| 1. |
- Tistad, Malin, et al.
(författare)
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Training and support for the role of facilitator in implementation of innovations in health and community care : a scoping review protocol
- 2023
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Ingår i: Systematic Reviews. - : BioMed Central (BMC). - 2046-4053. ; 12:1
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Forskningsöversikt (refereegranskat)abstract
- BackgroundImplementing and sustaining innovations in clinical practice, such as evidence-based practices, programmes, and policies, is frequently described as challenging. Facilitation as a strategy for supporting implementation requires a facilitator, i.e. an individual with a designated role to support the implementation process. A growing number of studies report that facilitation can help tackle the challenges in implementation efforts. To optimise the potential contribution of facilitation as a strategy to improve the implementation of new practices, there is a need to enhance understanding about what training and support is required for individuals in the facilitator role.The objective of this scoping review is to map how facilitators have been trained for, and supported in, the facilitator role in implementation studies in health and community care. Specifically, the review aims to examine what is reported on training and support of facilitators in terms of learning outcomes, content, dose, mode of delivery, learning activities, and qualifications of the trainers and how the facilitators perceive training and support.MethodsThis scoping review will follow the guidance of the Joanna Briggs Institute and the PRISMA Extension for Scoping Review checklist. We will include articles in which (a) facilitation is deployed as an implementation strategy, with identified facilitator roles targeting staff and managers, to support the implementation of specified innovations in health or community care, and (b) training and/or support of facilitators is reported. We will exclude articles where facilitation is directed to education or training in specific clinical procedures or if facilitation supports the implementation of general quality improvement systems. All types of peer-reviewed studies and study protocols published in English will be included. A systematic search will be performed in MEDLINE (Ovid), Embase (embase.com), Web of Science Core Collection, and CINAHL (Ebsco).DiscussionThe proposed scoping review will provide a systematic mapping of the literature on the training and support of implementation facilitators and contribute useful knowledge within the field of implementation science to inform future facilitation initiatives.
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| 2. |
- Winberg, Johanna, et al.
(författare)
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Chimerism Resulting From Parthenogenetic Activation and Dispermic Fertilization
- 2010
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Ingår i: American Journal of Medical Genetics, Part A. - : Wiley. - 1552-4825 .- 1552-4833. ; 152A:9, s. 2277-2286
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Tidskriftsartikel (refereegranskat)abstract
- Whole-body human chimerism is the result of two zygotes giving rise to one individual, and is a rarely detected condition. We have studied the molecular background and discuss the likely mechanism for the chimerism in a patient with a 46,XX/47,XY,+14 karyotype and ambiguous genitalia, cryptorchidism, pigment anomalies, and normal psychomotor development. We have used karyotyping, interphase-FISH and array-CGH analysis as well as molecular analysis of polymorphic markers from 48 loci in order to define the origin and percentage of 47,XY,+14 cells in different tissues. Based on the findings of two paternal alleles and the detection of homozygous maternal alleles without evidence of crossing-over, and the fact that four alleles were never detected, our results indicate that the chimerism in our patient is the result of dispermic fertilization of a parthenogenetically activated oocyte. Our report underlines that cytogenetic findings suggesting mosaicism might actually indicate chimerism as an underlying mechanism in patients. It also highlights the difficulties in predicting the clinical outcome in patients with genetic aberrations in mosaic or chimeric form.
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| 4. |
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| 7. |
- Bostrom, Anne-Marie, et al.
(författare)
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Factors associated with evidence-based practice among registered nurses in Sweden : a national cross-sectional study
- 2013
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Ingår i: BMC Health Services Research. - : BioMed Central. - 1472-6963. ; 13
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Tidskriftsartikel (refereegranskat)abstract
- Background: Evidence-based practice (EBP) is emphasized to increase the quality of care and patient safety. EBP is often described as a process consisting of distinct activities including, formulating questions, searching for information, compiling the appraised information, implementing evidence, and evaluating the resulting practice. To increase registered nurses' (RNs') practice of EBP, variables associated with such activities need to be explored. The aim of the study was to examine individual and organizational factors associated with EBP activities among RNs 2 years post graduation.Methods: A cross-sectional design based on a national sample of RNs was used. Data were collected in 2007 from a cohort of RNs, included in the Swedish Longitudinal Analyses of Nursing Education/Employment study. The sample consisted of 1256 RNs (response rate 76%). Of these 987 RNs worked in healthcare at the time of the data collection. Data was self-reported and collected through annual postal surveys. EBP activities were measured using six single items along with instruments measuring individual and work-related variables. Data were analyzed using logistic regression models.Results: Associated factors were identified for all six EBP activities. Capability beliefs regarding EBP was a significant factor for all six activities (OR = 2.6 - 7.3). Working in the care of older people was associated with a high extent of practicing four activities (OR = 1.7 - 2.2). Supportive leadership and high collective efficacy were associated with practicing three activities (OR = 1.4 - 2.0).Conclusions: To be successful in enhancing EBP among newly graduated RNs, strategies need to incorporate both individually and organizationally directed factors.
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| 8. |
- Bremer, Anna, et al.
(författare)
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Copy number variation characteristics in subpopulations of patients with autism spectrum disorders.
- 2011
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Ingår i: American Journal of Medical Genetics, Part B, Neuropsychiatric Genetics. - : Wiley. - 1552-4841. ; 156B156:2, s. 115-124
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Tidskriftsartikel (refereegranskat)abstract
- Autism spectrum disorders (ASDs) are a heterogeneous group of disorders with a complex genetic etiology. We used high-resolution whole genome array-based comparative genomic hybridization (array-CGH) to screen 223 ASD patients for gene dose alterations associated with susceptibility for autism. Clinically significant copy number variations (CNVs) were identified in 18 individuals (8%), of which 9 cases (4%) had de novo aberrations. In addition, 20 individuals (9%) were shown to have CNVs of unclear clinical relevance. Among these, 13 cases carried rare but inherited CNVs that may increase the risk for developing ASDs, while parental samples were unavailable in the remaining seven cases. Classification of all patients into different phenotypic and inheritance pattern groups indicated the presence of different CNV patterns in different patient groups. Clinically relevant CNVs were more common in syndromic cases compared to non-syndromic cases. Rare inherited CNVs were present in a higher proportion of ASD cases having first- or second-degree relatives with an ASD-related neuropsychiatric phenotype in comparison with cases without reported heredity (P=0.0096). We conclude that rare CNVs, encompassing potential candidate regions for ASDs, increase the susceptibility for the development of ASDs and related neuropsychiatric disorders giving us further insight into the complex genetics underlying ASDs
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| 9. |
- DeKeyser, Nicholas, et al.
(författare)
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Total cost comparison of standard antenatal care with a weight gain restriction programme for obese pregnant women
- 2011
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Ingår i: Public Health. - : Elsevier Science B.V., Amsterdam. - 0033-3506 .- 1476-5616. ; 125:5, s. 311-317
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To perform a cost comparison of a weight gain restriction programme for obese pregnant women with standard antenatal care, and to identify if there were differences in healthcare costs within the intervention group related to degree of gestational weight gain or degree of obesity at programme entry. Study design: A comparison of mean healthcare costs for participants of an intervention study at antenatal care clinics with controls in south-east Sweden. Methods: In total, 155 women in an intervention group attempted to restrict their gestational weight gain to less than7 kg. The control group comprised 193 women. Mean costs during pregnancy, delivery and the neonatal period were compared with the costs of standard care. Costs were converted from Swedish Kronor to Euros ((sic)). Results: Healthcare costs during pregnancy were lower in the intervention group. There was no significant difference in total healthcare costs (i.e. sum of costs during pregnancy, delivery and the neonatal period) between the intervention group and the control group. Within the intervention group, the subgroup that gained 4.5-9.5 kg had the lowest costs. The total cost, including intervention costs, was (sic)1283 more per woman/ infant in the intervention group compared with the control group (P = 0.025). The degree of obesity at programme entry had no bearing on the outcome. Conclusions: The weight gain restriction programme for obese pregnant women was effective in restricting gestational weight gain to less than7 kg, but had a higher total cost compared with standard antenatal care.
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| 10. |
- Ehrenberg, Anna, et al.
(författare)
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New graduate nurses' developmental trajectories for capability beliefs concerning core competencies for healthcare professionals : A national cohort study on patient-centered care, teamwork and evidence-based practice.
- 2016
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Ingår i: Worldviews on Evidence-Based Nursing. - : Wiley. - 1545-102X .- 1741-6787. ; 13:6, s. 454-462
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Tidskriftsartikel (refereegranskat)abstract
- Background:This study aimed to describe the developmental trajectories of registered nurses' capability beliefs during their first 3 years of practice. The focus was on three core competencies for health professionals-patient-centered care, teamwork, and evidence-based practice.Methods:A national cohort of registered nurses (n = 1,205) was recruited during their nursing education and subsequently surveyed yearly during the first 3 years of working life. The survey included 16 items on capability beliefs divided into three subscales for the assessment of patient-centered care, teamwork, and evidence-based practice, and the data were analyzed with linear latent growth modeling.Results:The nurses' capability beliefs for patient-centered care increased over the three first years of working life, their capability beliefs for evidence-based practice were stable over the 3 years, and their capability beliefs for teamwork showed a downward trend.Linking evidence to action:Through collaboration between nursing education and clinical practice, the transition to work life could be supported and competence development in newly graduated nurses could be enhanced to help them master the core competencies. Future research should focus on determining which factors impact the development of capability beliefs in new nurses and how these factors can be developed by testing interventions.
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| 11. |
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| 12. |
- Gad, Helge, et al.
(författare)
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MTH1 inhibition eradicates cancer by preventing sanitation of the dNTP pool
- 2014
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Ingår i: Nature. - : Nature Publishing Group. - 0028-0836 .- 1476-4687. ; 508:7495, s. 215-221
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Tidskriftsartikel (refereegranskat)abstract
- Cancers have dysfunctional redox regulation resulting in reactive oxygen species production, damaging both DNA and free dNTPs. The MTH1 protein sanitizes oxidized dNTP pools to prevent incorporation of damaged bases during DNA replication. Although MTH1 is non-essential in normal cells, we show that cancer cells require MTH1 activity to avoid incorporation of oxidized dNTPs, resulting in DNA damage and cell death. We validate MTH1 as an anticancer target in vivo and describe small molecules TH287 and TH588 as first-in-class nudix hydrolase family inhibitors that potently and selectively engage and inhibit the MTH1 protein in cells. Protein co-crystal structures demonstrate that the inhibitors bindin the active site of MTH1. The inhibitors cause incorporation of oxidized dNTPs in cancer cells, leading to DNA damage, cytotoxicity and therapeutic responses in patient-derived mouse xenografts. This study exemplifies the non-oncogene addiction concept for anticancer treatment and validates MTH1 as being cancer phenotypic lethal.
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| 13. |
- Gustavsson, Martin G H, et al.
(författare)
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The Atomic Nucleus
- 2003
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Ingår i: "Handbook of Molecular Physics and Quantum Chemistry". - : Wiley. ; , s. 477-484
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Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
- As molecules and heavy atoms get invoked for studies of fundamental interactions and properties, the demand for more accurate descriptions of the wavefunction within and close to the nucleus grow more stringent. With the generally increasing precision of quantum chemistry calculations, the simple point-nucleus approximation, resulting in the well-known Z=r potential, is no longer completely adequate. The inadequacy becomes more and more evident as quantum chemistry takes on the challenge of molecules including heavy, or even superheavy, atoms: For large Z, the behaviour close to the nucleus becomes too singular for a point nuclear charge, and for the|still hypothetical|case of Z > 137, the Dirac equation breaks down. For finite nuclear distributions, the possible range extends much further. Many properties depend on details of the nuclear structure. What are the alternatives for the nuclear distributions used in calculations? What are their advantages and disadvantages from a computational point of view? How should calculated results be presented in order to make possible meaningful comparisons between results obtained using different approaches? How much is known experimentally and how is that information best included in the calculations? These are a few of the questions addressed in this chapter. This chapter focuses mainly on the distribution of charge, which, however influences also other properties.
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| 14. |
- Laikre, Linda, et al.
(författare)
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Wanted : Scientists in the CBD process
- 2008
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Ingår i: Conservation Biology. - : Wiley. - 0888-8892 .- 1523-1739. ; 22:4, s. 814-815
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Tidskriftsartikel (refereegranskat)
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| 15. |
- Lindstrand, Anna, et al.
(författare)
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From cytogenetics to cytogenomics : whole-genome sequencing as a first-line test comprehensively captures the diverse spectrum of disease-causing genetic variation underlying intellectual disability
- 2019
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Ingår i: Genome Medicine. - : BMC. - 1756-994X. ; 11:1
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundSince different types of genetic variants, from single nucleotide variants (SNVs) to large chromosomal rearrangements, underlie intellectual disability, we evaluated the use of whole-genome sequencing (WGS) rather than chromosomal microarray analysis (CMA) as a first-line genetic diagnostic test.MethodsWe analyzed three cohorts with short-read WGS: (i) a retrospective cohort with validated copy number variants (CNVs) (cohort 1, n=68), (ii) individuals referred for monogenic multi-gene panels (cohort 2, n=156), and (iii) 100 prospective, consecutive cases referred to our center for CMA (cohort 3). Bioinformatic tools developed include FindSV, SVDB, Rhocall, Rhoviz, and vcf2cytosure.ResultsFirst, we validated our structural variant (SV)-calling pipeline on cohort 1, consisting of three trisomies and 79 deletions and duplications with a median size of 850kb (min 500bp, max 155Mb). All variants were detected. Second, we utilized the same pipeline in cohort 2 and analyzed with monogenic WGS panels, increasing the diagnostic yield to 8%. Next, cohort 3 was analyzed by both CMA and WGS. The WGS data was processed for large (>10kb) SVs genome-wide and for exonic SVs and SNVs in a panel of 887 genes linked to intellectual disability as well as genes matched to patient-specific Human Phenotype Ontology (HPO) phenotypes. This yielded a total of 25 pathogenic variants (SNVs or SVs), of which 12 were detected by CMA as well. We also applied short tandem repeat (STR) expansion detection and discovered one pathologic expansion in ATXN7. Finally, a case of Prader-Willi syndrome with uniparental disomy (UPD) was validated in the WGS data.Important positional information was obtained in all cohorts. Remarkably, 7% of the analyzed cases harbored complex structural variants, as exemplified by a ring chromosome and two duplications found to be an insertional translocation and part of a cryptic unbalanced translocation, respectively.ConclusionThe overall diagnostic rate of 27% was more than doubled compared to clinical microarray (12%). Using WGS, we detected a wide range of SVs with high accuracy. Since the WGS data also allowed for analysis of SNVs, UPD, and STRs, it represents a powerful comprehensive genetic test in a clinical diagnostic laboratory setting.
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| 16. |
- Lindstrand, Anna, et al.
(författare)
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Genome sequencing is a sensitive first-line test to diagnose individuals with intellectual disability
- 2022
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Ingår i: Genetics in Medicine. - : ELSEVIER SCIENCE INC. - 1098-3600 .- 1530-0366. ; 24:11, s. 2296-2307
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: Individuals with intellectual disability (ID) and/or neurodevelopment disorders (NDDs) are currently investigated with several different approaches in clinical genetic diagnostics. Methods: We compared the results from 3 diagnostic pipelines in patients with ID/NDD: genome sequencing (GS) first (N = 100), GS as a secondary test (N = 129), or chromosomal microarray (CMA) with or without FMR1 analysis (N = 421). Results: The diagnostic yield was 35% (GS -first), 26% (GS as a secondary test), and 11% (CMA/FMR1). Notably, the age of diagnosis was delayed by 1 year when GS was performed as a secondary test and the cost per diagnosed individual was 36% lower with GS first than with CMA/FMR1. Furthermore, 91% of those with a negative result after CMA/FMR1 analysis (338 individuals) have not yet been referred for additional genetic testing and remain undiagnosed. Conclusion: Our findings strongly suggest that genome analysis outperforms other testing strategies and should replace traditional CMA and FMR1 analysis as a first-line genetic test in individuals with ID/NDD. GS is a sensitive, time-and cost-effective method that results in a confirmed molecular diagnosis in 35% of all referred patients. (c) 2022 The Authors. Published by Elsevier Inc. on behalf of American College of Medical Genetics and Genomics. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
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| 17. |
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| 18. |
- Mårtensson-Pendrill, Ann-Marie, 1952, et al.
(författare)
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The atomic nucleus : Atomkärnan
- 2003
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Ingår i: Handbook of Molecular Physics and Quantum Chemistry. - : Wiley. ; , s. 477-484
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 19. |
- Rudman, Ann, et al.
(författare)
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Registered nurses' evidence-based practice : a longitudinal study of the first five years after graduation
- 2012
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Ingår i: International Journal of Nursing Studies. - London, UK : Elsevier. - 0020-7489 .- 1873-491X. ; 49:12, s. 1494-1504
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The capacity to provide evidence-based practice is one of five core competencies that it is proposed all healthcare professions should possess to meet the needs of the 21st century healthcare system. New nurses are faced with a challenging work environment which, combined with shortcomings in undergraduate education and their limited clinical experience, may affect their evidence-based practice.OBJECTIVE: The aim of this study was to prospectively examine the extent of Swedish nurses' evidence-based practice during the first five years of professional life.DESIGN: An observational longitudinal study, with yearly data collections over the course of five years. SETTINGS: Data was collected in two national cohorts (named EX2004 and EX2006) of Swedish registered nurses. Nurses in EX2006 were followed yearly during the first three years after graduation and nurses in EX2004 yearly three to five years after graduation. They had completed a three year academic nursing program and mainly worked in in-patient care settings.PARTICIPANTS: Participants were recruited while studying at any of the 26 universities in Sweden. A total of 2107 (EX2006) and 2331 (EX2004) nursing students were eligible. 1207 and 1227 nurses were included in the current longitudinal samples. The nurses had a mean age of 31.2/33.9years old and a majority were female. The cohorts were representative of the general nursing population.METHODS: Data was self-reported and collected through annual postal surveys. Evidence-based practice was conceptualized as a process and measured with an instrument including six items. Data was analyzed using latent growth curve modeling.RESULTS: The extent of evidence-based practice was stable, between the two cohorts and over time. Individual differences existed and remained stable over time. However, the extent of practicing the different components of evidence-based practice on a monthly basis varied considerably, from 10% of the nurses (appraising research reports) to 80% (using information sources other than databases to search for knowledge).CONCLUSION: The extent of evidence-based practice remained unchanged during the first five years of professional life. It appears important to enhance both the contribution of undergraduate education and the contextual conditions in work life, in order to improve evidence-based practice among newly graduated nurses.
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| 22. |
- Rudman, Ann, et al.
(författare)
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Sjuksköterskor i frontlinjen av COVID-19 pandemin : vilka blev konsekvenserna? Teknisk rapport om enkät och datainsamling
- 2022
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Denna rapport summerar datainsamlingen som genomfördes av SCB (Statistiska centralbyrån) i projektet ”Sjuksköterskor i frontlinjen av COVID-19 pandemin: Vilka blev konsekvenserna?”. Projektet är finansierat av AFA försäkring (Diarienr 200311). I kapitel 1 beskrivs bakgrund till LUST (Longitudinell Undersökning om Sjuksköterskors Tillvaro) studien. I kapitel 2 beskrivs studien utifrån design, rekrytering och datainsamling. I kapitel 3 redovisas översikt över innehållet i enkäten som skickades ut studiedeltagarna. Projektet bedrivs på Högskolan Dalarna och inom ramen för Petter Gustavssons forskargrupp vid Karolinska Institutet.Sjuksköterskor har varit i frontlinjen av COVID-19-pandemin och de stressorer som de utsatts för i sitt arbete inom hälso- och sjukvården kan orsaka hälsoproblem. I föreliggande projekt har en nationell kartläggning av sjuksköterskors arbetssituation och hälsa under COVID-19 pandemin gjorts. Undersökningen är gjord utifrån de tre sjuksköterskekohorter som följts inom ramen för LUST-studien sedan 2002 (Gustavsson et al., 2013; Rudman, Hörberg, et al., 2020; Rudman et al., 2010). I LUST-studien har närmare 4500 sjuksköterskestudenter följts med uppföljande enkäter från deras utbildningstid 11 till 15 år efter examen. En uppföljande enkätundersökning genomfördes i september 2021 till januari 2022 vilket motsvarar 15 till 19 år efter examen. En speciellt anpassad enkät med relevans och aktualitet för arbetet under pandemin hade utvecklats gemensamt med forskare som har expertis gällande sjuksköterskor i olika verksamheter som belastats under COVID-19 pandemin. Enkäterna besvarades när pandemin pågått i ungefär ett år och nio månader.I samarbete med SCB har datainsamlingen genomförts som en postenkät med påminnelser och med möjlighet att besvara frågorna online. Svarsfrekvensen för enkätstudien blev 57% för hela undersökningen (för samtliga kohorter), vilket bedöms vara en hög svarsfrekvens med tanke på hur belastad sjuksköterskekåren har varit under COVID-19 pandemin.
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| 23. |
- Sydsjö, Gunilla, et al.
(författare)
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Effects of a weight-gain restriction programme for obese pregnant women on sickness absence and pregnancy benefits
- 2013
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Ingår i: Scandinavian Journal of Primary Health Care. - : Informa Healthcare. - 0281-3432 .- 1502-7724. ; 31:2, s. 106-110
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Tidskriftsartikel (refereegranskat)abstract
- Objective. To evaluate the effect of a weight-gain restriction programme for obese pregnant women on sickness absence days and pregnancy benefit days during pregnancy and postpartum.Design. A prospective, controlled intervention study. The Swedish Social Security Agency's records were utilized to compile sickness absence and pregnancy benefit information.Setting. Antenatal care clinics in the south-east of Sweden.Subjects. One hundred fifty-five obese pregnant women who participated in a weight restriction program with weekly structured motivational and behavioural talks combined with aqua-aerobics during pregnancy. A total of 193 obese pregnant women with no intervention served as controls.Main outcome measures. Sickness absence benefits and pregnancy benefits expressed as a percentage.Results. On average women in the intervention group had 76.68 total full days of sickness absence benefit compared with 53.09days in the control group. Total full days of pregnancy benefits were 39.66% days and 41.41% for the intervention and control groups respectively. For the women who were on sick leave there were no differences between the groups in the amount of days taken.Conclusions. Given the complexity of factors that have an influence on sickness absence leave, it is possible that programmes that do not address the influence of social aspects and attitudes towards sickness absence have limited effect.
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