This in turn could contribute to placental inflammation and dysfunction and increased risk of placenta-related pregnancy complications.
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| 5. |
- Edfeldt, Katarina, 1979-, et al.
(författare)
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Missed nursing care in surgical care– a hazard to patient safety : a quantitative study within the inCHARGE programme
- 2024
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Ingår i: BMC Nursing. - : BioMed Central (BMC). - 1472-6955. ; 23:1
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundMissed nursing care occurs globally, and the consequences are severe for the patients when fundamental care needs are not fulfilled, nor delivered in a person-centred way. This study aimed to investigate the occurrence and cause of missed nursing care, and the relationship between registered nurses’ and nursing assistants’ perceptions of missed nursing care, in a surgical care context.MethodsA quantitative study was performed using the MISSCARE survey, measuring missed nursing care and associated reasons, in three surgical wards with registered nurses and nursing assistants as the participants (n = 118), during May-November in 2022. The MISSCARE survey also covers background data such as job satisfaction and intention to leave. The survey was distributed paper-based and the response rate was 88%.ResultsAspects of nursing care rated to be missed the most were ‘attending interdisciplinary care conferences’, ‘turning patient every 2 h’, ‘ambulation 3 times per day or as ordered’, and ‘mouth care’. Differences between registered nurse and nursing assistant ratings were detected for eight out of 24 items, where registered nurses rated more missed nursing care. The uppermost reasons for missed nursing care were ‘inadequate number of staff’ and ‘unexpected rise in patient volume and/or acuity on the unit’. Registered nurses and nursing assistants rated differently regarding six of 17 items. Almost every fourth staff member (24.6%, n = 29) had the intention to leave within a year in the present department.ConclusionsThe occurrence of missed nursing care is frequent in the surgical context, and in combination with a high number of staff members intending to leave their employment, poses a hazard to patient safety. Registered nurses, holding higher educational levels, reported more missed care compared with the nursing assistants. The main reason for missed nursing care was an inadequate number of staff. These findings support a warranted investment in nursing within the organisation. The results can be used to form strategies and interventions, to reduce nurse attrition and optimise competence utilisation, and to achieve safe person-centered fundamental care.
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| 6. |
- Hauffman, Anna, et al.
(författare)
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InCHARGE : Co-creating, implementing and evaluating interventions to utilize nurses' competence and achieve person-centred fundamental care-A research protocol describing an action research approach
- 2024
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Ingår i: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 19:7
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Tidskriftsartikel (refereegranskat)abstract
- Aim and objectives: This research protocol presents an action research project with the aim to demonstrate the value of person-centred fundamental care to nurses and nurse managers in surgical care units to encourage a far-reaching change in this direction. The objectives are to describe this process and to evaluate the effects on missed nursing care and person-centred fundamental care.Methods: In a novel collaboration between nursing science and medical humanities the action research design will be used to interact with nursing staff and leaders in three surgical care units and design interventions with the purpose to affect the direction of nursing. Initially, the care units will be presented with interactive workshops including evidence-based education on person-centered fundamental care, person-centredness, nurse role responsibility and leadership. This will be followed by cocreation of interventions to stimulate person-centered fundamental care. The Fundamentals of Care framework will be used as the overarching theoretical framework. Data on missed nursing care, person-centred climate and person-centered fundamental care will be collected repeatedly from patient- and nursing stakeholders through interviews and validated questionnaires. Additionally, data from written reflections following clinical observations and focus group interviews will be included. The duration of the study will be approximately five years from ethical approval.Discussion: It has been previously reported that the current working environments of registered nurses are forcing them to ration their caring responsibilities, leading to a lack of fulfillment of patients' fundamental care needs, with possible severe consequences for patients. The action research design helps researchers gain an understanding of the contextual factors important for forthcoming interventions, enabling reflective processes and cocreation of interventions with stakeholders. This may lead to feasible interventions and strengthen nursing leadership in the involved units.
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| 7. |
- Jangland, Eva, Docent, et al.
(författare)
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Effective learning activity to facilitate post-graduate nursing students' utilization of nursing theories : Using the fundamentals of care framework
- 2023
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Ingår i: Journal of Advanced Nursing. - : John Wiley & Sons. - 0309-2402 .- 1365-2648. ; 79:3, s. 1082-1093
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Tidskriftsartikel (refereegranskat)abstract
- AIMS: To explore how postgraduate nursing students used the Fundamentals of Care framework in a written assignment based on a clinical situation, and describe their learning process in using the framework.DESIGN: A qualitative descriptive study design applying the Fundamentals of Care framework.METHODS: Postgraduate nursing students' theoretical written assignments (n = 35) based on self-experienced clinical cases were included. The data were collected in 2021 in five specialties in a postgraduate nursing programme in Sweden. The data were analysed using content analysis.RESULTS: Applying the framework to a self-experienced clinical case illuminated the importance of nurse-patient relationships and clarified the meaning of person-centred care. The students assessed the framework as easy-to-use bedside as a guide to providing nursing care. By using the framework, the students were aided in reasoning about the fundamental values of care such as ethics, equality in healthcare and patient rights. When students reflected on their learning process, they stated that the assignment taught them how to use the framework, as well as paving the way for finding and applying other theories of nursing.CONCLUSION: Learning activities with an opportunity to practice analysing nursing care guided by a theory, combined with a self-evaluating element, are conducive to deepening students' learning and improving their ability to use theories in clinical practice.IMPACT: The framework illuminated the importance of the nurse-patient relationship in nursing care to the students and made them recognize and value the clinical use of theories. It is the responsibility of leaders in nurse education and healthcare to provide the next generation of specialist nurses-future nursing leaders-with regular opportunities to analyse nursing care through theories and frameworks. Nurses call for continuous learning on theories; leaders in nurse education and healthcare must meet these needs.
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| 8. |
- Petersson, Malin, et al.
(författare)
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Patient-reported symptom severity in a nationwide myasthenia gravis cohort : cross-sectional analysis of the Swedish GEMG study
- 2021
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Ingår i: Neurology. - : Lippincott Williams & Wilkins. - 0028-3878 .- 1526-632X. ; 97:14, s. e1382-e1391
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Tidskriftsartikel (refereegranskat)abstract
- Background and Objectives: To describe myasthenia gravis activities of daily living (MG-ADL) in relation to clinical characteristics in a large Swedish nationwide cohort.Methods: In a cross-sectional prevalence cohort study, the Genes and Environment in Myasthenia Gravis study, performed from November 2018 through August 2019, patients with myasthenia gravis (MG) were invited to submit an extensive 106-item life environment questionnaire, including the MG-ADL score. Patients were classified into early-onset MG (EOMG, <50 years), late-onset MG (LOMG, >= 50 years), or thymoma-associated MG (TAMG). Comparisons of disease-specific characteristics were made between subgroups, sexes, and different MG-ADL scores.Results: A total of 1,077 patients were included, yielding a 74% response rate: 505 (47%) were classified as EOMG, 520 (48%) LOMG, and 45 (4%) TAMG. Mean age at inclusion was 64.3 years (SD 15.7) and mean disease duration was 14.6 years (SD 14.0). Complete MG-ADL scores (n = 1,035) ranged from 0p to 18p, where 26% reported a score of 0p. Higher MG-ADL scores were associated with female sex, obesity, and diagnostic delay (odds ratio [OR] 1.62, 1.72, and 1.69; p(adj) = 0.017, 0.013, and 0.008) and inversely correlated with high educational attainment (OR 0.59; p(adj) = 0.02), but not with age at inclusion, disease subtype, or disease duration. Almost half of the population (47%) reported MG-ADL >= 3p, corresponding to an unsatisfactory symptom state.Discussion: In this nationwide study, comprising more than 40% of the prevalent MG population in Sweden, almost half of the patients reported current disease symptoms associated with an unsatisfactory symptom state, indicating the need for improved treatment options.
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| 9. |
- Sonesson, Ulf, et al.
(författare)
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Paths to a sustainable food sector: integrated design and LCA of future food supply chains : the case of pork production in Sweden
- 2016
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Ingår i: The International Journal of Life Cycle Assessment. - : Springer Ferlag. - 0948-3349 .- 1614-7502. ; 21:5, s. 664-676
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To describe a more sustainable food sector, a supply chain approach is needed. Changing a supply chain inevitably means that various attributes of the product and its system will change. This project assumed this challenge and delivered detailed descriptions, life cycle assessment (LCA) evaluations, and consequence assessments of the supply chains of six commodities, i.e., milk, cheese, beef, pork, chicken, and bread, from a Swedish region. This paper presents results for the pork supply chain. Methods: In the project setup, experts on production along supply chains designed three scenarios for environmentally improved systems. These scenarios, i.e., the ecosystem, plant nutrients, and climate scenarios, were intended to address different clusters of environmental goals. The next step was to challenge these scenarios by considering their possible consequences for products and systems from the food safety, sensory quality, animal welfare, consumer appreciation, and (for primary production only) cost perspectives. This led to changes in production system design to prevent negative consequences. The final supply chains were quantified using LCA and were again assessed from the three perspectives. Results and discussion: The scenario design approach worked well, thoroughly and credibly describing the production systems. Assessment of consequences bolstered the credibility and quality of the systems and results. The LCA of pig production and smoked ham identified large potentials for improvement by implementing available knowledge: global warming potential (GWP) could be reduced 21–54 % and marine eutrophication by 14–45 %. The main reason for these improvements was improved productivity (approaching the best producers’ current performance), though dedicated measures were also important, resulting in increased nitrogen efficiency, more varied crop rotations for crop production and better production management, and improved animal health and manure management for animal production. Reduced post-farm wastage contributed as did reduced emissions from fertilizer production. Conclusions: The working approach applied was successful in integrating LCA research with food system production expertise to deliver results relevant to supply chain decision-makers. The consequence assessments brought considerable value to the project, giving its results greater credibility. By introducing constraints in the form of “no negative consequences and no increased costs,” the work was “guided” so that the scenario design avoided being hampered by too many opportunities.
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| 10. |
- Torell, Agnes, 1993, et al.
(författare)
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Low-density granulocytes are related to shorter pregnancy duration but not to interferon alpha protein blood levels in systemic lupus erythematosus.
- 2023
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Ingår i: Arthritis research & therapy. - : BMC. - 1478-6362. ; 25:1
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Tidskriftsartikel (refereegranskat)abstract
- An increased risk of pregnancy complications is seen in women with systemic lupus erythematosus (SLE), but the specific immunopathological drivers are still unclear. Hallmarks of SLE are granulocyte activation, type I interferon (IFN) overproduction, and autoantibodies. Here we examined whether low-density granulocytes (LDG) and granulocyte activation increase during pregnancy, and related the results to IFNα protein levels, autoantibody profile, and gestational age at birth.Repeated blood samples were collected during pregnancy in trimesters one, two, and three from 69 women with SLE and 27 healthy pregnant women (HC). Nineteen of the SLE women were also sampled late postpartum. LDG proportions and granulocyte activation (CD62L shedding) were measured by flow cytometry. Plasma IFNα protein concentrations were quantified by single molecule array (Simoa) immune assay. Clinical data were obtained from medical records.Women with SLE had higher LDG proportions and increased IFNα protein levels compared to HC throughout pregnancy, but neither LDG fractions nor IFNα levels differed during pregnancy compared to postpartum in SLE. Granulocyte activation status was higher in SLE relative to HC pregnancies, and it was increased during pregnancy compared to after pregnancy in SLE. Higher LDG proportions in SLE were associated with antiphospholipid positivity but not to IFNα protein levels. Finally, higher LDG proportions in trimester three correlated independently with lower gestational age at birth in SLE.Our results suggest that SLE pregnancy results in increased peripheral granulocyte priming, and that higher LDG proportions late in pregnancy are related to shorter pregnancy duration but not to IFNα blood levels in SLE.
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| 11. |
- Abelson, Anna-Karin, et al.
(författare)
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No evidence of association between genetic variants of the PDCD1 ligands and SLE
- 2007
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Ingår i: Genes and Immunity. - : Springer Science and Business Media LLC. - 1466-4879 .- 1476-5470. ; 8:1, s. 69-74
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Tidskriftsartikel (refereegranskat)abstract
- PDCD1, an immunoreceptor involved in peripheral tolerance has previously been shown to be genetically associated with systemic lupus erythematosus (SLE). PDCD1 has two ligands whose genes are located in close proximity on chromosome 9p24. Our attention was drawn to these ligands after finding suggestive linkage to a marker (gata62f03, Z=2.27) located close to their genes in a genome scan of Icelandic families multiplex for SLE. Here, we analyse Swedish trios (N=149) for 23 single nucleotide polymorphisms (SNPs) within the genes of the PDCD1 ligands. Initially, indication of association to eight SNPs was observed, and these SNPs were therefore also analysed in Mexican trios (N=90), as well as independent sets of patients and controls from Sweden (152 patients, 448 controls) and Argentina (288 patients, 288 controls). We do not find support for genetic association to SLE. This is the first genetic study of SLE and the PDCD1 ligands and the lack of association in several cohorts implies that these genes are not major risk factors for SLE.
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| 12. |
- Edfeldt, Katarina, 1979-, et al.
(författare)
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Oral health and oral care in patients in a surgical context : A quantitative study comparing patients' and nurses' assessments
- 2023
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Ingår i: Journal of Clinical Nursing. - : John Wiley & Sons. - 0962-1067 .- 1365-2702. ; 33:6, s. 2201-2208
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Tidskriftsartikel (refereegranskat)abstract
- AimsTo investigate fundamental care delivery regarding oral care in a surgical context, and to compare patients' self-reported oral health with registered nurse assessments.DesignA descriptive and comparative study, with a consecutive selection.MethodsA patient oral health rating tool, including questions about performed oral care, was distributed to patients (n = 50), at four surgical wards in Sweden. The response rate was 72%. Oral health status was assessed by a registered nurse using the Revised Oral Assessment Guide (ROAG), and a comparison between patient and registered nurse assessment was performed by calculating Cohen's kappa coefficient and percentage agreement.ResultsPatients (38%) reported severe oral symptoms, mostly dry lips and not an adequate amount of saliva, and 80% were not offered help with oral care. ROAG assessments revealed that 74% had problems with oral health. Almost half of the patients (48%) needed assistance with oral care but only 10% received help. Registered nurses assessed the patient's oral health as worse than the patient's self-assessment did.ConclusionThere are deficiencies in fundamental care delivery regarding oral care in a surgical care context. Oral health assessments need to be performed by registered nurses. Routines for systematic oral assessments and for oral care need to be implemented by nurse managers to ensure that patients' fundamental care needs are fulfilled.Implications for the Profession and Patient CareOral health assessments need to be performed regularly by registered nurses since it is insufficient that patients self-assess their oral health. Nurse managers needto provide and implement routines for nurse assessments and oral care in surgical care contexts.ImpactThere are deficiencies in patients' oral health and oral care, and registered nurses need to perform oral health assessments. Nurse managers need to implement routines for registered nurse assessments and oral care.Patient ContributionPatients admitted to a surgical ward were included in the study after being screened for inclusion criteria. After participants signed informed consent, they filled in a questionnaire about oral health and oral care, and a registered nurse performed an oral health assessment.Reporting MethodThis study was carried out according to the STROBE checklist.
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| 13. |
- Fröjd, Camilla, et al.
(författare)
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Employers' requests when advertising for nurses : A national mapping of recruitment advertising for nurses in Sweden
- 2024
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Ingår i: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 19:7
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: There is a shortage of nurses and many are leaving the profession. Maintaining sufficient nursing staff is a major healthcare challenge for societies worldwide. Work conditions, job orientation, and career opportunities all factor into nurses' rates of attrition, exit, and turnover. Newly graduated nurses have requested structured introductory and/or mentoring programmes to ease their transition from education to work life and develop the skills and knowledge necessary in their particular work setting. Nurses also seek opportunities to continue learning and developing professionally.Aims: To map and describe the content of recruitment advertisements for nurses. Research questions were: 'What qualifications do healthcare employers request when recruiting nurses?' and 'What sorts of professional development do healthcare employers offer nurses?Materials and methods: A comprehensive national mapping of recruitment advertisements for nurses in Sweden where all advertisements, N = 450, on 20 of the 21 regional hospital websites were collected. A qualitative and a quantitative content analysis was performed.Results: Personal characteristics dominated requested competence in recruitment advertisements. Employers offered general nursing opportunities with unspecific work content and focused more on recruiting newly registered, rather than experienced, nurses. In only a few advertisements, employers asked for a master's degree. No employer requested nurses with a PhD or research experience.Conclusion: While the World Health Organization stresses the need for a sustainable recruitment and attainment of nurses to secure health care, employers' recruitment of mostly newly graduated nurses and offering little professional development and few career opportunities may be one explanation for the difficulties in securing safe nurse staffing.
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| 14. |
- Grönwall, Caroline, et al.
(författare)
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A Comprehensive Evaluation of the Relationship Between Different IgG and IgA Anti-Modified Protein Autoantibodies in Rheumatoid Arthritis
- 2021
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Ingår i: Frontiers in Immunology. - : Frontiers Media S.A.. - 1664-3224. ; 12
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Tidskriftsartikel (refereegranskat)abstract
- Seropositive rheumatoid arthritis (RA) is characterized by the presence of rheumatoid factor (RF) and anti-citrullinated protein autoantibodies (ACPA) with different fine-specificities. Yet, other serum anti-modified protein autoantibodies (AMPA), e.g. anti-carbamylated (Carb), -acetylated (KAc), and malondialdehyde acetaldehyde (MAA) modified protein antibodies, have been described. In this comprehensive study, we analyze 30 different IgG and IgA AMPA reactivities to Cit, Carb, KAc, and MAA antigens detected by ELISA and autoantigen arrays in N=1985 newly diagnosed RA patients. Association with patient characteristics such as smoking and disease activity were explored. Carb and KAc reactivities by different assays were primarily seen in patients also positive for anti-citrulline reactivity. Modified vimentin (mod-Vim) peptides were used for direct comparison of different AMPA reactivities, revealing that IgA AMPA recognizing mod-Vim was mainly detected in subsets of patients with high IgG anti-Cit-Vim levels and a history of smoking. IgG reactivity to acetylation was mainly detected in a subset of patients with Cit and Carb reactivity. Anti-acetylated histone reactivity was RA-specific and associated with high anti-CCP2 IgG levels, multiple ACPA fine-specificities, and smoking status. This reactivity was also found to be present in CCP2+ RA-risk individuals without arthritis. Our data further demonstrate that IgG autoreactivity to MAA was increased in RA compared to controls with highest levels in CCP2+ RA, but was not RA-specific, and showed low correlation with other AMPA. Anti-MAA was instead associated with disease activity and was not significantly increased in CCP2+ individuals at risk of RA. Notably, RA patients could be subdivided into four different subsets based on their AMPA IgG and IgA reactivity profiles. Our serology results were complemented by screening of monoclonal antibodies derived from single B cells from RA patients for the same antigens as the RA cohort. Certain CCP2+ clones had Carb or Carb+KAc+ multireactivity, while such reactivities were not found in CCP2- clones. We conclude that autoantibodies exhibiting different patterns of ACPA fine-specificities as well as Carb and KAc reactivity are present in RA and may be derived from multireactive B-cell clones. Carb and KAc could be considered reactivities within the "Cit-umbrella" similar to ACPA fine-specificities, while MAA reactivity is distinctly different.
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| 15. |
- Gunnarsson, Anna-Karin, et al.
(författare)
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Cranberry juice concentrate does not significantly decrease the incidence of acquired bacteriuria in female hip-fracture patients receiving urine catheter : a double-blind randomised trial
- 2017
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Ingår i: Clinical Interventions in Aging. - 1176-9092 .- 1178-1998. ; 12, s. 137-143
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundUrinary tract infection (UTI) is a common complication among patients with hip fractures. Receiving an indwelling urinary catheter is a risk factor for developing UTIs. Treatment of symptomatic UTIs with antibiotics is expensive and can result in the development of antimicrobial resistance. Cranberries (lat. Vaccinium macrocarpon Ait.) are thought to prevent UTI. There is no previous research on this potential effect in patients with hip fracture who receive urinary catheters.AimTo investigate whether cranberry capsules given pre- and postoperatively are useful in preventing hospital-acquired UTIs in female patients with hip fracture and urinary catheter.DesignRandomised, placebo-controlled double-blind trial.MethodFemale patients, age 60 years and older, with hip fracture were recruited (n=227). The patients were randomised to receive cranberry (n=113) or placebo (n=114) capsules daily, from admission to the ward, until five days postoperatively. Urine cultures were obtained at admission and at five and 14 days postoperatively. In addition, EQ-5D assessments were performed and patients were screened for UTI symptoms.ResultThere was no difference between the groups in the proportion of patients with postoperative positive urine cultures. When excluding patients with positive cultures at admission, patients with antibiotic treatment during follow-up, and patients that did not adhere to the protocol, there was a trend towards a protective effect of cranberry treatment against hospital-acquired UTIs ; e.g. 36% (n=33) in the control group vs. 22% (n=41) in cranberry group (p=0.17) at 5 days postoperatively.ConclusionCranberry concentrate does not seem to have an effect in preventing UTI in female patients with hip fracture and indwelling urinary catheter.
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| 16. |
- Gunnarsson, Anna-Karin, et al.
(författare)
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Does nutritional intervention for patients with hip fractures reduce postoperative complications and improve rehabilitation?
- 2009
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Ingår i: Journal of Clinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 18:9, s. 1325-1333
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Tidskriftsartikel (refereegranskat)abstract
- The aims were to investigate whether there were any differences between patients receiving nutritional intervention preoperatively and over five days postoperatively and patients who did not, in terms of postoperative complications, rehabilitation, length of stay and food and liquid intake. BACKGROUND: Patients with hip fractures are often malnourished at admission to hospital and they typically do not receive the energy and calories needed postoperatively. DESIGN: The design was a quasi-experimental, pre- and post-test comparison group design without random group assignment. METHODS: One hundred patients with hip fractures were consecutively included. The control group (n = 50) received regular nutritional support. The intervention group (n = 50) received nutrition according to nutritional guidelines. The outcome measures used were risk of pressure ulcer, pressure ulcers, weight, nosocomial infections, cognitive ability, walking assistance and functional ability, collected preoperatively and five days postoperatively. Each patient's nutrient and liquid intake were assessed daily for five days postoperatively. RESULTS: Significantly fewer (p = 0.043) patients in the intervention group (18%) had pressure ulcers five days postoperatively compared with the control group (36%). Nutrient and liquid intake was significantly higher (p < 0.001) in the intervention group. Median length of stay decreased from nine to seven days (p = 0.137), as did nosocomial infections, from 18-8.7% (p = 0.137). CONCLUSION: Patients with hip fractures receiving nutrition according to nutritional guidelines developed fewer pressure ulcers. This is invaluable to patients' quality of life and a major economic saving for society. RELEVANCE TO CLINICAL PRACTICE: Great benefits can be gained for the patients through modest efforts by nurses and physicians such as nutritional intervention.
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| 17. |
- Gunnarsson, Anna-Karin, et al.
(författare)
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Hip-fracture patients’ experience of involvement in their care : A qualitative study
- 2014
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Ingår i: The International Journal of Person Centered Medicine. - 2043-7730 .- 2043-7749. ; 4:2
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Tidskriftsartikel (refereegranskat)abstract
- Little is known about how hip-fracture patients experience involvement in their own nursing care. Yet understanding this is essential in order to both meet patient expectations and ensure delivery of high-quality nursing care. The aim of the study was to describe how elderly hip-fracture patients experienced their involvement in the nursing care they received while in the orthopaedics ward. A descriptive design with a qualitative interview approach was used. Semi-structured interviews were conducted with16 hip-fracture patients, 14 days postoperative in 2012. Systematic Text Condensation was used to analyse the data collected. The findings reveal six themes: 1) experiencing severe pain, 2) feeling dependent on the nurses, 3) feeling they were not valued, 4) poor organisation, 5) positives and negatives of sharing a room with fellow patients, and 6) positive interactions with nurses that encouraged the patient. Hip-fracture patients reported experiencing very little involvement in their nursing care, to the extent that fundamental aspects of nursing care went unfulfilled. Patients did not feel valued by the nurses. Most patients described experiencing unbearable pain during their stay in the orthopaedics ward despite the existence of evidence-based and established guidelines for pain management. The result of this study indicates that there is much to do on a number of levels in the health care system to improve patient involvement in nursing care.
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| 18. |
- Gunnarsson, Anna-Karin, et al.
(författare)
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Hip-fracture patients’ experience of involvement in their care: A qualitative study
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- Little is known about how hip-fracture patients experience involvement in their own nursing care. Yet understanding this is essential in order to both meet patient expectations and ensure delivery of high-quality nursing care. The aim of the study was to describe how elderly hip-fracture patients experienced their involvement in the nursing care they received while in the orthopaedics ward. A descriptive design with a qualitative interview approach was used.Semi-structured interviews were conducted with16 hip-fracture patients, 14 days postoperative in 2012. Systematic Text Condensation was used to analyse the data collected. The findings reveal six themes: 1) experiencing severe pain, 2) feeling dependent on the nurses, 3) feeling they were not valued, 4) poor organisation, 5) positives and negatives of sharing a room with fellow patients, and 6) positive interactions with nurses that encouraged the patient. Hip-fracture patients reported experiencing very little involvement in their nursing care, to the extent that fundamental aspects of nursing care went unfulfilled. Patients did not feel valued by the nurses. Most patients described experiencing unbearable pain during their stay in the orthopaedics ward despite the existence of evidence-based and established guidelines for pain management. The result of this study indicates that there is much to do on a number of levels in the health care system to improve patient involvement in nursing care.
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| 19. |
- Gunnarsson, Anna-Karin, et al.
(författare)
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Increased energy intake in hip fracture patients affects nutritional biochemical markers
- 2012
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Ingår i: Scandinavian Journal of Surgery. - 1457-4969 .- 1799-7267. ; 101:3, s. 204-210
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Tidskriftsartikel (refereegranskat)abstract
- Background and Aims: We have previously shown that nutritional guidelines decreased the incidence of pressure ulcers in hip fracture patients. In the present study, we evaluate whether the nutritional biochemical markers S-IGF-1 (Insulin-like Growth Factor 1), S-Transthyretin and S-Albumin are affected by patients' energy intake, and whether the markers are useful as predictors of postoperative complications. Material and Methods: Quasi-experimental design, with one intervention and one control group, as well as pre- and post-study measurements. Eighty-eight hip fracture patients were included: 42 in the control group and 46 in the intervention group. The control group received regular nutritional support pre- and postoperatively, while the intervention group received nutritional support that followed new, improved clinical guidelines from admission to five days postoperatively. S-Albumin, S-Transthyretin, C-Reactive Protein (S-CRP) and S-IGF-1 were analysed at admission and five days postoperatively as well as complications like pressure ulcer and infection. Results: The intervention group had a significantly higher energy intake; for example, 1636 kcal versus 852 kcal postoperative day 1. S-IGF-1 levels decreased significantly in the control group, while no decrease in the intervention group. S-Albumin and S-Transthyretin decreased and S-CRP increased significantly in both groups, indicating that those markers were not affected short-term by a high-energy intake. There was no correlation between short-term postoperative complications and S-IGF-1, S-Transthyretin or S-Albumin at admission. Conclusion: The results of our study showed that S-IGF-1 can be used as a short-term nutritional biochemical marker, as it was affected by a five-day high-energy regimen. However, neither S-IGF-1, S-Transthyretin or S-Albumin were useful in predicting postoperative complications within five days postoperatively.
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| 20. |
- Gunnarsson, Anna-Karin
(författare)
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Patients with Hip Fracture : Various aspects of patient safety
- 2014
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The overall aim of the thesis was to investigate whether patient safety can be improved for patients with hip fracture by nutritional intervention and by pharmacological treatment with cranberry concentrate. Another aim was to describe the patients’ experience of involvement in their care. The thesis includes results from four studies that include both quantitative and qualitative design. Studies I and II were intervention studies with a quasi-experimental design, with intervention and comparison groups. Study III was a randomised, double-blind, placebo-controlled trial with intervention and control groups. Study IV took a qualitative approach.Study I showed that when patients with hip fracture received nutritional supplementation according to nutritional guidelines, from admission until five days postoperatively, fewer patients developed pressure ulcers. Study II showed that it is possible to objectively evaluate a short-term nutritional intervention through the nutritional biochemical marker IGF-1, as it was affected by a five-day high-energy regimen. The randomised controlled trial, Study III, showed that a short-term treatment from admission until five days postoperatively with cranberry as capsules does not seem to be useful in preventing positive urine cultures in female patients with hip fracture and a urinary catheter. Finally, Study IV showed that patients with hip fracture reported experiencing very little involvement in their nursing care, to the extent that fundamental aspects of nursing care went unfulfilled. Patients did not feel valued by the nurses and unbearable pain that affected rehabilitation was reported. Positive interactions with nurses, however, did encourage patients to be more active.It is possible for every nurse to improve patient safety at bedside when caring for patients with hip fracture. Simply by increasing caloric/energy intake, it is possible to prevent pressure ulcers. It is also important to involve patients in nursing care, since the patients have experienced low or almost no involvement in care. Nurses need to see each patient as a whole person with different wishes and needs. However, certain prerequisites have to be in place to give nurses the opportunity to increase patient safety at bedside for patients with hip fracture.
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| 21. |
- Janelidze, Shorena, et al.
(författare)
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Immunizations With IFN gamma Secreting Tumor Cells can Eliminate Fully Established and Invasive Rat Gliomas
- 2009
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Ingår i: Journal of Immunotherapy. - 1524-9557. ; 32:6, s. 593-601
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Tidskriftsartikel (refereegranskat)abstract
- Immunotherapy of malignant primary brain tumors holds the potential to improve the dismal prognosis after current clinical therapy. Although immunotherapy of experimental gliomas has been demonstrated to have the capacity to cure intracerebral tumors no convincing effects of immunotherapy have been shown in clinical trials. One reason for this could be that some of the models used do not display full features of human glioblastomas. The N29 rat gliomas exhibited all the histologic features of human glioblastoma multiforme including nuclear atypia, mitotic figures, necrosis, and diffuse infiltration into the normal brain tissue. Surprisingly, immunotherapy with autologous interferon gamma producing tumor cells against preestablished intracerebral N29 turners yielded a higher cure rate than immunotherapy against less invasive tumors. Furthermore, when immunizations were postponed until day 5 after tumor establishment 50% of the animals survived. When immunizations were postponed until day 11 after tumor establishment no glioma-bearing animals were cured but survival was significantly prolonged. The superior effect of immunotherapy in the invasive N29 model compared with the less invasive tumors could depend oil combined effects of up-regulation of major histocompatibility complex I and induction of major histocompatibility complex II plus CD80 after transfection and irradiation of the tumor cells used for immunizations. This study demonstrates that immunotherapy against experimental brain tumors indeed is feasible even against highly invasive and established tumors. These results strengthen the translational potential of immunotherapy against malignant brain tumors.
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| 22. |
- Jönsen, Andreas, et al.
(författare)
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Mutations in genes encoding complement inhibitors CD46 and CFH affect the age at nephritis onset in patients with systemic lupus erythematosus
- 2011
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Ingår i: Arthritis Research & Therapy. - : Springer Science and Business Media LLC. - 1478-6362 .- 1478-6354. ; 13, s. R206-
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Tidskriftsartikel (refereegranskat)abstract
- INTRODUCTION: Inherited deficiencies of several complement components strongly predispose to systemic lupus erythematosus (SLE) while deficiencies of complement inhibitors are found in kidney diseases such as atypical hemolytic uremic syndrome (aHUS). METHODS: The exons of complement inhibitor genes: CD46 and CFH (factor H) were fully sequenced using Sanger method in SLE patients with nephritis originating from two cohorts from southern and mid Sweden (n = 196). All identified mutations and polymorphisms were then analyzed in SLE patients without nephritis (n = 326) and healthy controls (n = 523). RESULTS: We found non-synonymous, heterozygous mutations in CFH in 6.1% patients with nephritis in comparison to 4.0% and 5.4% in patients without nephritis and controls, respectively. No associations of SLE or nephritis with common variants in CFH (V62I/Y402H/E936D) were found. Furthermore, we found two non-synonymous heterozygous mutations in CD46 in SLE patients but not in controls. The A353V polymorphism, known to affect function of CD46, was found in 6.6% of nephritis patients vs 4.9% and 6.1% of the non-nephritis SLE patients and controls. The presence of mutations in CD46 and CFH did not predispose to SLE or nephritis but was associated with earlier onset of nephritis. Furthermore, we found weak indications that there is one protective and one risk haplotype predisposing to nephritis composed of several polymorphisms in non-coding regions of CD46, which were previously implicated in aHUS. CONCLUSION: SLE nephritis is not associated with frequent mutations in CFH and CD46 as found in aHUS but these may be modifying factors causing earlier onset of nephritis.
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| 23. |
- Kozyrev, Sergey V, et al.
(författare)
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Functional variants in the B-cell gene BANK1 are associated with systemic lupus erythematosus
- 2008
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Ingår i: Nature Genetics. - : Springer Science and Business Media LLC. - 1546-1718 .- 1061-4036. ; 40:2, s. 211-216
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Tidskriftsartikel (refereegranskat)abstract
- Systemic lupus erythematosus (SLE) is a prototypical autoimmune disease characterized by production of autoantibodies and complex genetic inheritance(1-3). In a genome-wide scan using 85,042 SNPs, we identified an association between SLE and a nonsynonymous substitution (rs10516487, R61H) in the B-cell scaffold protein with ankyrin repeats gene, BANK1. We replicated the association in four independent case-control sets (combined P = 3.7 x 10(-10); OR = 1.38). We analyzed BANK1 cDNA and found two isoforms, one full-length and the other alternatively spliced and lacking exon 2 (Delta 2), encoding a protein without a putative IP3R-binding domain. The transcripts were differentially expressed depending on a branch point-site SNP, rs17266594, in strong linkage disequilibrium (LD) with rs10516487. A third associated variant was found in the ankyrin domain (rs3733197, A383T). Our findings implicate BANK1 as a susceptibility gene for SLE, with variants affecting regulatory sites and key functional domains. The disease-associated variants could contribute to sustained B cell-receptor signaling and B-cell hyperactivity characteristic of this disease.
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| 24. |
- Larsson, Karin, et al.
(författare)
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Ways of understanding cognitive impairment in cardiac arrest survivors : a phenomenographic study
- 2021
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Ingår i: Intensive & Critical Care Nursing. - : Elsevier. - 0964-3397 .- 1532-4036. ; 63
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Tidskriftsartikel (refereegranskat)abstract
- Aim: To describe the variation in ways that registered nurses perceive and understand cognitive impair- ment in cardiac arrest survivors.Design: A qualitative, inductive design with individual semi-structured interviews was applied. Data was analysed using a phenomenographic approach.Setting: The participants were nineteen Swedish registered nurses, experienced in cardiovascular care and providing follow-up care.Findings: The nurses perceived the cognitive impairment of the survivors in qualitatively different ways, as illustrated in two categories: ‘The perceptible and obvious’ and ‘The elusive and challenging’. The nurses perceived a variety of signs of cognitive impairment, emotional expressions related to these, and recovery from cognitive impairment. They perceived confidence in capturing cognitive function when they understood the signs of cognitive impairment as severe and obvious. However, it was per- ceived as difficult to assess cognitive function when impairments were subtle, resulting in uncertainty in terms of how to make assessments. Nurses made use of their own strategies for assessments, which were sometimes found to be inadequate when they understood that they had misinterpreted the sur- vivors’ cognitive impairment.Conclusion: Nurses feel uncertainty regarding detecting mild impairment in cardiac arrest survivors. By involving next of kin, nurses will gain a broader understanding of survivors’ cognitive function.
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| 25. |
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| 26. |
- Lyngfelt, Anna, 1965, et al.
(författare)
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Vart leder en bro av poesi?
- 2022
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Ingår i: Språk och litteratur - en omöjlig eller skön förening? SMDI konferens 23-24 november. Lunds universitet..
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Under 2021 gjorde Svenska akademin och En bok för alla en satsning på poesi genom att ge ut lyriksamlingen En bro av poesi till alla elever i förskoleklass i Sverige. Syftet med vårt arbete är då att undersöka hur denna satsning fallit ut. Utnyttjas diktsamlingen, och i så fall hur? Påverkar användningen av boken undervisningen i flerspråkiga klasser? Och går det att säga något om hur läsare ”konstrueras” genom bokens utformning och den lärarhandledning som hör till En bro av poesi? För att få svar på de första två frågorna används en enkät som delats ut till alla lärare i förskoleklass i Göteborg. Fördjupade analyser av svaren bidrar till en diskussion om lärare använder sig av olika modaliteter när eleverna tolkar dikterna och utvecklar egna poetiska uttryck. Frågan om elevernas utveckling som skribenter genom poesiarbete uppmärksammas också, liksom betydelsen av poesins rika formspråk för språkutvecklande arbete i flerspråkiga klassrum. Utöver detta sker en textanalys med avsikten att kritiskt granska En bro av poesi. Resultatet från denna analys bidrar med svar på den tredje frågan och ger möjlighet att diskutera förväntningar på läsare av boken och bokens lärarhandledning. Till grund för arbetet ligger tidigare studier om poesiarbete i skolan, som G. Heards/B. Stenssons Allt gott på jorden och i solen (Daidalos, 2021), J. Alfredssons och A. Skarets Ordlek, bildspråk, scenkonst – nya artiklar om poesi i Barnboken (2021) och Anna Sigvardssons Möten med dikten (2020).
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| 27. |
- Manniche, Jesper, et al.
(författare)
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Destination: A circular tourism economy : a handbook for transitioning toward a circular economy within the tourism and hospitality sectors in the South Baltic Region
- 2017. - 1
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Bok (populärvet., debatt m.m.)abstract
- This handbook provides an overall understanding of the concept of the circular economy and of the societal dynamics through which innovations and transitioning processes towards a circular economy are realised. It describes and discusses the specific economic and political context for applying and developing the circular economy in the CIRTOINNO project. The specific contexts are the tourism sectors in the South Baltic partner regions. It investigates and discusses the opportunities for small and medium-sized tourism businesses to adopt circular economy ideas, and to identify possible ‘good practices’ among tourism SMEs in developing and applying circular economy solutions, especially in relation to the fields of foci of the CIRTOINNO project: accommodation, food and spa services.
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| 28. |
- Sánchez, Elena, et al.
(författare)
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Association of a CD24 Gene Polymorphism with Susceptibility to Systemic Lupus Erythematosus
- 2007
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Ingår i: Arthritis and Rheumatism. - : Wiley. - 0004-3591 .- 1529-0131. ; 56:9, s. 3080-3086
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Tidskriftsartikel (refereegranskat)abstract
- Objective. To determine the potential role of the CD24 A57V gene polymorphism in systemic lupus erythematosus (SLE). Methods. We studied 3 cohorts of Caucasian patients and controls. The Spanish cohort included 696 SLE patients and 539 controls, the German cohort included 257 SLE patients and 317 controls, and the Swedish cohort included 310 SLE patients and 247 controls. The CD24 A57V polymorphism was genotyped by polymerase chain reaction, using a predeveloped TaqMan allele discrimination assay. Odds ratios (ORs) and 95% confidence intervals (95% CIs) were calculated. Results. In the Spanish cohort there was a statistically significant difference in the distribution of the CD24 V allele between SLE patients and controls (OR 3.6 [95% CI 2.13-6.16], P < 0.0001). In addition, frequency of the CD24 V/V genotype was increased in SLE patients compared with controls (OR 3.7 [95% CI 2.16-6.34], P < 0.00001). We sought to replicate this association with SLE in a German population and a Swedish population. A similar trend was found in the German group. The CD24 V/V genotype and the CD24 V allele were more frequent in SLE patients than in controls, although this difference was not statistically significant. No differences were observed in the Swedish group. A meta-analysis of the Spanish and German cohorts demonstrated that the CD24 V allele has a risk effect in SLE patients (pooled OR 1.25 [95% Cl 1.08-1.46], P = 0.003). In addition, homozygosity for the CD24 V risk allele significantly increased the effect (pooled OR 2.1,9 [95% Cl 1.50-3.22], P = 0.00007). Conclusion. These findings suggest that the CD24 A57V polymorphism plays a role in susceptibility to SLE in a Spanish population.
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| 29. |
- Sreih, Antoine, et al.
(författare)
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Dual effect of the macrophage migration inhibitory factor gene on the development and severity of human systemic lupus erythematosus
- 2011
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Ingår i: Arthritis and Rheumatism. - : Wiley. - 0004-3591 .- 1529-0131. ; 63:12, s. 3942-3951
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Tidskriftsartikel (refereegranskat)abstract
- Objective To study the effect of the innate cytokine macrophage migration inhibitory factor (MIF) on the susceptibility and severity of systemic lupus erythematosus (SLE) in a multinational population of 1,369 Caucasian and African American patients. Methods. Two functional polymorphisms in the MIF gene, a -794 CATT5-8 microsatellite repeat (rs5844572) and a -173 G/C single-nucleotide polymorphism (rs755622), were assessed for association with SLE in 3,195 patients and healthy controls. We also measured MIF plasma levels in relation to genotypes and clinical phenotypes, and assessed Toll-like receptor 7 (TLR-7)-stimulated MIF production in vitro. Results. Both Caucasians and African Americans with the high-expression MIF haplotype -794 CATT(7)/ -173* C had a lower incidence of SLE (in Caucasians, odds ratio [OR] 0.63, 95% confidence interval [95% CI] 0.53-0.89, P = 0.001; in African Americans, OR 0.46, 95% CI 0.23-0.95, P = 0.012). In contrast, among patients with established SLE, reduced frequencies of low-expression MIF genotypes (-794 CATT(5)) were observed in those with nephritis, those with serositis, and those with central nervous system (CNS) involvement when compared to patients without end-organ involvement (P = 0.023, P = 0.005, and P = 0.04, respectively). Plasma MIF levels and TLR-7-stimulated MIF production in vitro reflected the underlying MIF genotype of the studied groups. Conclusion. These findings suggest that MIF, which has both proinflammatory properties and macrophage and B cell survival functions, exerts a dual influence on the immunopathogenesis of SLE. Highexpression MIF genotypes are associated with a reduced susceptibility to SLE and may contribute to an enhanced clearance of infectious pathogens. Once SLE develops, however, low-expression MIF genotypes may protect from ensuing inflammatory end-organ damage.
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| 30. |
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| 31. |
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| 32. |
- Wallenbeck, Anna, et al.
(författare)
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Research on organic animal husbandry in Sweden
- 2012
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Studies on animal husbandry in the research regarding organic production in Sweden place a high emphasis on animal welfare and adaptation of production systems to local conditions. Rotational clover/grass ley is the most abundant crop due to excellent growing conditions and forms the base in Swedish dairy and beef production. During the growing season, grazing is compulsory for all animals according to the standards of organic production in Sweden. One important resource for researchers in Sweden is the unique data available from the herd monitoring databases created by Swedish farming organisations. Research on organic production is coordinated by EPOK (Centre for Organic Food and Farming) at the Swedish University of Agricultural Sciences. The main topics of current research in organic animal husbandry are animal health, welfare and breeding and how these factors interact with different feed sources or feeding strategies that have the potential to mitigate environmental effects.
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| 33. |
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| 34. |
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