| 1. |
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| 2. |
- Duong, Thi Hoa, et al.
(författare)
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Micturition pattern in young boys with posterior urethral valves—A pilot study in small boys who are potty-trained from infancy
- 2013
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Ingår i: Open Journal of Pediatrics. - : Scientific Research Publishing, Inc.. - 2160-8741 .- 2160-8776. ; 03, s. 358-363
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: To investigate if potty training from infancy can affect bladder dysfunction in boys with posterior urethral valves (PUV). Subjects and Meth- ods: The voiding pattern and emptying ability were followed using the 4-hour voiding observation method in 17 Vietnamese boys with PUV aged 3 months to 4 years who had been potty-trained from infancy. This group was compared with a group of healthy Viet- namese boys. Results: In the boys with PUV, the bladder volume increased according to age, and in- terrupted voiding was rare. However, when compar- ing boys with PUV with healthy boys, a significant difference was noted with more frequent voidings and lower voided volumes in the age group 0 - 1 year (P < 0.001). Despite the minimum amount of residual urine, average 8 ml or less in the boys with PUV, the age groups 1 - 2 and 2 - 4 years had significantly higher residual volumes compared with those of the healthy boys (P < 0.001). Conclusion: The findings from the 4-hour voiding observation showed few signs of dysfunctional bladder in the Vietnamese boys with PUV, including residual urine, even if there were signs of dysfunction compared with the healthy Viet- namese boys. Potty training from infancy could favor early bladder rehabilitation in boys with PUV.
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| 3. |
- Duong, Thi Hoa, et al.
(författare)
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Urinary bladder control during the first 3years of life in healthy children in Vietnam - A comparison study with Swedish children.
- 2013
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Ingår i: Journal of Pediatric Urology. - : Elsevier BV. - 1477-5131 .- 1873-4898. ; 9:6, s. 700-706
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To study outcomes of early potty training in a population of healthy children with a tradition of early potty training and to compare these findings with a group of children to whom potty training was applied later. SUBJECTS AND METHODS: Mothers and their 47 healthy children in Vietnam participated in this longitudinal study. The voiding pattern and emptying ability were followed by the 4-hvoiding observation method from 3 months to 3 years of age. A comparison is made with a group of 57 Swedish children investigated in a similar manner. RESULTS: In the group of Vietnamese children, 89% were on daily potty training at the age of 6 months. At the age of 24 months, potty training was complete for 98%. In the Swedish group, just a few (5%) had started daily potty training by the age of 24 months (p<0.001). The Vietnamese group had fewer voidings and lower voided volumes than the Swedish group. In the Vietnamese children, bladder emptying could be regarded as having been completed, with no residual urine at 9 months, compared with the Swedish group, which first showed complete emptying at the age of 36 months. CONCLUSION: Potty training performed daily affects the emptying ability positively. In the Vietnamese group, no residual urine was found at the age of 9 months. These results differ significantly from those of the group of Swedish children.
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| 4. |
- Jansson, Ulla-Britt, 1950, et al.
(författare)
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Life events and their impact on bladder control in children.
- 2007
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Ingår i: Journal of pediatric urology. - : Elsevier BV. - 1873-4898 .- 1477-5131. ; 3:3, s. 171-7
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To investigate the relationship between incidence and nature of life events within families and age of bladder control acquisition in healthy children. SUBJECTS AND METHODS: Thirty-five parents of 36, 6-year-old children were interviewed using the Coddington life events questionnaire. RESULTS: The children had experienced a total of 185 life events (mean 5, median 4.5, range 1-12) before the time of dryness. The most common were related to childcare/occupation of parent (51%), illness/injury/death (24%), family composition (16%) and living conditions (9%). There was a strong correlation between the number of life events and the age of dryness; the more life events and the older the child was when experiencing them, the later the child became dry. The only single event that was significantly associated with a later age of dryness was the birth of a sister or brother. In general, children had reacted positively (39%) or neutrally, but to 30% of events there was a negative reaction. There was a correlation between the reaction of the child and adaptation to the life event, and if the child had difficulty adapting to an event, that child became day dry at a later age. CONCLUSION: Although life events are a natural part of daily life, this study supports the conclusion that a large number of events and events to which the child has difficulty adapting can be of importance for the age of acquisition of bladder control.
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| 5. |
- Jansson, Ulla-Britt, 1950, et al.
(författare)
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Voiding pattern and acquisition of bladder control from birth to age 6 years--a longitudinal study.
- 2005
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Ingår i: The Journal of urology. - : Ovid Technologies (Wolters Kluwer Health). - 0022-5347 .- 1527-3792. ; 174:1, s. 289-93
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: We describe the voiding pattern and acquisition of bladder control in healthy children up to age 6 years. MATERIALS AND METHODS: We determined age for daytime and nighttime dryness, voiding patterns, voiding volumes and post-void residual volume per 4 hours individually and noninvasively every 3 months up to age 3 years and every 6 months up to age 6 years in 36 female and 23 male patients using 4-hour voiding observation and uroflowmetry/ultrasound. RESULTS: Median age for attaining daytime and nighttime dryness was 3.5 and 4 years, respectively. No significant difference was found between girls and boys. All but 1 child attained daytime dryness an average of 10 months before attaining nighttime dryness. Bladder sensation was reported in 31%, 79% and 100% of patients at ages 2, 3 and 4 years, respectively. Median bladder capacity was 67 ml, 123 ml and 140 ml at years 1, 3 and 6, respectively. Median post-void residual volume was 5.5 ml, 0 ml and 2 ml at ages 1, 3 and 6 years, respectively. CONCLUSIONS: Today bladder control is acquired at a later stage despite earlier awareness of bladder function. The occurrence of bladder sensation from age 1.5 years motivates an earlier start with toilet training. Infants with small post-void residual volume at age 6 months or large bladder capacity will probably attain daytime dryness earlier than those with large post-void residual volume at age 6 months or small bladder capacity.
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| 6. |
- Jansson, Ulla-Britt, 1950, et al.
(författare)
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Voiding pattern in healthy children 0 to 3 years old: a longitudinal study.
- 2000
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Ingår i: The Journal of urology. - 0022-5347. ; 164:6, s. 2050-4
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: We describe the development of voiding patterns and bladder control in healthy children during the first 3 years of life. MATERIALS AND METHODS: We determined voiding patterns, bladder capacity and post-void residual urine volume per 4 hours individually and noninvasively every 3 months in 36 female and 23 male healthy infants using the 4-hour voiding observation. RESULTS: Voiding frequency decreased slowly from 5 to 2 voiding episodes per 4 hours from ages 3 months to 3 years. We noted interrupted voiding in 33% of subjects at age 3 months but this condition was rare after age 2 years. Voiding during sleep occurred mainly during the first 7 months of life and did not continue after age 18 months. Bladder capacity increased from a median of 52 to 67, 68 and 123 ml. during years 1 to 3, respectively. As measured by post-void residual urine volume, bladder emptying was unchanged during years 1 and 2 but it decreased during year 3 (median 6 versus 0 and mean 4 versus 3 ml. per 4 hours). CONCLUSIONS: During the first 3 years of life the number of voiding episodes, including interrupted voiding, post-void residual urine and voiding during sleep, decreased while bladder capacity increased.
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| 7. |
- Andersson, Alexander, et al.
(författare)
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Presence of Calcium Cations Stimulate Alkaline Hydrolysis of Cellulose During Kraft Pulping Conditions
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- Simulated kraft pulping has been performed on cotton linters fibers consisting of almost pure cellulose with varying content of calcium ions. These concentrations were obtained by soaking and drying cotton linters in calcium sulfate solutions. The viscosities of the pulped fibers were generally lower with higher calcium ion concentration and, therefore, in line with earlier suggested ideas that calcium ions could catalyze alkaline hydrolysis. The technical importance of these results is discussed.
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| 8. |
- Berends, Gerrit, 1965-
(författare)
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Skrivsamarbete i högre utbildning : Tre studenters skribentprofiler i kollaborativa skrivargrupper
- 2013
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The overarching aim of this thesis is to probe more deeply into how collaborative writing can help to socialise students in a writing practice. More specifically, the thesis deals with lab report writing and the relationship of three students with different backgrounds to the educational practices of a university department. The three students differ in language background, previous higher education and vocational experience. The material comprises recordings of student discussions while writing lab reports in a group. The students and their lab report writing in different group constellations has been followed longitudinally for between two to four semesters. In addition the development of the lab reports over time has been studied, as well as teachers’ comments on them. Student acquisition of the genre is linked to internal textual criteria (textual aspects) and to extratextual criteria in the educational context.In view of the study’s focus on group collaboration a socio-cultural perspective has been adopted as a frame. A model developed by Storch (2002) based on Vygotsky’s role relationships between expert and novice is used to shed light on how the students resolve problems related to the writing task through group discussions.The results show that the students’ backgrounds play a role in the creation of their profiles in the collaborative writing groups. The student with a second-language background often seeks support, not least where linguistic correctness is concerned, and cites what teachers say as arguments. The student with prior experience of academic writing appears to be a seasoned writer, for instance by daring to deviate from instructions and teachers’ directives. The third student uses his professional experience of writing lab reports in discussions to gain acceptance for his ideas.
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| 9. |
- Chantzichristos, Dimitrios, 1976, et al.
(författare)
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Identification of human glucocorticoid response markers using integrated multi-omic analysis from a randomized crossover trial.
- 2021
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Ingår i: eLife. - 2050-084X. ; 10
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Tidskriftsartikel (refereegranskat)abstract
- Glucocorticoids are among the most commonly prescribed drugs, but there is no biomarker that can quantify their action. The aim of the study was to identify and validate circulating biomarkers of glucocorticoid action.In a randomized, crossover, single-blind, discovery study, 10 subjects with primary adrenal insufficiency (and no other endocrinopathies) were admitted at the in-patient clinic and studied during physiological glucocorticoid exposure and withdrawal. A randomization plan before the first intervention was used. Besides mild physical and/or mental fatigue and salt craving, no serious adverse events were observed. The transcriptome in peripheral blood mononuclear cells and adipose tissue, plasma miRNAomic, and serum metabolomics were compared between the interventions using integrated multi-omic analysis.We identified a transcriptomic profile derived from two tissues and a multi-omic cluster, both predictive of glucocorticoid exposure. A microRNA (miR-122-5p) that was correlated with genes and metabolites regulated by glucocorticoid exposure was identified (p=0.009) and replicated in independent studies with varying glucocorticoid exposure (0.01 ≤ p≤0.05).We have generated results that construct the basis for successful discovery of biomarker(s) to measure effects of glucocorticoids, allowing strategies to individualize and optimize glucocorticoid therapy, and shedding light on disease etiology related to unphysiological glucocorticoid exposure, such as in cardiovascular disease and obesity.The Swedish Research Council (Grant 2015-02561 and 2019-01112); The Swedish federal government under the LUA/ALF agreement (Grant ALFGBG-719531); The Swedish Endocrinology Association; The Gothenburg Medical Society; Wellcome Trust; The Medical Research Council, UK; The Chief Scientist Office, UK; The Eva Madura's Foundation; The Research Foundation of Copenhagen University Hospital; and The Danish Rheumatism Association.NCT02152553.
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| 10. |
- Day, Annika L., et al.
(författare)
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An evaluation of daily relaxation training and psychosomatic symptoms in young children
- 2016
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Ingår i: Health Behavior and Policy Review. - : Paris Scholar Publishing. - 2326-4403. ; 3:3, s. 198-208
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: We evaluated the efficacy of daily relaxation training on psychosomatic symptoms during one school year among 8-year-old children. Methods: Cortisol in saliva, abdominal circumference including body mass index (BMI), heart rate, rate pressure product (RPP), and stress in children (SIC) were measured. Teachers in the intervention classes were interviewed. The intervention consisted of a daily relaxation therapy (RT). Results: The intervention group showed reduced heart rate. Individuals of the intervention group showed an improvement regarding headaches and the ability to fall asleep. The qualitative results showed that the RT had a calming effect on both the children and the teachers. Conclusions: RT among children may be of use to cope with stress as interpreted by some improved parameters in the intervention group.
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| 11. |
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| 12. |
- de Brun, Maryam, 1991-, et al.
(författare)
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Changing diagnostic criteria for gestational diabetes (CDC4G) in Sweden : A stepped wedge cluster randomised trial
- 2024
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Ingår i: PLoS Medicine. - : Public Library of Science (PLoS). - 1549-1277 .- 1549-1676. ; 21:7
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The World Health Organisation (WHO) 2013 diagnostic criteria for gestational diabetes mellitus (GDM) has been criticised due to the limited evidence of benefits on pregnancy outcomes in different populations when switching from previously higher glycemic thresholds to the lower WHO-2013 diagnostic criteria. The aim of this study was to determine whether the switch from previous Swedish (SWE-GDM) to the WHO-2013 GDM criteria in Sweden following risk factor-based screening improves pregnancy outcomes.METHODS AND FINDINGS: A stepped wedge cluster randomised trial was performed between January 1 and December 31, 2018 in 11 clusters (17 delivery units) across Sweden, including all pregnancies under care and excluding preexisting diabetes, gastric bypass surgery, or multifetal pregnancies from the analysis. After implementation of uniform clinical and laboratory guidelines, a number of clusters were randomised to intervention (switch to WHO-2013 GDM criteria) each month from February to November 2018. The primary outcome was large for gestational age (LGA, defined as birth weight >90th percentile). Other secondary and prespecified outcomes included maternal and neonatal birth complications. Primary analysis was by modified intention to treat (mITT), excluding 3 clusters that were randomised before study start but were unable to implement the intervention. Prespecified subgroup analysis was undertaken among those discordant for the definition of GDM. Multilevel mixed regression models were used to compare outcome LGA between WHO-2013 and SWE-GDM groups adjusted for clusters, time periods, and potential confounders. Multiple imputation was used for missing potential confounding variables. In the mITT analysis, 47 080 pregnancies were included with 6 882 (14.6%) oral glucose tolerance tests (OGTTs) performed. The GDM prevalence increased from 595/22 797 (2.6%) to 1 591/24 283 (6.6%) after the intervention. In the mITT population, the switch was associated with no change in primary outcome LGA (2 790/24 209 (11.5%) versus 2 584/22 707 (11.4%)) producing an adjusted risk ratio (aRR) of 0.97 (95% confidence interval 0.91 to 1.02, p = 0.26). In the subgroup, the prevalence of LGA was 273/956 (28.8%) before and 278/1 239 (22.5%) after the switch, aRR 0.87 (95% CI 0.75 to 1.01, p = 0.076). No serious events were reported. Potential limitations of this trial are mainly due to the trial design, including failure to adhere to guidelines within and between the clusters and influences of unidentified temporal variations.CONCLUSIONS: In this study, implementing the WHO-2013 criteria in Sweden with risk factor-based screening did not significantly reduce LGA prevalence defined as birth weight >90th percentile, in the total population, or in the subgroup discordant for the definition of GDM. Future studies are needed to evaluate the effects of treating different glucose thresholds during pregnancy in different populations, with different screening strategies and clinical management guidelines, to optimise women's and children's health in the short and long term.TRIAL REGISTRATION: The trial is registered with ISRCTN (41918550).
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| 13. |
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| 14. |
- Duong, Thi Hoa, et al.
(författare)
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Vietnamese mothers' experiences with potty training procedure for children from birth to 2 years of age.
- 2013
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Ingår i: Journal of pediatric urology. - : Elsevier BV. - 1873-4898 .- 1477-5131. ; 9:6, Part A, s. 808-814
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: This study addresses mothers' experiences with potty training in a Vietnamese population. SUBJECTS AND METHODS: Forty-seven mothers were interviewed and followed from the time that their children were newborns until they were 24-months old. The interviews were analyzed using qualitative content analysis. RESULTS: According to tradition, diapers were used only rarely. The mothers used a whistling sound at certain times to remind their children to eliminate and frequently checked for signs of need. With this process, all children used the potty by the age of 9 months. At the age of 24 months the potty training was completed, and most of the children managed the whole process independent of help. CONCLUSION: This study shows that it is possible to start potty training with good outcomes very early in life. The process described can be achieved through an ongoing communication between parent and child.
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| 15. |
- Ekman, Stina, et al.
(författare)
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Effect of circadian rhythm, age, training and acute lameness on serum concentrations of cartilage oligomeric matrix protein (COMP) neo-epitope in horses
- 2019
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Ingår i: Equine Veterinary Journal. - : Wiley. - 0425-1644 .- 2042-3306. ; 51:5, s. 674-680
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Tidskriftsartikel (refereegranskat)abstract
- Background Molecular serum markers that can identify early reversible osteoarthritis (OA) in horses are lacking. Objectives We studied serum concentrations of a novel cartilage oligomeric matrix protein (COMP) neo-epitope in horses subjected to short-term exercise and with acute lameness. The effects of circadian rhythm and age were also evaluated. Study design Longitudinal studies in healthy horses and cross-sectional comparison of lame and non-lame horses. Methods Sera were collected from five horses before and after short-term interval exercise and during full-day box rest. Sera from 32 acutely lame horses were used to evaluate age-related effects. Independent samples from control horses (n = 41) and horses with acute lameness (n = 71) were included. COMP neo-epitope concentrations were analysed using custom-developed inhibition ELISAs validated for equine serum. The presence of COMP neo-epitope was delineated in healthy and osteoarthritic articular cartilage with immunohistochemistry. Results COMP neo-epitope concentrations decreased after speed training but returned to baseline levels post-exercise. No correlations between age and serum COMP neo-epitope concentrations were found (r = 0.0013). The mean (+/- s.d.) serum concentration of COMP neo-epitope in independent samples from non-lame horses was 0.84 +/- 0.38 mu g/mL, and for lame horses was 5.24 +/- 1.83 mu g/mL (P<0.001). Antibodies against COMP neo-epitope did not stain normal articular cartilage, but intracytoplasmic staining was found in superficial chondrocytes of mild OA cartilage and in the extracellular matrix of moderately osteoarthritic cartilage. Main limitations ELISA was based on polyclonal antisera rather than a monoclonal antibody. There is a sex and breed bias within the groups of horses, also it could have been of value to include horses with septic arthritis and tendonitis and investigated joint differences. Conclusions This COMP neo-epitope can be measured in sera, and results indicate that it could be a biomarker for pathologic fragmentation of cartilage in connection with acute joint lameness.
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| 16. |
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| 17. |
- Fadl, Helena, 1965-, et al.
(författare)
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Changing diagnostic criteria for gestational diabetes in Sweden-a stepped wedge national cluster randomised controlled trial-the CDC4G study protocol
- 2019
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Ingår i: Bmc Pregnancy and Childbirth. - : Springer Science and Business Media LLC. - 1471-2393. ; 19:1
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Tidskriftsartikel (refereegranskat)abstract
- Background The optimal criteria to diagnose gestational diabetes mellitus (GDM) remain contested. The Swedish National Board of Health introduced the 2013 WHO criteria in 2015 as a recommendation for initiation of treatment for hyperglycaemia during pregnancy. With variation in GDM screening and diagnostic practice across the country, it was agreed that the shift to new guidelines should be in a scientific and structured way. The aim of the Changing Diagnostic Criteria for Gestational Diabetes (CDC4G) in Sweden () is to evaluate the clinical and health economic impacts of changing diagnostic criteria for GDM in Sweden and to create a prospective cohort to compare the many long-term outcomes in mother and baby under the old and new diagnostic approaches. Methods This is a stepped wedge cluster randomised controlled trial, comparing pregnancy outcomes before and after the switch in GDM criteria across 11 centres in a randomised manner. The trial includes all pregnant women screened for GDM across the participating centres during January-December 2018, approximately two thirds of all pregnancies in Sweden in a year. Women with pre-existing diabetes will be excluded. Data will be collected through the national Swedish Pregnancy register and for follow up studies other health registers will be included. Discussion The stepped wedge RCT was chosen to be the best study design for evaluating the shift from old to new diagnostic criteria of GDM in Sweden. The national quality registers provide data on the whole pregnant population and gives a possibility for follow up studies of both mother and child. The health economic analysis from the study will give a solid evidence base for future changes in order to improve immediate pregnancy, as well as long term, outcomes for mother and child.
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| 18. |
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Geographies of Communication. The Spatial Turn in Media Studies
- 2006
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Samlingsverk (redaktörskap) (övrigt vetenskapligt/konstnärligt)abstract
- The relationship between space and communication is becoming more complex. Mediatisation blurs the boundaries between different spaces, as well as between dimensions of space. It also leads to the re-articulation of geographical territories – often (re)producing socio-political values and power struggles. This book departs from the assertion that the changing character of media society calls for a spatial turn in media studies. There are clear signs that such a turn is on its way. But no account has yet been formulated for the full potential of this. Gathering new analyses from leading Nordic media scholars, geographers and ethnologists, this book provides a broad view of the perspectives that emerge from the spatial turn. The chapters explore issues such as (trans)nationality, tourism, urban culture, interactive media, and the networking of domestic space. Together, they map out what might become a new sub-field within media and cultural studies: the geography of communication.
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| 19. |
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| 20. |
- Graneheim, Ulla Hällgren, et al.
(författare)
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The meaning of living with dementia and disturbing behaviour as narrated by three persons admitted to a residential home.
- 2006
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Ingår i: Journal of Clinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 15:11, s. 1397-403
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Tidskriftsartikel (refereegranskat)abstract
- AIM: The aim of our study was to illuminate the meaning of living with dementia and disturbing behaviour, as narrated by three persons admitted to a residential home. BACKGROUND: Living with dementia and so-called disturbing behaviour in an institution involves interaction with care providers and fellow residents and poses a challenge to all who are involved. METHODS: We asked the head nurses at a residential home to select persons with dementia and disturbing behaviour who were willing to be interviewed and able to communicate verbally. We performed 10 informal conversational interviews with three persons. The interviews were transcribed into text and interpreted using a phenomenological hermeneutic method inspired by Ricoeur's philosophy. RESULTS: The findings indicate that the meaning of living with dementia and disturbing behaviour, as narrated by three persons admitted to a residential home, is about being surrounded by disorder, being trapped by restriction and being set aside, as well as about being included. The findings are interpreted as a collapse of relations to self and others intertwined with occasional episodes of togetherness. This is reflected on in relation to the literature on homelessness and at-homeness and loss and maintenance of personal and social selves. RELEVANCE TO CLINICAL PRACTICE: The view others have of the person with dementia and of disturbing behaviour determines the nursing care given. Taking the residents' personal history and actual context into account, disturbing behaviour may be seen as a way persons with dementia express their story and maintain their self.
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| 21. |
- Grim, Katarina, 1971-, et al.
(författare)
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Legitimizing user knowledge in mental health services : Epistemic (in)justice and barriers to knowledge integration
- 2022
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Ingår i: Frontiers in Psychiatry. - Lausanne : Frontiers Media S.A.. - 1664-0640. ; 13
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Tidskriftsartikel (refereegranskat)abstract
- Including the voices and knowledge of service users is essential for developing recovery-oriented and evidence-based mental health services. Recent studies have however, suggested that challenges remain to the legitimization of user knowledge in practice. To further explore such challenges, a co-production study was conducted by a team of researchers and representatives from user organizations in Sweden. The aim of the study was to explore the barriers and facilitators to the legitimacy of user knowledge, as a central factor in sustainably implementing user influence in mental health practice. A series of workshops, with representatives of mental health services and user organizations were conducted by the research team to explore these issues. The analysis built on the theoretical framework of epistemic injustice, and the underlying aspects, testimonial, hermeneutic and participation-based injustice, were utilized as a framework for a deductive analysis. Results suggest that this is a useful model for exploring the complex dynamics related to the legitimacy of user knowledge in mental health systems. The analysis suggests that the legitimacy of user knowledge is related to the representativeness of the knowledge base, the systematic formulation of this knowledge inapplicable methods, access to resources and positions within the mental health system and participation in the process of integrating this knowledge-base in mental health contexts. Legitimizing user knowledge in practice additionally challenges mental health systems to support readiness for change in working environments and to address the power and role issues that these changes involve. Copyright © 2022 Grim, Näslund, Allaskog, Andersson, Argentzell, Broström, Jenneteg, Jansson, Schön, Svedberg, Svensson, Wåhlstedt and Rosenberg.
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| 22. |
- Hallgren Graneheim, Ulla, et al.
(författare)
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Hovering between Heaven and Hell : An Observational Study Focusing on the Interactions between One Woman with Schizophrenia, Dementia, and Challenging Behaviour and her Care Providers
- 2015
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Ingår i: Issues in Mental Health Nursing. - : Taylor & Francis. - 0161-2840 .- 1096-4673. ; 36:7, s. 543-550
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Tidskriftsartikel (refereegranskat)abstract
- This case study aims to illuminate the interactions between one woman (Alice) with schizophrenia, dementia, and challenging behaviour and her professional caregivers. We performed participant observations of these interactions and conducted informal interviews at the residential home where the woman lived. The transcripts were subjected to qualitative content analysis. The results showed that the interactions between Alice and her caregivers were experienced as hovering between heaven and hell. Alice struggled to bring order into her chaotic life world by splitting herself and others, and her caregivers struggled to protect Alice's and their own dignity by limiting her challenging behaviours. They also strived to understand their own and Alice's behaviour. Current practice in caring for people with challenging behaviour usually focuses on symptom reduction through medication and behavioural modification. Instead, we suggest moving toward an understanding of the experiences behind the challenging behaviours and designing person-centred care based on each patients' reality.
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| 23. |
- Heid, Iris M, et al.
(författare)
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Meta-analysis identifies 13 new loci associated with waist-hip ratio and reveals sexual dimorphism in the genetic basis of fat distribution
- 2010
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Ingår i: Nature Genetics. - : Springer Science and Business Media LLC. - 1061-4036 .- 1546-1718. ; 42:11, s. 949-960
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Tidskriftsartikel (refereegranskat)abstract
- Waist-hip ratio (WHR) is a measure of body fat distribution and a predictor of metabolic consequences independent of overall adiposity. WHR is heritable, but few genetic variants influencing this trait have been identified. We conducted a meta-analysis of 32 genome-wide association studies for WHR adjusted for body mass index (comprising up to 77,167 participants), following up 16 loci in an additional 29 studies (comprising up to 113,636 subjects). We identified 13 new loci in or near RSPO3, VEGFA, TBX15-WARS2, NFE2L3, GRB14, DNM3-PIGC, ITPR2-SSPN, LY86, HOXC13, ADAMTS9, ZNRF3-KREMEN1, NISCH-STAB1 and CPEB4 (P = 1.9 × 10⁻⁹ to P = 1.8 × 10⁻⁴⁰) and the known signal at LYPLAL1. Seven of these loci exhibited marked sexual dimorphism, all with a stronger effect on WHR in women than men (P for sex difference = 1.9 × 10⁻³ to P = 1.2 × 10⁻¹³). These findings provide evidence for multiple loci that modulate body fat distribution independent of overall adiposity and reveal strong gene-by-sex interactions.
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| 24. |
- Hellström Muhli, Ulla, et al.
(författare)
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Meeting the Challenges for the health and elderly care: Problematizing Vulnerability in Care Encounters.
- 2014
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Ingår i: <em>Symphosium: Meeting the Challenges for the health and elderly care: Problematizing Vulnerability in Care Encounters.</em>. - : Equinox Publishing Ltd..
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Konferensbidrag (refereegranskat)abstract
- Research statement/question: The main concern in this panel (colloquium) presentation was to show how a discourse and communication based approach in the context of the health and elderly care, provides a basis for reflecting on vulnerability. How can the patient`s and/or elderly client´s vulnerability be reflected and reduced within the context of health and elderly care? How can professional vulnerability be understood in the light of patient involvement? In general, the panel (colloquium) analyzed the challenges of different kind of vulnerability in client encounters e.g. to be or not to treated as accountable.Theoretical framework: From a four-dimensional, interdisciplinary perspective. Discourse Analysis, Micro-sociology, Phenomenology and Nursing, the panel (colloquium) featured five different presentations.Methods: Different kind (video, audio and interview) of transcribed and translated data from talk encounters between care professionals and clients, have been analyzed. Used analytical methods were qualitative method of Conversation Analysis; Meta-synthesis; activity analysis and phenomenographic analysis.Findings: When looking for possible convergence between principles characterizing the approaches used by the authors and their findings, in this panel (colloquium) there are key-ideas which also have to do with what we would call communicative vulnerability. E.g., considering the vulnerability of older persons with dementia, the authors argue that a flexibility of practices may be a step towards implementing a client-centred approach in care plan meetings; it is also suggested that the caring aspect of professional skills in client encounter is to support hope; and that awareness of and understanding of the own professional vulnerability may gain understanding of implicit motives for decision-making.Conclusions:Humanization of health and eldercare professionals´ work by identifying the aspect of patients´ vulnerability is dealt with in this panel (colloquium) through carefully applied research methods from areas as discourse analysis, phenomenology, phenomenographic, and micro-sociology. This panel (colloquium) attests to relevant productivity of the researcher network: Talk, Text and Tools (3T), Scandinavian Interdisciplinary Health Communication Research.
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| 25. |
- Hällgren Graneheim, Ulla, et al.
(författare)
-
Balancing between contradictions : the meaning of interaction with people suffering from dementia and "behavioral disturbances"
- 2005
-
Ingår i: The International Journal of Aging & Human Development. - 0091-4150 .- 1541-3535. ; 60:2, s. 145-157
-
Tidskriftsartikel (refereegranskat)abstract
- Interacting with people who suffer from dementia poses a challenge for care providers, and the presence of behavioral disturbances adds a further complication. Our article is based on the assumption that behavioral disturbances are meaningful expressions of experiences. Six narrative interviews were conducted with care providers with the aim of illuminating the meaning of interaction with people suffering from dementia and behavioral disturbances. The interviews were tape-recorded, transcribed into text, and interpreted using a phenomenological hermeneutic methodology. The findings indicate that interacting with people with dementia and behavioral disturbances, as narrated by care providers, means balancing between contradictions concerning meeting the person in my versus her/his world, feeling powerless versus capable, and feeling rejected versus accepted. Interaction involves being at various positions along these continua at different points in time. Furthermore, it means facing ethical dilemmas concerning doing good for the individual or the collective. This is interpreted as a dialectic process and is reflected on in light of Hegel's reasoning about the struggle between the master and the slave.
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| 26. |
- Hällgren Graneheim, Ulla, et al.
(författare)
-
Interaction relating to privacy, identity, autonomy and security. An observational study focusing on a woman with dementia and 'behavioural disturbances', and on her care providers
- 2001
-
Ingår i: Journal of Advanced Nursing. - : Wiley. - 0309-2402 .- 1365-2648. ; 36:2, s. 256-265
-
Tidskriftsartikel (refereegranskat)abstract
- AIM: The study aims to illuminate how one woman with severe dementia and so-called behavioural disturbances acts in relation to her care providers and how the care providers act in relation to her. METHODS: Fourteen participant observations, including one woman with dementia and six care providers, were performed. A reflective dialogue focusing on the interaction between the woman and her care providers followed each observation. The tape-recorded observational notes and reflective dialogues were fixed as a text, which was subjected to a thematic content analysis. FINDINGS: The main findings are that the interaction between a woman with severe dementia and "behavioural disturbances" and her care providers relates to privacy, identity, autonomy and security. The phenomena are intertwined and also in conflict with each other. Interaction is a complex dialectic process in which those who are engaged meet problems that can be solved and are involved in dilemmas that cannot be solved, only related to.
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| 27. |
- Hällgren Graneheim, Ulla, 1947-
(författare)
-
Störande beteende i interaktionen mellan personer med demens och deras vårdare
- 2004
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Det övergripande syftet med avhandlingen var att belysa innebörden i interaktionen mellan personer med demens och så kallat störande beteende och deras vårdare. I delstudierna I och II deltog en kvinna med frontallobsdemens och störande beteende (Ruth) respektive en kvinna med schizofreni, demens och störande beteende (Alice) och deras vårdare. Fjorton respektive 30 deltagande observationer samt sex respektive sju reflekterande samtal med vårdare genomfördes. Texterna tolkades med hjälp av kvalitativ innehållsanalys. I delstudie III gjordes narrativa intervjuer med sex vårdare och i delstudie IV genomfördes 10 informella samtal med tre personer med demens och störande beteende. Dessa texter tolkades med hjälp av fenomenologisk hermeneutisk metod. Innebörden i interaktionen mellan personerna med demens och störande beteende och deras vårdare handlar om att befinna sig i kaos och pendla mellan motsatser: att känna sig hemlös och hemma och att ”vara herre ”och ”vara slav”. Vårdarna upplever konflikter mellan att göra gott för individen och/eller kollektivet samt mellan de demensdrabbades beroende och önskan om självbestämmande. Såväl personerna med demens och störande beteende som deras vårdare pendlar mellan att känna sig hemlösa och hemma. Ruth lever i en fragmenterad värld där hon slåss för att skydda sitt revir. Hon kämpar också för att bli bekräftad samtidigt som hon bekräftar andra. Vårdarna bekräftar henne genom att möta henne i hennes värld. Alice lever i en tudelad värld där hon pendlar mellan ”himmel och helvete”. Hon misstror vårdarnas avsikter och slåss för sitt liv men hon visar också sin uppskattning och bekräftar vårdarnas ansträngningar. Även vårdarna upplever en tudelad värld. Innebörden i att leva med demens och störande beteende på institution handlar om att vara omgiven av oordning, fångad av begränsningar, satt åt sidan men också räknad med. Vårdarna befinner sig också i kaos och förstår inte vad det störande beteendet betyder. De upplever att de är fråntagna initiativet och känner sig utmattade och hjälplösa. Då och då upplever de att de har kontroll och känner sig dugliga och accepterade. Vårdarna pendlar mellan att ”vara herre” och ”vara slav”. Dialektiken mellan herre och slav handlar om kampen för ömsesidig bekräftelse. När vårdaren möter den demensdrabbade i sin egen (vårdarens) värld reduceras personen med demens till ett objekt. Därmed objektifierar vårdaren också sig själv. När vårdaren möter personen med demens i hans eller hennes värld, betraktar vårdaren den demensdrabbade som en betydelsefull person vars existens är viktig att bekräfta. Därmed känner sig också vårdaren betydelsefull. I hemmastaddheten bekräftas både personen med demens och vårdaren och kampen mellan herre och slav övergår i en Jag- Du relation. Störande beteenden är beteenden som inte bekräftar den andre. När vårdarna inte blir bekräftade upplever de personerna med demens vara störande och när personerna med demens inte blir bekräftade upplever de vårdarna vara störande. Bekräftelse uppstår i interaktioner som präglas av hemmastaddhet medan störande beteende visar sig i interaktioner som kännetecknas av hemlöshet.
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| 28. |
- Jansson, Leila, et al.
(författare)
-
Nurses' Experiences of Assessing Suicide Risk in Specialised Mental Health Outpatient Care in Rural Areas
- 2018
-
Ingår i: Issues in Mental Health Nursing. - : Informa UK Limited. - 0161-2840 .- 1096-4673. ; 39:7, s. 554-560
-
Tidskriftsartikel (refereegranskat)abstract
- This study describes nurses' experiences of assessing suicide risk in specialised mental health outpatient care in rural areas in Sweden. We used a qualitative, descriptive design based on twelve interviews that were subjected to qualitative content analysis. The results showed that the nurses felt anguish due to a lack of control. They expressed uncertainty and loneliness, and they struggled with ethical issues and organisational challenges. Having the sole responsibility to assess suicide risk can increase a person's emotional vulnerability and moral stress. Consequently, in order to prevent ill health among these nurses, there is a need for a tolerant work climate and an organisation that provides support to its employees. Assessing suicide risk is a demanding task within mental health outpatient care. Further, nurses operating in rural areas have to initiate and conduct assessments on their own, and they are, together with the physician in charge, also held individually responsible for their assessments. Consequently, it is important to describe nurses' experiences of how they deal with questions concerning suicide risk. Their experiences can foster awareness of the responsibility and the ethical standpoints related to assessing suicide risk, can help outline the need for further education and supervision, and can improve support from co-workers and management.
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| 29. |
- Jansson, Sören, et al.
(författare)
-
Södertörns högskola 25 år : i med- och motvind - mångvetenskap i teori och praktik
- 2021
-
Bok (populärvet., debatt m.m.)abstract
- Lagom till att Södertörns högskola fyller 25 år kommer denna betraktelse över hur högskolan växte fram och hur tvär- och mångvetenskapliga utbildningsprogram utvecklades.Författaren Sören Jansson beskriver hur man ville bygga något nytt, en högskola utan institutioner och fakulteter.Intervjuer, arkivmaterial och egna observationer ger en levande bild av en hur en annorlunda högskola hittar sin form.
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| 30. |
- Jansson, Ulla-Britt, 1950, et al.
(författare)
-
Parents' experiences of their children achieving bladder control.
- 2008
-
Ingår i: Journal of pediatric nursing. - : Elsevier BV. - 1532-8449 .- 0882-5963. ; 23:6, s. 471-8
-
Tidskriftsartikel (refereegranskat)abstract
- Achieving bladder control is important for children and parents, but there is a shortage of knowledge about experiences from parents' points of view. The aim of this study was to describe parents' experiences of how their children achieved dryness. Twenty-two parents of 21 healthy children were interviewed about the process. The transcribed interviews were analyzed using the qualitative content analysis. How children achieve dryness, as reported mainly by their mothers, seems to be influenced by knowing the time had come, implementing new daily routines, the child's willingness, and a desire to be like others.
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| 31. |
- Jansson, Ulla-Britt, 1950
(författare)
-
Urinary bladder function and acquisition of bladder control in healthy children
- 2007
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The overall aim was to advance the knowledge of urinary bladder function and the acquisition of bladder control in healthy children. The participants in papers I, II and III were from the same population (n=59). In paper IV the participants (n=22) were parents of children who had been dry for at least 6 months. The voiding pattern was observed through the 4-hour voiding observation method and thereafter through uroflow measurements and post-void residual urine (Papers I, II). Using a questionnaire, the parents? perceptions of the occurrence of life events, how upsetting they had been for the child and the degree of adaptation needed was studied (Paper III). In order to share parents? experiences of how their children became dry, parents were interviewed (Paper IV). The children voided 5 times/4hours at 3 months of age and 2 times/4hours at 3 years. Signs of arousal during sleep at voiding were noted in the infants (76% and 90%) at ages 3 and 6 months respectively. The storing ability increased from 67 ml at 3 months to 123 ml at 3 years. Interrupted voidings were seen in decreasing numbers: 33% at 3 months and 3% at 2 years of age. The post-void residual urine decreased from 5 ml at 3 months to 0 ml at 3 years of age. Awareness of the voiding process was reported from age 1.5 years. Signs of bladder dysfunction were occasionally reported in 30-50% of the children from age 3 to 6 years. The children achieved day dryness at a median age of 3.5 years and night dryness at 4 years. The children experienced an average of 5 life events. Half these life events were related to childcare, 24% to illness/accident/death, 16% to family composition and 9% to living conditions. The children had experienced these life events as negatively in 30% of the cases. Adaptation had been difficult in 15%. Many life events and difficulties in adapting to a life event were associated with a later age of dryness. The parents experiences of how their children became dry was divided into four categories: ?The time had come? including making a decision and having time, ?New daily routines? including creating a positive atmosphere and testing different activities, ?The child?s willingness? including cognitive skills and personality traits, ?Being like others? including unspoken rules and comparing the child with others to fit in and not to deviate. Healthy children do not void at constant volumes and they do not empty their bladders completely at each voiding but at least once every 4 hours. The decreasing number of interrupted voidings and the fact that most voidings were performed while awake may indicate that the voiding process is part of a maturation process. Children become dry at later ages today. The more life events and the more difficult adaptation, the later the child will become dry. The parents experienced that they were responsible for initiating the process for their children to become dry and that the process is time consuming. The parents compared their children with others and tried to fit within the unspoken norms and limits about when it is not longer acceptable to wear diapers. The parents missed having support and guidance about how to help their children become dry. The findings from this thesis can be used as reference values in both healthy children and in children with bladder dysfunction.
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| 32. |
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| 33. |
- Johansson, Pegah, 1978, et al.
(författare)
-
Nuclear factor-kappaB binds to the Epstein-Barr Virus LMP1 promoter and upregulates its expression.
- 2009
-
Ingår i: Journal of virology. - 1098-5514. ; 83:3, s. 1393-401
-
Tidskriftsartikel (refereegranskat)abstract
- The latent membrane protein 1 (LMP1) oncogene carried by Epstein-Barr virus (EBV) is essential for transformation and maintenance of EBV-immortalized B cells in vitro, and it is expressed in most EBV-associated tumor types. The activation of the NF-kappaB pathway by LMP1 plays a critical role in the upregulation of antiapoptotic proteins. The EBV-encoded EBNA2 transactivator is required for LMP1 activation in latency III, while LMP1 itself appears to be critical for its activation in the latency II gene expression program. In both cases, additional viral and cellular transcription factors are required in mediating transcription activation of the LMP1 promoter. Using DNA affinity purification and chromatin immunoprecipitation assay, we showed here that members of the NF-kappaB transcription factor family bound to the LMP1 promoter in vitro and in vivo. Electrophoretic mobility shift assay analyses indicated the binding of the p50-p50 homodimer and the p65-p50 heterodimer to an NF-kappaB site in the LMP1 promoter. Transient transfections and reporter assays showed that the LMP1 promoter is activated by exogenous expression of NF-kappaB factors in both B cells and epithelial cells. Exogenous expression of NF-kappaB factors in the EBNA2-deficient P3HR1 cell line induced LMP1 protein expression. Overall, our data are consistent with the presence of a positive regulatory circuit between NF-kappaB activation and LMP1 expression.
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| 34. |
- Johansson, Pegah, 1978, et al.
(författare)
-
The p38 signaling pathway upregulates expression of the Epstein-Barr virus LMP1 oncogene.
- 2010
-
Ingår i: Journal of virology. - 1098-5514. ; 84:6, s. 2787-97
-
Tidskriftsartikel (refereegranskat)abstract
- The Epstein-Barr virus (EBV)-encoded LMP1 oncogene has a role in transformation, proliferation, and metastasis of several EBV-associated tumors. Furthermore, LMP1 is critically involved in transformation and growth of EBV-immortalized B cells in vitro. The oncogenic properties of LMP1 are attributed to its ability to upregulate anti-apoptotic proteins and growth signals. The transcriptional regulation of LMP1 is dependent on the context of cellular and viral proteins present in the cell. Here, we investigated the effect of several signaling pathways on the regulation of LMP1 expression. Inhibition of p38 signaling, using p38-specific inhibitors SB203580 and SB202190, downregulated LMP1 in estrogen-induced EREB2.5 cells. Similarly, p38 inhibition decreased trichostatin A-induced LMP1 expression in P3HR1 cells. Exogenous expression of p38 in lymphoblastoid cell lines (LCLs) led to an increase in LMP1 promoter activity in reporter assays, and this activation was mediated by the previously identified CRE site in the promoter. Inhibition of p38 by SB203580 and p38-specific small interfering RNA (siRNA) also led to a modest decrease in endogenous LMP1 expression in LCLs. Chromatin immunoprecipitation indicated decreased binding of CREB-ATF1 to the CRE site in the LMP1 promoter after inhibition of the p38 pathway in EREB2.5 cells. Taken together, our results suggest that an increase in p38 activation upregulates LMP1 expression. Since p38 is activated in response to stimuli such as stress or possibly primary infection, a transient upregulation of LMP1 in response to p38 may allow the cells to escape apoptosis. Since the p38 pathway itself is activated by LMP1, our results also suggest the presence of an autoregulatory loop in LMP1 upregulation.
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| 35. |
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| 36. |
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| 37. |
- Kilpeläinen, Tuomas O, et al.
(författare)
-
Physical activity attenuates the influence of FTO variants on obesity risk: a meta-analysis of 218,166 adults and 19,268 children.
- 2011
-
Ingår i: PLoS medicine. - : Public Library of Science (PLoS). - 1549-1676 .- 1549-1277. ; 8:11
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The FTO gene harbors the strongest known susceptibility locus for obesity. While many individual studies have suggested that physical activity (PA) may attenuate the effect of FTO on obesity risk, other studies have not been able to confirm this interaction. To confirm or refute unambiguously whether PA attenuates the association of FTO with obesity risk, we meta-analyzed data from 45 studies of adults (n=218,166) and nine studies of children and adolescents (n=19,268). METHODS AND FINDINGS: All studies identified to have data on the FTO rs9939609 variant (or any proxy [r(2)>0.8]) and PA were invited to participate, regardless of ethnicity or age of the participants. PA was standardized by categorizing it into a dichotomous variable (physically inactive versus active) in each study. Overall, 25% of adults and 13% of children were categorized as inactive. Interaction analyses were performed within each study by including the FTO×PA interaction term in an additive model, adjusting for age and sex. Subsequently, random effects meta-analysis was used to pool the interaction terms. In adults, the minor (A-) allele of rs9939609 increased the odds of obesity by 1.23-fold/allele (95% CI 1.20-1.26), but PA attenuated this effect (p(interaction) =0.001). More specifically, the minor allele of rs9939609 increased the odds of obesity less in the physically active group (odds ratio =1.22/allele, 95% CI 1.19-1.25) than in the inactive group (odds ratio =1.30/allele, 95% CI 1.24-1.36). No such interaction was found in children and adolescents. CONCLUSIONS: The association of the FTO risk allele with the odds of obesity is attenuated by 27% in physically active adults, highlighting the importance of PA in particular in those genetically predisposed to obesity.
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| 38. |
- Ljungars, A., et al.
(författare)
-
A platform for phenotypic discovery of therapeutic antibodies and targets applied on Chronic Lymphocytic Leukemia
- 2018
-
Ingår i: JCO Precision Oncology. - : Springer Science and Business Media LLC. - 2473-4284 .- 2397-768X. ; 2:1
-
Tidskriftsartikel (refereegranskat)abstract
- Development of antibody drugs against novel targets and pathways offers great opportunities to improve current cancer treatment. We here describe a phenotypic discovery platform enabling efficient identification of therapeutic antibody-target combinations. The platform utilizes primary patient cells throughout the discovery process and includes methods for differential phage display cell panning, high-throughput cell-based specificity screening, phenotypic in vitro screening, target deconvolution, and confirmatory in vivo screening. In this study the platform was applied on cancer cells from patients with Chronic Lymphocytic Leukemia resulting in discovery of antibodies with improved cytotoxicity in vitro compared to the standard of care, the CD20-specific monoclonal antibody rituximab. Isolated antibodies were found to target six different receptors on Chronic Lymphocytic Leukemia cells; CD21, CD23, CD32, CD72, CD200, and HLA-DR of which CD32, CD200, and HLA-DR appeared as the most potent targets for antibody-based cytotoxicity treatment. Enhanced antibody efficacy was confirmed in vivo using a patient-derived xenograft model.
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| 39. |
- Ljungberg, Ulla K, et al.
(författare)
-
The interaction between different domains of staphylococcal protein A and human polyclonal IgG, IgA, IgM and F(ab')2: separation of affinity from specificity
- 1993
-
Ingår i: Molecular Immunology. - 1872-9142. ; 30:14, s. 1279-1285
-
Tidskriftsartikel (refereegranskat)abstract
- Binding properties of staphylococcal protein A (SpA) to different human immunoglobulins have been investigated. In this analysis, intact SpA as well as SpA-derived fragments containing one to five IgG-binding domains of different compositions, were used. The affinity binding constants of the different proteins to human polyclonal IgG, IgA, IgM and F(ab')2-fragments as well as their binding capacity to the immunoglobulin molecules were determined. The results show that although all the proteins bound to IgG, regardless of size or composition, the binding strength differed significantly. Proteins containing five domains have a stronger affinity for IgG than those containing one or two. There were no marked differences in binding strength between different domains. However, the binding ability to IgA and IgM showed a marked difference between the various SpA-derived proteins of different compositions. This discrepancy was correlated to differences in their relative binding properties to isolated F(ab')2-fragments of IgG. Hence, we conclude that the binding affinity is mainly affected by the number of domains, whereas the binding specificity is to a large extent determined by which domains are selected.
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| 40. |
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| 41. |
- Löf, Liza, et al.
(författare)
-
Flow Cytometric Measurement of Blood Cells with BCR-ABL1 Fusion Protein in Chronic Myeloid Leukemia
- 2017
-
Ingår i: Scientific Reports. - : Nature Publishing Group. - 2045-2322. ; 7:1
-
Tidskriftsartikel (refereegranskat)abstract
- Chronic myeloid leukemia (CML) is characterized in the majority of cases by a t(9;22)(q34;q11) translocation, also called the Philadelphia chromosome, giving rise to the BCR-ABL1 fusion protein. Current treatment with tyrosine kinase inhibitors is directed against the constitutively active ABL1 domain of the fusion protein, and minimal residual disease (MRD) after therapy is monitored by real-time quantitative PCR (RQ-PCR) of the fusion transcript. Here, we describe a novel approach to detect and enumerate cells positive for the BCR-ABL1 fusion protein by combining the in situ proximity ligation assay with flow cytometry as readout (PLA-flow). By targeting of the BCR and ABL1 parts of the fusion protein with one antibody each, and creating strong fluorescent signals through rolling circle amplification, PLA-flow allowed sensitive detection of cells positive for the BCR-ABL1 fusion at frequencies as low as one in 10,000. Importantly, the flow cytometric results correlated strongly to those of RQ-PCR, both in diagnostic testing and for MRD measurements over time. In summary, we believe this flow cytometry-based method can serve as an attractive approach for routine measurement of cells harboring BCR-ABL1 fusions, also allowing simultaneously assessment of other cell surface markers as well as sensitive longitudinal follow-up.
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| 42. |
- Markström, Urban, et al.
(författare)
-
Developing sustainable service user involvement practices in mental health services in Sweden : the “Userinvolve” research program protocol
- 2023
-
Ingår i: Frontiers in Psychiatry. - Lausanne : Frontiers Media S.A.. - 1664-0640. ; 14, s. 1-12
-
Tidskriftsartikel (refereegranskat)abstract
- Background: The purpose of this paper is to outline the protocol for the research program “UserInvolve,” with the aim of developing sustainable, service user involvement practices in mental health services in Sweden. Methods: This protocol outlines the knowledge gap and aim of the UserInvolve-program. It further provides an overview of the research infrastructure, with specific focus on the organization and management of the program as well as the design of the six underlying research projects. These six research projects form the core of the UserInvolve-program and will be carried out during a six-year period (2022–2027). The projects are focused on examining articulations of experiential knowledge in user collectives, on four specific user involvement interventions (shared decision-making, peer support, user-focused monitoring, and systemic involvement methods) and on developing theory and method on co-production in mental health research and practice. Results or conclusion: The knowledge gained through the co-production approach will be disseminated throughout the program years, targeting service users, welfare actors and the research community. Based on these research activities, our impact goals relate to strengthening the legitimacy of and methods for co-production in the mental health research and practice field. Copyright © 2023 Markström, Näslund, Schön, Rosenberg, Bejerholm, Gustavsson, Jansson, Argentzell, Grim, Engdahl, Nouf, Lilliehorn and Svedberg.
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| 43. |
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| 44. |
- Pundziute-Lyckå, Auste, et al.
(författare)
-
Diet, growth, and the risk for type 1 diabetes in childhood : a matched case-referent study.
- 2004
-
Ingår i: Diabetes Care. - : American Diabetes Association. - 0149-5992 .- 1935-5548. ; 27:12, s. 2784-9
-
Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To study the association between type 1 diabetes risk and previous intake of energy, accounting for body size and previous intake of nutrients and foods, accounting for the energy intake. RESEARCH DESIGN AND METHODS: We conducted an incident population-based case-referent study in Stockholm, Sweden, including 99 of 100 eligible 7- to 14-year-old diabetic children and 180 of 200 age-, sex-, and area-matched referent children identified through the Swedish population register. Average daily energy and nutrient intake 1 year before diabetes diagnosis/interview was estimated using the food frequency questionnaire with assessment of consumed food amounts. Mean SD scores of growth measurements taken during the last 4 years before the diagnosis were used. Odds ratios (ORs) were calculated by conditional logistic regression. RESULTS: Average intake of energy, carbohydrate, fat, and protein was significantly higher among the case subjects as well as mean weight-for-age SD score. Higher energy intake and weight-for-age were both associated with increased diabetes risk after adjustment for each other: OR (95% CI) for medium and high levels of energy intake were 1.33 (0.52-3.42) and 5.23 (1.67-16.38), respectively, and for weight-for-age were 3.20 (1.30-7.88) and 3.09 (1.16-8.22), respectively. High intake of carbohydrates, especially disaccharides and sucrose, increased diabetes risk. CONCLUSIONS: Higher energy intake and larger body size were independently associated with increased diabetes risk. Of the different nutrients, higher intake of carbohydrates, particularly disaccharides and sucrose, increased the risk. Lifestyle habits leading to higher energy intake and more rapid growth in childhood may contribute to the increase of childhood-onset type 1 diabetes by different mechanisms.
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| 45. |
- Ringnér, Anders, 1975-
(författare)
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Information till föräldrar som har barn med cancer
- 2013
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Bakgrund. Föräldrar till barn som har cancer upplever en livssituation som präglas av osäkerhet och oro och de ställs inför sociala och känslomässiga utmaningar. Jämfört med föräldrar till friska barn, upplever de också högre stress och drabbas i större utsträckning av posttraumatiska stressymptom. Trots att information om barnets sjukdom är ett centralt behov för föräldrarna, upplever de otillfredsställelse med den information som ges.Syfte. Syftet med denna avhandling var att inom barnonkologisk vård beskriva vårdares och föräldrars upplevelser av information, studera deras inbördes interaktion samt beskriva upplevelser och effekter av en intervention för personcentrerad information till föräldrar.Metod. I delstudie I–III användes fokusgruppintervjuer (I, II), individuella intervjuer (II, III) och deltagande observationer (III). Deltagarna bestod av 20 vårdare (I), 14 föräldrar till barn med cancer (II) respektive 25 vårdare och 25 föräldrar (III). Data analyserades med kvalitativ innehållsanalys (I, II) och diskurspsykologi (III). I delstudie IV testades en intervention för personcentrerad information på åtta föräldrar med hjälp av en experimentell single-case-design. Data samlades in med kvalitativa intervjuer och internetenkäter. Upplevd stress, kroppsliga symptom på stress, ångest, nedstämdhet och tillfredsställelse med information var utfallsmått.Resultat. I delstudie I bestod resultatet av två teman: anpassa mängden information till föräldrarnas behov, som handlade om skillnader i hur mycket information som gavs till föräldrarna utifrån vårdarnas bedömning av föräldrarnas behov, och navigera i en vag struktur, som handlade om brister i ansvar, miljö, tajming och språk när informationen lämnades.I delstudie II konstruerades två teman. Känna sig bekräftad som en viktig person handlade om att föräldrarna kände sig trygga, kunde hålla hoppet uppe och fick stöd från andra föräldrar. Temat var mer framträdande under behandlingens tidiga skeden. Det andra temat var känna sig som en objuden gäst vilket handlade om att kännas övergiven vid viktiga milstolpar, att tvingas tjata sig till information och att belastas av att själv behöva informera andra inom sjukvården.I delstudie III använde vårdarna tolkningsrepertoarer som var barn-, föräldra- eller familjeorienterade, vilket avspeglade deras primära fokus i interaktionen. Föräldrarna använde tolkningsrepertoarer som talesperson, observatör eller familjemedlem. Hur dessa kombinerades inbördes påverkade interaktionen.I delstudie IV erfor föräldrarna stor tillfredsställelse med den personcentrerade informationen och upplevde att de hade nytta av att på egen hand få diskutera barnets sjukdom och ställa frågor de annars inte skulle ställt. Interventionen visade ingen effekt på stress eller kroppsliga symptom på stress, ångest och nedstämdhet.Slutsatser. För att förbättra information till föräldrar som har barn med cancer är det en central uppgift att bedöma hur mycket och vilken information som ska ges vid varje tillfälle, att uppmärksamma att föräldrarna kan ha andra informationsbehov än barnet och att möten med föräldrarna ska ske i lugn och ro samt att organisera vården så att ansvaret är tydligt. I synnerhet bör det ske förbättringar kring det som föräldrarna upplever som viktiga milstolpar under barnets sjukdomstid. Interventionen för personcentrerad information uppskattades av föräldrar som har barn med cancer men effekten på föräldrarnas psykosociala välbefinnande behöver utforskas ytterligare.
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- Ringnér, Anders, 1975-, et al.
(författare)
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Parental experiences of information within pediatric oncology
- 2011
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Ingår i: Journal of Pediatric Oncology Nursing. - : SAGE Publications. - 1043-4542 .- 1532-8457. ; 28:4, s. 244-251
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Tidskriftsartikel (refereegranskat)abstract
- Parents of children with cancer use information to create knowledge about their child's disease. Information can help parents reduce chaos and create a feeling of control, but there are often obstacles to its acquisition, which has been described as similar to learning a new language. The purpose of this study was to describe parents' experiences of acquiring and using information to create knowledge about their child's cancer during the course of the illness. The authors used qualitative content analysis on data from focus groups and individual interviews with 14 parents of children with cancer. Two themes were constructed: (a) feeling acknowledged as a person of significance included feeling safe and secure in spite of uncertainty, having one's hopes supported, and getting relief from other families' experiences; (b) feeling like an unwelcome guest included feeling abandoned at important milestones, feeling forced to nag for information, and feeling burdened by the obligation to inform others. Parents may need extra attention at important milestones such as treatment cessation, with information meetings grounded in the parents' own needs.
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| 48. |
- Ringnér, Anders, 1975-, et al.
(författare)
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Professional caregivers' perceptions of providing information to parents of children with cancer
- 2011
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Ingår i: Journal of Pediatric Oncology Nursing. - : SAGE Publications. - 1043-4542 .- 1532-8457. ; 28:1, s. 34-42
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Tidskriftsartikel (refereegranskat)abstract
- Information has been described as a critical part of the care for parents of children with cancer, but not much is known about how caregivers makes decisions about informing parents. This study aims to illuminate professional caregivers' perceptions of providing information to parents of children with cancer. Twenty caregivers at a Swedish pediatric oncology ward participated in four focus group interviews. The interviews were transcribed verbatim and subjected to qualitative content analysis. Two themes were found: Matching the amount of information to the parents' needs concerned situations where the amount of information provided according to the caregivers' assessment is deemed too small, appropriate, or too large. Navigating through a vague structure dealt with a disrupted setting, unclear responsibilities within the team, difficult timing, unintelligible information, and underused tools for communication. Implications for intervention development are discussed.
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