| 1. |
- Augustsson, Anna, et al.
(författare)
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Challenges in assessing the health risks of consuming vegetables in metal-contaminated environments
- 2018
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Ingår i: Environment International. - : Elsevier BV. - 0160-4120 .- 1873-6750. ; 113, s. 269-280
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Tidskriftsartikel (refereegranskat)abstract
- A great deal of research has been devoted to the characterization of metal exposure due to the consumption of vegetables from urban or industrialized areas. It may seem comforting that concentrations in crops, as well as estimated exposure levels, are often found to be below permissible limits. However, we show that even a moderate increase in metal accumulation in crops may result in a significant increase in exposure. We also highlight the importance of assessing exposure levels in relation to a regional baseline. We have analyzed metal (Pb, Cd, As) concentrations in nearly 700 samples from 23 different vegetables, fruits, berries and mushrooms, collected near 21 highly contaminated industrial sites and from reference sites. Metal concentrations generally complied with permissible levels in commercial food and only Pb showed overall higher concentrations around the contaminated sites. Nevertheless, probabilistic exposure assessments revealed that the exposure to all three metals was significantly higher in the population residing around the contaminated sites, for both low-, medianand high consumers. The exposure was about twice as high for Pb and Cd, and four to six times as high for As. Since vegetable consumption alone did not result in exposure above tolerable intakes, it would have been easy to conclude that there is no risk associated with consuming vegetables grown near the contaminated sites. However, when the increase in exposure is quantified, its potential significance is harder to dismiss - especially when considering that exposure via other routes may be elevated in a similar way.
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| 2. |
- Karlsson, Margareta, 1958-, et al.
(författare)
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Community nurses' experiences of ethical problems in end-of-life care in the patient's own home.
- 2013
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Ingår i: Scandinavian Journal of Caring Sciences. - : Wiley. - 0283-9318 .- 1471-6712. ; 27:4, s. 831-838
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Tidskriftsartikel (refereegranskat)abstract
- AIM: To gain a deeper understanding of community nurses' experiences of ethical problems in end-of-life care in the patient's own home. METHOD: Ten female nurses from five different communities with experience of end-of-life care were interviewed. A hermeneutic approach inspired by Gadamer was used to analyse the qualitative data from the interviews. FINDINGS: In the first step of interpretation, two themes emerged: Uncomfortable feelings and Lack of cooperation and in the second step, one theme Lack of security emerged. Finally, the overall interpretation revealed the theme Feelings of loss of control in end-of-life care in the patient's own home. CONCLUSION: The nurses exhibited commitment and a desire to do good when caring for patients in the end-of-life phase, even if they sometimes experienced feelings of lack of control. This implies that, when confronted with care-related issues, they have the power to both act and react. This study aimed to increase understanding of ethical problems that arise in end-of-life care in the patient's own home and revealed the need to take the patients', relatives' and nurses' perspectives on health and suffering into consideration to ensure good end-of-life home care.
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| 3. |
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| 4. |
- Abrahamsen Grøndahl, Vigdis, 1964-, et al.
(författare)
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Exploring patient satisfaction predictors in relation to a theoretical model
- 2013
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Ingår i: International Journal of Health Care Quality Assurance. - : Emerald Group Publishing Limited. - 0952-6862 .- 1758-6542. ; 26:1, s. 37-54
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Tidskriftsartikel (refereegranskat)abstract
- The aim is to describe patients' care quality perceptions and satisfaction and to explore potential patient satisfaction predictors as person‐related conditions, external objective care conditions and patients' perception of actual care received (“PR”) in relation to a theoretical model.Design/methodology/approachA cross‐sectional design was used. Data were collected using one questionnaire combining questions from four instruments: Quality from patients' perspective; Sense of coherence; Big five personality trait; and Emotional stress reaction questionnaire (ESRQ), together with questions from previous research. In total, 528 patients (83.7 per cent response rate) from eight medical, three surgical and one medical/surgical ward in five Norwegian hospitals participated. Answers from 373 respondents with complete ESRQ questionnaires were analysed. Sequential multiple regression analysis with ESRQ as dependent variable was run in three steps: person‐related conditions, external objective care conditions, and PR (p < 0.05).FindingsStep 1 (person‐related conditions) explained 51.7 per cent of the ESRQ variance. Step 2 (external objective care conditions) explained an additional 2.4 per cent. Step 3 (PR) gave no significant additional explanation (0.05 per cent). Steps 1 and 2 contributed statistical significance to the model. Patients rated both quality‐of‐care and satisfaction highly.Originality/valueThe paper shows that the theoretical model using an emotion‐oriented approach to assess patient satisfaction can explain 54 per cent of patient satisfaction in a statistically significant manner.
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| 5. |
- Abrahamsen Grøndahl, Vigdis, 1964-, et al.
(författare)
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Patients' experiences of care quality and satisfaction satisfaction during hospital stay : a qualitative study
- 2013
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Ingår i: European Journal for Person Centered Healthcare. - : University of Buckingham Press. - 2052-5656 .- 2052-5648. ; 1:1, s. 185-192
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Tidskriftsartikel (refereegranskat)abstract
- Rationale, aim and objectives: Patients experiencing high care quality and satisfied patients are more likely to follow treatments. Patient satisfaction is an important contributor to physical and mental health-related quality of life. Research emphasises the need to further study satisfaction from the patients’ perspective. The aim was to describe patients’ experiences of care quality and the relation to their satisfaction during hospital stay. Methods: A qualitative descriptive design was used. Interviews were conducted with 22 patients discharged from hospital. Data was analysed by conventional content analysis.Results: Four categories and seven subcategories describing patients’ experiences of care quality and the relation to their satisfaction emerged. Desire to regain health comprised waiting for treatment, being cured, having hopes of being cured and described the treatment and health outcome of hospitalisation. Need to be met in a professional way as a unique person comprised receiving personalized knowledge, receiving healthcare by competent healthcare personnel and described the way patients need to be met by healthcare personnel. Need to be involved comprised taking responsibility for own health, leaving responsibility for own health and concerned the patients’ way of handling hospitalisation. Need to have balance between privacy and companionship concerned the relationship to fellow patients. Conclusions: Health condition is of great importance to patients’ experiences of quality of care and their satisfaction in relation to hospital stay. The healthcare personnel need to be aware that seriously ill patients may never be completely satisfied. Furthermore, healthcare personnel must do their utmost to provide the patients with person-centered care. Hospital managers must consider the design of wards with respect to such matters as multiple-bed versus single-bed rooms and heads of nursing must carefully plan each patient’s accommodation.
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| 6. |
- Abrahamsen Grøndahl, Vigdis, 1964-
(författare)
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Patients’ perceptions of actual care conditions and patient satisfaction with care quality in hospital
- 2012
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- There are theoretical and methodological difficulties in measuring the concepts of quality of care and patient satisfaction, and the conditions associated with these concepts. A theoretical framework of patient satisfaction and a theoretical model of quality of care have been used as the theoretical basis in this thesis. Aim. The overall aim was to describe and explore relationships between person-related conditions, external objective care conditions, patients’ perceptions of quality of care, and patient satisfaction with care in hospital. Methods. Quantitative and qualitative methods were used. In the quantitative study (I-III), 528 patients (83.7%) from eight medical, three surgical and one mixed medical/surgical ward in five hospitals in Norway agreed to participate (10% of total discharges). Data collection was conducted using a questionnaire comprising four instruments: Quality from Patients’ Perspective (QPP); Sense of Coherence scale (SOC); Big Five personality traits – the Single-Item Measures of Personality (SIMP); and Emotional Stress Reaction Questionnaire (ESRQ). In addition, questions regarding socio-demographic data and health conditions were asked, and data from ward statistics were included. Multivariate statistical analysis was carried out (I-III). In the qualitative study 22 informants were interviewed (IV). The interviews were analysed by conventional content analysis. Main findings. Patients’ perceptions of quality of care and patient satisfaction ranged from lower to higher depending on whether all patients or groups of patients were studied. The combination of person-related and external objective care conditions explained 55% of patients’ perceptions of quality of care (I). 54.7% of the variance in patient satisfaction was explained, and the person-related conditions had the strongest impact, explaining 51.7% (II). Three clusters of patients were identified regarding their scores on patient satisfaction and patients’ perceptions of quality of care (III). One group consisted of patients who were most satisfied and had the best perceptions of quality of care, a second group of patients who were less satisfied and had better perceptions, and a third group of patients who were less satisfied and had the worst perceptions. The qualitative study revealed four categories of importance for patients’ satisfaction: desire to regain health, need to be met in a professional way as a unique person, perspective on life, and need to have balance between privacy and companionship (IV). Conclusions. Patients’ perceptions of quality of care and patient satisfaction are two different concepts. The person-related conditions seem to be the strongest predictors of patients’ perceptions of quality of care and patient satisfaction. Registered nurses need to be aware of this when planning and conducting nursing care. There is a need of guidelines for handling over‑occupancy, and of procedures for emergency admissions on the wards. The number of registered nurses on the wards needs to be considered. Healthcare personnel must do their utmost to provide the patients with person‑centred care.
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| 7. |
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| 8. |
- Abrahamsen Grøndahl, Vigdis, 1964-, et al.
(författare)
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Quality of care from patients' perspective : impact of the combination of person-related and external objective care conditions
- 2011
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Ingår i: Journal of Clinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 20:17/18, s. 2540-2551
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Tidskriftsartikel (refereegranskat)abstract
- Aims and objectives. To describe patients' perceptions of quality of care and to explore combinations of person-related and external objective care conditions as potential predictors of these perceptions. Background. Several studies have examined various single factors of person-related and external objective care conditions in relation to quality of care. None of these has included the effect of over-occupancy on patients' perception of quality of care. Furthermore, little is known about how combinations of different factors are related to each other and to the perception of quality of care using multivariate analysis. Design. A cross-sectional design. Method. A total of 528 patients (83·7%) from 12 medical, surgical or medical-surgical wards in five hospitals in Norway participated. Perceptions of quality of care and person-related conditions were measured with the 'Quality from Patient's Perspective' instrument. Data on external objective care conditions was collected from ward statistics provided by head nurses. Multivariate general linear modelling was used ( p < 0·05). Results. The combination of person-related and external objective care conditions revealed five factors that predict patients' perception of quality of care. Three of these are person-related conditions: sex, age and self-reported psychological well-being and two of them are external objective care conditions: RNs (headcount) on the wards and frequency of over-occupancy. These five factors explained 55% of the model. Patients rated the quality of care high. Conclusions. Sex, age, psychological well-being, frequency of over-occupancy and the number of RNs are important factors that must be emphasised if patients are to perceive the quality of care as high. Relevance to clinical practice. Head nurses and healthcare authorities must continually prepare the wards for over-occupancy and they must consider the number of RNs working on the wards.
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| 9. |
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| 10. |
- Ahlstedt Karlsson, Susanne, et al.
(författare)
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An intervention mapping-based support program that empowers patients with endocrine therapy management
- 2022
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Ingår i: Evaluation and Program Planning. - : Elsevier BV. - 0149-7189. ; 92
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Tidskriftsartikel (refereegranskat)abstract
- Background: For women diagnosed with hormone-receptor-positive breast cancer, endocrine therapy (ET) is recommended. Patients experience diverse side effects, and difficulties in managing these side effects have been identified as obstacles for treatment continuation. The aim of this study was to describe the development of a support program for patients prescribed ET. Methods: Intervention mapping (IM) a comprehensive theory-based approach was used in the support program development. A participatory design was used and four advisory groups was formed including both patients and healthcare professionals. Results: This study employed the systematic stages of IM to develop a theory-based support program with the goal to empower patients prescribed ET to manage ETrelated symptoms and problems, and to illuminate the healthcare structure. The needs assessment identified three performance objectives: (1) Patients have knowledge of and understand their symptoms and their management strategies. (2) Patients have the knowledge and confidence to express their care needs and to ask for guidance from healthcare professionals. (3) Patients are active in and lead their healthcare process. Conclusion: This is a systematic developed model, built upon aspects of ET both from a patient´ perspective as well as from healthcare professionals’ perspectives.
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| 11. |
- Ahlstedt Karlsson, Susanne, et al.
(författare)
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Experiences of endocrine therapy after breast cancer surgery
- 2019
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Ingår i: Annals of Oncology. Abstract Book of the 44th ESMO Congress (ESMO 2019) 27 September – 1 October 2019, Barcelona, Spain. Vol. 30, Suppl. 5, s. v840. - : Elsevier BV. - 0923-7534.
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Konferensbidrag (refereegranskat)abstract
- Background For patients diagnosed with hormone-receptor-positive breast cancer, endocrine therapy (ET) is prescribed, which reduces recurrence and mortality rates (Early Breast Cancer Trialists’ Collaborative Group, 2011). Despite the prognostic benefits of ET, the adherence to treatment varies, and 30%–70% of the patients discontinue their treatment within five years (Daly et al., 2017; Tinari et al., 2015; Ursem et al., 2015), often during their first year of treatment (He et al., 2015), due to the fact that ET is associated with adverse side-effects (Regan et al., 2011). Methods The study was conducted in a surgical out-patient care unit at a hospital in Sweden. Inclusion criteria were women diagnosed with breast cancer and treated with ET after surgery. Forty-eight patients were invited to participate, of which 23 declined, thus 25 women were included. Seven focus group interviews, with two to five participants in each group, were conducted using an interview guide according to Krueger’s (2014) strategy. The interview guide contained six open-ended questions aiming to explore the women’s experiences of ET after breast cancer surgery. Inductive qualitative content analysis was used (Graneheim & Lundman, 2004). Results The analysis resulted in three categories that described the women’s experiences: the treatment “creates discomfort”; “promotes levels of management”; and “causes feelings of abandonment”. Women’s experiences of treatment could at first glance be seen as positive, as perceived protection, but after further analysis, a deeper meaning was identified: protection with reservation. When experiencing discomfort, the women were urged to manage the situation, although the mode of management sometimes varied. The women reported that they needed support, but when the support did not appear, they felt as though they had been abandoned. Moreover, knowledge about side-effects became an obstacle. The participants described feeling abandoned, but they also described their disease as “cancer light”. Conclusions Professionals need to explore the pre-knowledge and preconceptions that patients might have. This could be achieved by listening to the patient before providing them with information. The information needs to be customized specifically to each person. Funding Assar Gabrielsson’s Foundation, Herbert and Karin Jacobsson’s Foundation, and the Swedish Society of Nursing. Disclosure All authors have declared no conflicts of interest.
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| 12. |
- Ahlstedt Karlsson, Susanne, et al.
(författare)
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“It is not just any pill”—Women’s experiences of endocrine therapy after breast cancer surgery
- 2019
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Ingår i: European Journal of Cancer Care. - : Hindawi Limited. - 0961-5423 .- 1365-2354. ; 28:3
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Tidskriftsartikel (refereegranskat)abstract
- Objective: For patients diagnosed with hormone-receptor-positive breast cancer, endocrine therapy (ET) is usually prescribed to reduce recurrence and mortality rates. Despite the benefits, compliance with treatment varies. The aim of this study was to provide qualitative data about women's experiences with ET after breast cancer surgery. Methods: Twenty-five women, treated with Tamoxifen after breast cancer surgery, were interviewed in seven focus groups. Six open-ended questions were used to explore their experiences. The interviews were recorded, transcribed verbatim and analysed using inductive content analysis. Results: The analysis resulted in three categories that described the women's experiences: the treatment “creates discomfort”; “promotes levels of management”; and “causes feelings of abandonment”. Women's experiences of treatment could at first glance be seen as positive, as perceived protection, but after further analysis, a deeper meaning was identified: protection with reservation. When experiencing discomfort, the women tried to manage the situation, although the mode of management sometimes varied. The women reported that they needed support, but when the support did not appear, they felt as though they had been abandoned. Moreover, knowledge about side effects became an obstacle, as it could create fear of more severe symptoms. They also described that their disease was perceived by healthcare professionals as “cancer light”. Conclusion: The information needs to be customised specifically to each person. © 2019 John Wiley & Sons Ltd
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| 13. |
- Ahlstedt Karlsson, Susanne, et al.
(författare)
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Person-centred support programme (RESPECT intervention) for women with breast cancer treated with endocrine therapy: a feasibility study
- 2022
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Ingår i: Bmj Open. - : BMJ. - 2044-6055. ; 12:10
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Tidskriftsartikel (refereegranskat)abstract
- Objective The peRson-cEntred Support Programme EndoCrine Therapy intervention is a complex intervention encompassing a person-centred support programme for patients with breast cancer being treated with endocrine therapy (ET). The aim of this study was to explore the feasibility of the trial design and patient acceptability of the intervention and outcome measures and to provide data to estimate the parameters required to design the final intervention. Design A controlled before-and-after design following the Consolidated Standards of Reporting Trials 2010 statement for feasibility trials. Setting A surgical outpatient clinic in Sweden. Participants Forty-one patients (aged 47-85) with breast cancer who were treated with ET. Interventions Eligible patients were assigned to the control group or intervention group, which included individual education material, an individualised learning plan and a personalised reminder letter using a person-centred approach. The intervention could be delivered as a telephone or digital follow-up during a 12-week follow-up. Outcome measures The aims were to determine the recruitment rate, assess the rate of retention, explore whether the intervention was delivered according to the protocol, assess the preferred form of educational support, rate of education sessions, length per education session and length between each education session, determine the distribution of education materials and assess completion rates of patient-reported instruments, including the General Self-efficacy Scale, the Quality of Care from the Patient's Perspective Questionnaire and the Memorial Symptom Assessment Scale. Results Eighty-six per cent of the patients in the intervention group completed the intervention and questionnaires 3 months after their inclusion. The call attendance was 90%. During the intervention, the contact nurse complied with the intervention protocol. For self-efficacy, symptoms and quality of care, there were no differences in effect size between the control and intervention groups. Conclusions This intervention seems to be feasible and acceptable among patients.
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| 14. |
- Ahlstedt Karlsson, Susanne, et al.
(författare)
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Women’s coping strategies during the first three months of adjuvant endocrine therapy for breast cancer
- 2020
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Ingår i: Nursing Open. - : Wiley. - 2054-1058. ; 7:2, s. 605-612
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Tidskriftsartikel (refereegranskat)abstract
- Abstract Aim: The aim was to explore stressful events, experienced problems and used coping strategies during the first three months of undergoing ET. Design: This study used a mixed method design. Methods: A consecutive sample of 39 women newly diagnosed with breast cancer were included at the start of their adjuvant endocrine therapy. A daily coping assessment was used to create daily reports about stressful events or experienced problems and coping strategies. Results: The most frequently reported physical problems were sleeping difficulties. Anxiety was the most reported emotional problem. Patients used both emotion-and problem-focused coping, and sleeping difficulties were coped by relaxing, and anxiety was coped by thinking about something else. Conclusions: Patients experienced a variety of stressful events or problems during the first three months of endocrine therapy. They also used several coping strategies to endure the treatment.
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| 15. |
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| 16. |
- Andersson, Per, et al.
(författare)
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Characteristics of patients with acute myocardial infarction contacting primary healthcare before hospitalisation: a cross-sectional study
- 2018
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Ingår i: BMC Family Practice. - : BMC. - 1471-2296. ; 19
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Tidskriftsartikel (refereegranskat)abstract
- Background: The characteristics of patients with on-going myocardial infarction (MI) contacting the primary healthcare (PHC) centre before hospitalisation are not well known. Prompt diagnosis is crucial in patients with MI, but many patients delay seeking medical care. The aims of this study was to 1) describe background characteristics, symptoms, actions and delay times in patients contacting the PHC before hospitalisation when falling ill with an acute MI, 2) compare those patients with acute MI patients not contacting the PHC, and 3) explore factors associated with a PHC contact in acute MI patients. Methods: This was a cross-sectional multicentre study, enrolling consecutive patients with MI within 24 hours of admission to hospital from Nov 2012 until Feb 2014. Results: A total of 688 patients with MI, 519 men and 169 women, were included; the mean age was 66 +/- 11 years. One in five people contacted PHC instead of the recommended emergency medical services (EMS), and 94% of these patients experienced cardinal symptoms of an acute MI; i.e., chest pain, and/or radiating pain in the arms, and/or cold sweat. Median delay time from symptom-onset-to-decision-to-seek-care was 2:15 hours in PHC patients and 0:40 hours in non-PHC patients (pamp;lt;0.01). The probability of utilising the PHC before hospitalisation was associated with fluctuating symptoms (OR 1.74), pain intensity (OR 0.90) symptoms during off-hours (OR 0.42), study hospital (OR 3.49 and 2.52, respectively, for two of the county hospitals) and a final STEMI diagnosis (OR 0.58). Conclusions: Ambulance services are still underutilized in acute MI patients. A substantial part of the patients contacts their primary healthcare centre before they are diagnosed with MI, although experiencing cardinal symptoms such as chest pain. There is need for better knowledge in the population about symptoms of MI and adequate pathways to qualified care. Knowledge and awareness amongst primary healthcare professionals on the occurrence of MI patients is imperative.
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| 17. |
- Arinder, Pernilla, et al.
(författare)
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Transfer and Decontamination of S. aureus in Transmission Routes Regarding Hands and Contact Surfaces
- 2016
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Ingår i: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 11:6
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Tidskriftsartikel (refereegranskat)abstract
- Hand hygiene, cleaning and disinfection are pre-requirements for hygiene management in hospital settings and the food industry. In order to facilitate risk management, different contamination scenarios and interventions need to be evaluated. In the present study data on transfer rates and reductions of Staphylococcus aureus were provided in an experimental set-up using artificial skin. Using this methodology, test persons were not exposed with pathogenic bacteria. An exposure assessment model was developed and applied to evaluate different contamination routes and hygiene interventions. The transfer rates of S. aureus from inoculated VITRO-SKIN® to fomites were calculated from blotting series. The VITRO-SKIN® was more prone to spread bacteria than fomites. When different surfaces were cleaned, the reduction of S. aureus varied between <1 and 7 log CFU. It could not be concluded that a certain coupon material, cleaning agent, cleaning wipe, soiling or humidity consistently resulted in a high or low reduction of S. aureus. The reduction of S. aureus and E. coli during hand washing was evaluated on artificial skin, VITRO-SKIN®. The reduction of E. coli on VITRO-SKIN® was similar to the log reduction obtained when washing human hands. The S. aureus count on a human hand was both calculated in different scenarios describing different contamination routes starting from a contaminated hand using the exposure assessment model, and measured on an experimental setup using VITRO-SKIN® for validation. A linear relationship was obtained between the analysed level of S. aureus and the calculated level. However, the calculated levels of S. aureus on the VITRO-SKIN® in the scenarios were 1–1.5 log lower than the analysed level. One of the scenarios was used to study the effect of interventions like hand washing and cleaning of surfaces.
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| 18. |
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| 19. |
- Backe-Forsberg, Yvonne, 1946-
(författare)
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Crossing the Bridge : An Interpretation of the Archaeological Remains in the Etruscan Bridge Complex at San Giovenale, Etruria
- 2005
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This thesis discusses the archaeological remains in the Etruscan bridge complex, found during the excavations at San Giovenale in 1959–1963, and 1999. The aim has been to reach a holistic perspective of the bridge complex with the bridge seen as a link between topography, economy, social relationships, politics, symbols and ritual, reflecting its importance for the whole community at San Giovenale and its surroundings. Situated at the border between the two largest city-states Tarquinia and Caere, the site seems to have been an important middle range transit town for foreign ideas, goods and people. The character of the remains and the various levels of contextual analyses made it possible to distinguish five distinctive functions for the structures at the bridge over the Pietrisco. From a more generalised point of view these suggested that specialized functions may be divided into practical, social and symbolic functions and these aspects have been of help in identifying an object or a structure. Besides practical functions of everyday use, economic and strategic functions have also been considered. These functions were more or less in use contemporaneously, at least during several hundred years, from about the middle of the 6th down to the first century B.C. Pottery and small finds show that some activity has taken place at the site from the 9th century. Features of continuity, such as in the choice of crossing, the direction of the bridge construction after its destruction, the architectural ground-plans, the use of basins and a well, pottery fabrics of local and Greek imports and shapes, as well as changes in ground-plans, slight changes in the environment due to water erosion, earth-quakes and slides, have been observed. The physical as well as the liminal boundary between land and water as well as between man and spirits was accentuated by the tufa building, the water installations, and the road at the northern abutment. The thesis raises the hypothesis that the Etruscans believed that a crossing of a river via a bridge could violate the spirits of nature on land and in the water and therefore special rites were needed to restore the balance between nature and man before entering the bridge in order to reach safely at the other side of the ravine. The bridge itself can be seen as sacred, a liminal area where time and space do not exist and a place where it is easy to gain contact with the supernatural world.
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| 20. |
- Bengtsson, Mariette, et al.
(författare)
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Utveckling och samstämmighet avseende bedömningskriterier i de vetenskapliga metodkurserna 1, 4, 8 och 9 på sjuksköterskeprogrammet på Malmö Högskola
- 2008
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- BAKGRUND Idag sker den vetenskapliga metodskolningen i huvudämnet omvårdnad i kurserna 1, 4, 8 och 9 på sjuksköterskeprogrammet på Malmö Högskola. Studenter har visat i utvärderingar att det inte fanns någon kontinuitet och progression mellan de vetenskapliga metodkurserna på sjuksköterskeprogrammet, vilket också uppmärksammats av undervisarna. Enligt förvaltningslagen är det en myndighetsutövning gentemot en enskild person när en examinator sätter ett betyg. Därför måste betygssättning hanteras rättsäkert och konsekvent vilket kräver väl förankrade betygskriterier (Ekecrantz, 2007). För att säkra kvalitet och kontinuitet mellan kurserna 1, 4, 8 och 9 på sjuksköterskeprogrammet på Malmö Högskola och för att EU-anpassa betygsgraderingen enligt ECTS-skalan (ECTS USERS`GUIDE) behövdes nya bedömningskriterier baserade på nya lärandemål enligt Bologna processen utarbetas. För att successivt öka kunskapsstegringen mellan de vetenskapliga metodkurserna har i ett tidigare projekt nya lärandemål enligt Bologna modellen för respektive kurs utarbetats. SYFTE Syftet med projektet är att identifiera och formulera bedömningskriterier baserade på en successiv kunskapsstegring inom forskningsområdet omvårdnad både avseende metod och ett kritiskt förhållningssätt. GENOMFÖRANDE Arbetet påbörjades i augusti 2007 och projektgruppen består av sex undervisande och examinerande lärare i de berörda kurserna. Litteratur i ämnet studerades och gruppen samlade in information om hur andra universitet och högskolor tillämpat ECTS-skalan. Arbetsgrupper för respektive kurs bildades som utarbetade förslag för bedömningskriterier A till F för respektive kurs. Därefter strålade arbetsgrupperna samman för att gemensamt fastställa samstämmighet samt progression mellan kurserna. Gruppen har också diskuterat examinationsformer, undervisningsmetoder, litteratur och begreppsdefinitioner relaterade till betygskriterier. Arbetet har också lett till att lärandemålen för respektive kurs har fått korrigeras och anpassat för att kunna vara utvärderingsbara. För att få studenternas synpunkter kommer de utarbetade förslagen att presenteras för studenter i respektive kurs för att få deras syn på bedömningskriterierna. Studenter i kurs 4 och 8/9 kommer under läsåret 08/09 att få vara delaktiga i utvecklingsprocessen av bedömningskriterierna. Implementering av resultatet kan tidigast ske VT09 och kommer därefter att utvärderas. Betygskriterierna kan ses i bilaga 1-5. DISKUSSION Dessa kriterier skall vara ett stöd för betygsättning av examensarbete såväl som seminarier och enskilda uppgifter dock utan att minska examinatorns ansvar för bedömningen. Bedömningskriterierna bör också ge utrymme för examinatorns egen bedömning (Boij m.fl., 2007). Betygskriterierna skall fungera som ett stöd för examinatorn så väl som för studenten, som kan inspireras att sträva efter ett högre betyg. Eftersom ECTS-graderingen är målrelaterad så finns det inget krav på att en viss del av studenterna skall få ett visst betyg. Det är dock viktigt att kraven för E skall vara likvärdiga med betyget GODKÄND. Det finns både fördelar och nackdelar med betyg i många grader. Enligt Ekecrantz (2007) ger det större precision och rättvisa samt en bättre feedback till studenterna på deras prestationer. Ekecrantz menar dock att många grader kan leda till ökad stress för studenten och ge en ökad arbetsbelastning för läraren samt att examinationsformerna kan försämras. Arbetsgruppen håller inte riktigt med om detta. Visserligen kan examinationsformerna behöva förändras men det behöver nödvändigtvis inte leda till en försämring. En intressant aspekt som Boij m.fl. (2007) tar upp i sin rapport från Kungliga Tekniska Högskolan är att bedömning av t.ex. examensarbete kan göras utifrån flera perspektiv såsom process, vetenskapligt innehåll och prestation för att examinatorn skall kunna skaffa ett bra underlag för att sätta betyg. Studentinflytande är viktigt och det är en utmaning att få studenterna delaktiga i processen, vilket inte har varit så lätt inom alla verksamheter (Åkesson 2006).
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| 21. |
- Bjorvell, Catrin, et al.
(författare)
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Creating Subsets of International Classification for Nursing Practice Precoordinated Concepts
- 2024
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Ingår i: Computers, Informatics, Nursing. - : Lippincott Williams & Wilkins. - 1538-2931 .- 1538-9774. ; 42:1, s. 21-26
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Tidskriftsartikel (refereegranskat)abstract
- The International Classification for Nursing Practice is a comprehensive terminology representing the domain of nursing practice. A categorization of the diagnoses/outcomes and interventions may further increase the usefulness of the terminology in clinical practice. The aim of this study was to categorize the precoordinated concepts of the International Classification for Nursing Practice into subsets for nursing diagnoses/outcomes and interventions using the structure of an established documentation model. The aim was also to investigate the distribution of the precoordinated concepts of the International Classification for Nursing Practice across the different areas of nursing practice. The method was a descriptive content analysis using a deductive approach. The VIPS model was used as a theoretical framework for categorization. The results showed that all the precoordinated concepts of the International Classification for Nursing Practice could be categorized according to the keywords in the VIPS model. It also revealed the parts of nursing practice covered by the concepts of the International Classification for Nursing Practice as well as the parts that needed to be added to the International Classification for Nursing Practice. This has not been identified in earlier subsets as they covered only one specific area of nursing.
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| 22. |
- Björvell, Catrin, et al.
(författare)
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Creating Subsets of International Classification for Nursing Practice Precoordinated Concepts: Diagnoses/Outcomes and Interventions Categorized Into Areas of Nursing Practice
- 2024
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Ingår i: Computers, informatics, nursing : CIN. - 1538-9774. ; 42:1, s. 21-26
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Tidskriftsartikel (refereegranskat)abstract
- The International Classification for Nursing Practice is a comprehensive terminology representing the domain of nursing practice. A categorization of the diagnoses/outcomes and interventions may further increase the usefulness of the terminology in clinical practice. The aim of this study was to categorize the precoordinated concepts of the International Classification for Nursing Practice into subsets for nursing diagnoses/outcomes and interventions using the structure of an established documentation model. The aim was also to investigate the distribution of the precoordinated concepts of the International Classification for Nursing Practice across the different areas of nursing practice. The method was a descriptive content analysis using a deductive approach. The VIPS model was used as a theoretical framework for categorization. The results showed that all the precoordinated concepts of the International Classification for Nursing Practice could be categorized according to the keywords in the VIPS model. It also revealed the parts of nursing practice covered by the concepts of the International Classification for Nursing Practice as well as the parts that needed to be added to the International Classification for Nursing Practice. This has not been identified in earlier subsets as they covered only one specific area of nursing.
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| 23. |
- Bondemark, Lars, et al.
(författare)
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Extraoral vs intraoral appliance for distal movement of maxillary first molars : a randomized controlled trial
- 2005
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Ingår i: Angle orthodontist. - : Angle Society. - 0003-3219 .- 1945-7103. ; 75:5, s. 699-706
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Using randomized controlled trial methodology, the aim of this study was to evaluate and compare the treatment effects of an extraoral appliance (EOA) and an intraoral appliance (IOA) for distal movement of maxillary first molars. A total of 40 patients (mean 11.5 years, SD 1.29) at the Orthodontic Clinic, National Health Service, Skane County Council, Malmö, Sweden, were randomized to receive treatment with either extraoral traction (cervical headgear) or an IOA us-ing superelastic coils for distal movement of maxillary first molars. The inclusion criteria were a nonextraction treatment plan, a Class II molar relationship and maxillary first molars in occlusion with no erupted maxillary second molars. The outcome measures to be assessed in the trial were treatment time, cephalometric analysis of distal molar movement, anterior movement of maxillary central incisors, ie, anchorage loss and sagittal and vertical skeletal positional changes of the maxilla and mandible. In the IOA group, the molars were distalized during an average time of 5.2 months, whereas in the EOA group the corresponding time was 6.4 months (P < .01). The mean amount of distal molar movement was significantly higher in the IOA than in the EOA group, three mm vs 1.7 mm (P < .001). Moderate anchorage loss was produced with the IOA implying increased overjet (0.9 mm) whereas the EOA created decreased overjet (0.9 mm). It can be concluded that the IOA was more effective than the EOA to create distal movement of the maxillary first molars.
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| 24. |
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| 25. |
- Duhalde, Henrik, et al.
(författare)
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Missed nursing care in emergency departments : A scoping review
- 2023
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Ingår i: International Emergency Nursing. - : Elsevier. - 1755-599X .- 1878-013X. ; 69
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Forskningsöversikt (refereegranskat)abstract
- Background: Patient safety is a global health priority. Errors of omission, such as missed nursing care in hospitals, are frequent and may lead to adverse events. Emergency departments (ED) are especially vulnerable to patient safety errors, and the significance missed nursing care has in this context is not as well known as in other contexts. Aim: The aim of this scoping review was to summarize and disseminate research about missed nursing care in the context of EDs. Method: A scoping review following the framework suggested by Arksey and O’Malley was used to (1) identify the research question; (2) identify relevant studies; (3) select studies; (4) chart the data; (5) collate, summarize, and report the results; and (6) consultation. Results: In total, 20 themes were derived from the 55 included studies. Missed or delayed assessments or other fundamental care were examples of missed nursing care characteristics. EDs not staffed or dimensioned in relation to the patient load were identified as a cause of missed nursing care in most included studies. Clinical deteriorations and medication errors were described in the included studies in relation to patient safety and quality of care deficiencies. Registered nurses also expressed that missed nursing care was undignified and unsafe. Conclusion: The findings from this scoping review indicate that patients’ fundamental needs are not met in the ED, mainly because of the patient load and how the ED is designed. According to registered nurses, missed nursing care is perceived as undignified and unsafe.
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| 26. |
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| 27. |
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| 28. |
- Fridriksson, Jón O., et al.
(författare)
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Long-term adverse effects after curative radiotherapy and radical prostatectomy : population-based nationwide register study
- 2016
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Ingår i: Scandinavian Journal of Urology. - : Medical Journals Sweden AB. - 2168-1805 .- 2168-1813. ; 50:5, s. 338-345
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The aim of this study was to assess the risk of serious adverse effects after radiotherapy (RT) with curative intention and radical prostatectomy (RP). Materials and methods: Men who were diagnosed with prostate cancer between 1997 and 2012 and underwent curative treatment were selected from the Prostate Cancer data Base Sweden. For each included man, five prostate cancer-free controls, matched for birth year and county of residency, were randomly selected. In total, 12,534 men underwent RT, 24,886 underwent RP and 186,624 were controls. Adverse effects were defined according to surgical and diagnostic codes in the National Patient Registry. The relative risk (RR) of adverse effects up to 12 years after treatment was compared to controls and the risk was subsequently compared between RT and RP in multivariable analyses. Results: Men with intermediate- and localized high-risk cancer who underwent curative treatment had an increased risk of adverse effects during the full study period compared to controls: the RR of undergoing a procedures after RT was 2.64 [95% confidence interval (CI) 2.56–2.73] and after RP 2.05 (95% CI 2.00–2.10). The risk remained elevated 10–12 years after treatment. For all risk categories of prostate cancer, the risk of surgical procedures for urinary incontinence was higher after RP (RR 23.64, 95% CI 11.71–47.74), whereas risk of other procedures on the lower urinary tract and gastrointestinal tract or abdominal wall was higher after RT (RR 1.67, 95% CI 1.44–1.94, and RR 1.86, 95% CI 1.70–2.02, respectively). Conclusion: The risk of serious adverse effects after curative treatment for prostate cancer remained significantly elevated up to 12 years after treatment.
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| 29. |
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| 30. |
- Gedeborg, Rolf, et al.
(författare)
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Uptake of doublet therapy for de novo metastatic castration sensitive prostate cancer : a population-based drug utilisation study in Sweden
- 2023
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Ingår i: Scandinavian journal of urology. - : Medical Journals Sweden. - 2168-1805 .- 2168-1813. ; 58, s. 93-100
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Tidskriftsartikel (refereegranskat)abstract
- Background: Randomised controlled trials have demonstrated prolonged survival with new upfront treatments in addition to standard androgen deprivation therapy (ADT) in men with de novo metastatic castration-sensitive prostate cancer. We describe patient characteristics, time trends and regional differences in uptake of these new treatment strategies in clinical practice.Material and methods: This descriptive study consisted of men registered in the National Prostate Cancer Register of Sweden from 1 January 2018 to 31 March 2022 with de novo metastatic castration-sensitive prostate cancer defined by the presence of metastases on imaging at the time of diagnosis. Life expectancy was calculated based on age, Charlson Comorbidity Index and a Drug Comorbidity Index.Results: Within 6 months from diagnosis, 57% (1,677/2,959) of men with de novo metastatic castration-sensitive prostate cancer and more than 3 years of life expectancy had received docetaxel, abiraterone, enzalutamide, apalutamide and/or radiotherapy. Over time, there was a 2-fold increase in uptake of any added treatment, mainly driven by a 6-fold increase in use of abiraterone, enzalutamide or apalutamide, with little change in use of other treatments.Conclusions: Slightly more than half of men diagnosed with de novo metastatic castration-sensitive prostate cancer and a life expectancy of at least 3 years received additions to standard ADT as recommended by national guidelines in 2019-2022 in Sweden. There was a 2-fold increase in use of these treatments during the study period; however, efforts to further increase adherence to guidelines are warranted.
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| 31. |
- Glawing, Carina, et al.
(författare)
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Work-related stress, stress reactions and coping strategies in ambulance nurses : A qualitative interview study
- 2024
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Ingår i: Journal of Advanced Nursing. - : John Wiley & Sons. - 0309-2402 .- 1365-2648. ; 80:2, s. 538-549
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Tidskriftsartikel (refereegranskat)abstract
- Aim: To describe experiences of work-related stress, stress reactions and coping strategies among registered nurses (RNs) in the ambulance service (AS).Design: A descriptive and qualitative design.Methods: Participants were recruited from eight different ambulance stations from different geographical locations in central Sweden. Data were collected from 14 RNs during the period from January 2022 to May 2022 using a semi-structured interview guide. Qualitative content analysis was used to analyse data using an abductive approach.Results: Three categories describe the RNs' experiences; (1) Situations that cause work-related stress, (2) Reactions and feelings that occur and (3) Management of work-related stress. These three main categories included a total of 12 subcategories. Work-related stress was experienced when participants were a part of traumatic events or experienced insufficient cooperation or a disturbing event in the work environment. The different causes lead to different kinds of reactions with feelings of frustration, fear and loneliness being prominent. To manage the work-related stress, RNs used different kinds of strategies and support from colleagues or lack thereof seemed to have a major impact.Conclusions: Findings revealed the importance of having competent colleagues in the AS. Working with a competent colleague can reduce experiences of stress and prevent feelings of loneliness. It is important for the AS to provide stress-reduction support, to promote cooperation and to maintain and develop RNs' professional competence to ensure quality care and patient safety in the AS.
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| 32. |
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| 33. |
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| 34. |
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| 35. |
- Hasselqvist-Ax, Ingela, et al.
(författare)
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Early cardiopulmonary resuscitation in out-of-hospital cardiac arrest.
- 2015
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Ingår i: The New England journal of medicine. - 1533-4406 .- 0028-4793. ; 372:24, s. 2307-15
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Tidskriftsartikel (refereegranskat)abstract
- Three million people in Sweden are trained in cardiopulmonary resuscitation (CPR). Whether this training increases the frequency of bystander CPR or the survival rate among persons who have out-of-hospital cardiac arrests has been questioned.
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| 36. |
- Helmfrid, Ingela, 1964-
(författare)
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Exposure and body burden of environmental pollution and risk of cancer in a historically contaminated areas
- 2019
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- There are many villages where environmental contamination is substantial due to historical industrial activities. According to the European Environment Agency, there are about 2.5 million potentially contaminated sites in the European member states. In Sweden, there are about 80 000 more or less contaminated areas. About 1000 of them are classified into the highest risk category, Hazard Class 1, and should be remediated. Population exposure due to these industrially contaminated sites may contribute to adverse health effects and is a global environmental problem.The general aim of this thesis was to evaluate the occurrence of cancer in populations residing in contaminated areas in relation to indirect exposure via the long-term consumption of locally produced food, taking into account residential, occupational and lifestyle factors. Associations between reported local food consumption frequencies, biomarker concentrations and environmental and lifestyle factors were explored. The Swedish national cancer registers and questionnaire information was used to identify cancer risk groups in the study population. The questionnaire was evaluated regarding how well it reflected measured levels of biomarkers in human biological samples, and how the consumption of local food from contaminated areas contributed to the total body burden of contaminants.Despite historically high environmental levels of contaminants in the soil and sediments, current contaminant exposure in the studied population living in the contaminated areas was similar to or only moderately higher than that of the general population.No significant associations with increased cancer risk were detected in the highest tertile of metals concentrations in blood or PAH in urine.Reported long-term high consumption of certain local foods was associated with higher cadmium (vegetarian food) and lead (fish, meat) concentrations in blood and urine. Long-term high consumption of non-local food from places outside the study areas was not associated with increased concentrations of metals compared with consumers of local food. It was concluded that the questionnaire information on consumption of locally produced food describes differences in food consumption in the study population reasonably well.An increased risk of cancer was associated with smoking, family history of cancer and obesity. Residing in a contaminated area during the first five years of life was associated with an increased risk of cancer, which may indicate exposure to contaminants in early life. Also, long-term high consumption of particular local foods (fish, chicken, lamb, game meat) was associated with an increased risk of various forms of cancer, while reported high consumption of these foods from non-local sources was not associated with increased risk of cancer. The associations between habitual consumption of local food and different types of cancer may reflect a higher exposure in the past, and thus, if consumption of local food contributes to the risk of acquiring cancer, that contribution is probably lower today than previously. Furthermore, it cannot be ruled out that other contaminants in the food contribute to the increased cancer risks observed.In conclusion, the questionnaire that was developed for the present thesis can identify risk groups within populations and can be used as a tool in a health-risk assessment.
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| 37. |
- Helmfrid, Ingela, 1964-, et al.
(författare)
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Exposure of metals and PAH through local foods and risk of cancer in a historically contaminated glassworks area
- 2019
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Ingår i: Environment International. - : Elsevier. - 0160-4120 .- 1873-6750. ; 131, s. 1-10
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundProduction of crystal glass and colored art glassware have been going on in the south-eastern part of Sweden since the 1700s, at over 100 glassworks and smaller glass blowing facilities, resulting in environmental contamination with mainly arsenic (As), cadmium (Cd), lead (Pb) and polycyclic hydrocarbons (PAH). High levels of metals have been found in soil, and moderately elevated levels in vegetables, mushrooms and berries collected around the glassworks sites compared with reference areas. Food in general, is the major exposure source to metals, such as Cd and Pb, and PAHs. Exposure to these toxic metals and PAH has been associated with a variety of adverse health effects in humans including cancer.ObjectiveThe aim of the present study was to evaluate the occurrence of cancer in a cohort from the contaminated glasswork area in relation to long-term dietary intake of locally produced foods, while taking into account residential, occupational and life styles factors.MethodsThe study population was extracted from a population cohort of 34,266 individuals who, at some time between the years 1979–2004, lived within a 2 km radius of a glassworks or glass landfill. Register information on cancer incidence and questionnaire information on consumption of local foods (reflecting 30 years general eating habits), life-time residence in the area, life style factors and occupational exposure was collected. Furthermore, blood (n = 660) and urine (n = 400) samples were collected in a subsample of the population to explore associations between local food consumption frequencies, biomarker concentrations in blood (Cd, Pb, As) and urine (PAH metabolite 1-OHPy) as well as environmental and lifestyle factors. The concurrent exposure to persistent organic pollutants (POPs) from food was also considered. A case-control study was performed for evaluation of associations between intakes of local food and risk of cancer.ResultsDespite high environmental levels of Cd, Pb and As at glasswork sites and landfills, current metal exposure in the population living in the surrounding areas was similar or only moderately higher in our study population compared to the general population. Reported high consumption of certain local foods was associated with higher Cd and Pb, but not As, concentrations in blood, and 1-OHPy in urine. An increased risk of cancer was associated with smoking, family history of cancer, obesity, and residence in glasswork area before age 5 years. Also, a long-term high consumption of local foods (reflecting 30 years general eating habits), i.e. fish and meat (game, chicken, lamb), was associated with increased risk of various cancer forms.ConclusionsThe associations between consumption of local food and different types of cancer may reflect a higher contaminant exposure in the past, and thus, if consumption of local food contributes to the risk of acquiring cancer, that contribution is probably lower today than before. Furthermore, it cannot be ruled out that other contaminants in the food contribute to the increased cancer risks observed.
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| 38. |
- Helmfrid, Ingela, et al.
(författare)
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Miljögifter i blod hos högkonsumenter av Vätternfisk
- 2003
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Blodprover från kvinnliga "Vätternfiskkonsumenter" har bestämts med avseende på halten av polyklorerade bifenyler (PCB), 1,1-diklor-2,2-bis(4-klordifenyl)etylen (DDE), Hexaklorben-sen (HCB), hexaklor cyklohexan (HCH), Polybromerade difenyletrar (PBDE) och kvicksilver (Hg). Gruppen bestod av 37 kvinnor som var fritidsfiskare eller fruar till fritids- eller yrkes-fiskare. Halterna jämfördes med kontroller och förutom analys av blodets halt av miljögifter kartlades också gruppens dietvanor med hjälp av en kostenkät.Resultaten visar att halterna av samtliga miljögifter med undantag av HCB var högre hos Vät-ternfiskkonsumenter än i kontrollgrupperna. Halten av PCB 153 (en variant av PCB) låg un-gefär i samma nivå (115-625 ng/g fett) som tidigare rapporterats hos fruar till fiskare på ost-kusten (151-463 ng/g fett) då personer i samma åldersgrupp jämförs (37-59 år). Vid jämförel-ser av medelvärden utan hänsyn till ålder, hade kvinnor som konsumerar fisk från Vättern högre halter (354 ng/g fett) än som har rapporterats i en studie av fruar till fiskare på ostkusten (160 ng/g fett). De höga halterna beror på att flertalet av deltagarna i denna studie är äldre och att blodets halt av PCB, DDE och HCB ökar med stigande ålder.Blodets medianhalter av den ingående varianten i flamskyddsmedel, BDE 47 var generellt låg men var något högre bland Vätternfiskkonsumenter jämfört med kontrollen (3,6 respekti-ve 2,9 ng/g fett). Fiskkonsumtion anses enligt tidigare studier vara en viktig orsak till att PBDEs som används som flamskyddsmedel samlas i kroppen.Medelvärdet av halten metylkvicksilver hos Vätternfiskkonsumenter var 9,4 μg/l vilket är 3-5 gånger högre än den hos kontrollgrupperna (2,6 μg/l respektive 1,6 μg/l). Förklaringen är sannolikt Vätternfiskkonsumenternas höga konsumtionen av både mager (abborre, gädda) och fet (lax, röding, öring) rovfisk under flera års tid. Samtliga Vätternfiskkonsumenter med halter över 19μg/l i blodet åt främst abborre och/eller lax, röding, öring 1-3 gånger vecka. Andra studier har tidigare visat att nervsystemet hos foster kan påverkas om mödrarna har kvicksil-verhalter över 10 μg/l och flera kvinnor i denna studie hade alltså halter som översteg detta värde.Även om halterna av främst PCB och metylkvicksilver i blodet hos Vätternfiskkonsumenter är höga är det inte motiverat att avråda äldre personer eller kvinnor som inte tänker skaffa fler barn att äta fet fisk. Tvärtom, nyttan med sådan fisk överväger. Den feta fisken innehåller Omega-3-fettsyror som minskar risken för hjärt- och kärlsjukdomar. Däremot indikerar fyn-den i denna undersökning att kvinnor i barnafödande ålder ej bör äta stora mängder av framför allt abborre och fet fisk från Vättern.
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| 39. |
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| 40. |
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| 41. |
- Isaksson, Rose-Marie, 1964-, et al.
(författare)
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Geographical Diversities in Symptoms, Actions and Prehospital Delay Times in Swedish ST-Elevation Myocardial Infarction(STEMI) Patients : A Descriptive Multicenter Cross-Sectional Survey Study
- 2019
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Ingår i: Insights of Cardiology Open Access. - : GRF Publishers.
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Geographical variations in cardiovascular mortality have been reported in Sweden as well as in other countries. Little attention has been given to possible variations in symptoms, actions and pre-hospital delay times in ST-elevation myocardial infarction (STEMI) patients, as a reason for this diversity. We aimed to study whether STEMI patients from the northern and southern parts of Sweden differ in symptoms and actions that may affect the pre-hospital delay times.Methods: SymTime was a multicentre cross-sectional survey study where STEMI patients admitted to the coronary care unit completed a validated questionnaire within 24 hours after admission. In total, 531 patients were included, 357 in the southern and 174 in the northern part of Sweden.Results: There were no significant differences in age. However, patients in the north had more often hypertension (52 vs 42%, p=0.02) or other concomitant comorbidities (24 vs 14%, p=0.01). Patients in the south experienced more anxiety (14 vs. 7%, p=0.01) and fear (23 vs. 14%, p=0.02) and more often contacted the emergency medical services (EMS) as first medical contact (FMC) (54 vs 44%, p=0.05). There were no differences in other main or associated symptoms or in pre-hospital delay times. Conclusions: Patients with STEMI in the southern vs. the northern part of Sweden had more anxiety and fear, despite that they were less often alone at onset of symptoms. There were no differences in pre-hospital delay times. Although patients from the southern region contacted EMS as their FMC more frequently, it is still worrying that too few patients utilize the EMS.
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| 42. |
- Johanson, Urban, et al.
(författare)
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The complete set of genes encoding major intrinsic proteins in Arabidopsis provides a framework for a new nomenclature for major intrinsic proteins in plants
- 2001
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Ingår i: Plant Physiology. - : Oxford University Press (OUP). - 1532-2548 .- 0032-0889. ; 126:4, s. 1358-1369
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Tidskriftsartikel (refereegranskat)abstract
- Major intrinsic proteins (MIPs) facilitate the passive transport of small polar molecules across membranes. MIPs constitute a very old family of proteins and different forms have been found in all kinds of living organisms, including bacteria, fungi, animals, and plants. In the genomic sequence of Arabidopsis, we have identified 35 different MIP-encoding genes. Based on sequence similarity, these 35 proteins are divided into four different subfamilies: plasma membrane intrinsic proteins, tonoplast intrinsic proteins, NOD26-like intrinsic proteins also called NOD26-like MIPs, and the recently discovered small basic intrinsic proteins. In Arabidopsis, there are 13 plasma membrane intrinsic proteins, 10 tonoplast intrinsic proteins, nine NOD26-like intrinsic proteins, and three small basic intrinsic proteins. The gene structure in general is conserved within each subfamily, although there is a tendency to lose introns. Based on phylogenetic comparisons of maize (Zea mays) and Arabidopsis MIPs (AtMIPs), it is argued that the general intron patterns in the subfamilies were formed before the split of monocotyledons and dicotyledons. Although the gene structure is unique for each subfamily, there is a common pattern in how transmembrane helices are encoded on the exons in three of the subfamilies. The nomenclature for plant MIPs varies widely between different species but also between subfamilies in the same species. Based on the phylogeny of all AtMIPs, a new and more consistent nomenclature is proposed. The complete set of AtMIPs, together with the new nomenclature, will facilitate the isolation, classification, and labeling of plant MIPs from other species.
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| 43. |
- Johansson, Ingela, et al.
(författare)
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The role of aquaporins in cellular and whole plant water balance
- 2000
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Ingår i: Biochimica et Biophysica Acta - Biomembranes. - 0005-2736. ; 1465:1-2, s. 324-342
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Forskningsöversikt (refereegranskat)abstract
- Aquaporins are water channel proteins belonging to the major intrinsic protein (MIP) superfamily of membrane proteins. More than 150 MIPs have been identified in organisms ranging from bacteria to animals and plants. In plants, aquaporins are present in the plasma membrane and in the vacuolar membrane where they are abundant constituents. Functional studies of aquaporins have hitherto mainly been performed by heterologous expression in Xenopus oocytes. A main issue is now to understand their role in the plant, where they are likely to be important both at the cellular and at the whole plant level. Plants contain a large number of aquaporin isoforms with distinct cell type- and tissue-specific expression patterns. Some of these are constitutively expressed, whereas the expression of others is regulated in response to environmental factors, such as drought and salinity. At the protein level, regulation of water transport activity by phosphorylation has been reported for some aquaporins.
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| 44. |
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| 45. |
- Johnson, Urban, 1961-, et al.
(författare)
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An ultra-runner's experience of physical and emotional challenges during a 10-week continental run
- 2016
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Ingår i: International Journal of Sport and Exercise Psychology. - New York, NY : Taylor & Francis. - 1612-197X .- 1557-251X. ; 14:1, s. 72-84
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Tidskriftsartikel (refereegranskat)abstract
- The main purpose of this study was to investigate relationships between self-report measures such as mood state, emotional recovery, and perceived exertion for a runner during a continental run. Second, the purpose was to examine psychological factors that enable an ultra-distance runner during an event. A case study report from a 49-year-old female ultra-distance runner, running a 3641 kilometre adventure event during a 10-week period was made. Data were collected during 15 weeks with three self-report questionnaires – more specifically, an initial report 3 weeks prior to the run, a weekly report during the 10 weeks of running, and, finally, a report 2 weeks after the run. In addition, a follow-up narrative interview was performed nine months after the run was completed. The main result showed that perceived exertion level had a statistically significant negative relationship with negative mood and a positive statistically significant relationship with positive mood. Results also showed a statistically significant difference between the three measurement points based on the variable perceived exertion level. In addition, the runner's narration suggested four main categories of psychologically assisting attributes: motivation, group cohesiveness, self-awareness, and mental stamina. The findings highlight the complex balance between extreme physical load and feelings of comfort and elevated mood. Another finding is that the joint effect of different psychological factors – especially the runner's high self-awareness, strong-minded attitude, and ability to use humour in problematic situations – was helpful during the run. Practical and methodological implications, as well strategies for further research, are provided. © 2015 International Society of Sport Psychology
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| 46. |
- Karlsson, Christina, et al.
(författare)
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Dignified end-of-life care in the patients’ own homes
- 2011
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Ingår i: Nursing Ethics. - 0969-7330 .- 1477-0989. ; 18:3, s. 374-385
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Tidskriftsartikel (refereegranskat)abstract
- Nowadays it is increasingly common that the patients in the end of life phase choose to be cared for in their own home. Therefore it is vital to identify significant factors in order to prevent unnecessary suffering for dying patients and their families in end-of-life homecare. This study aimed to describe 10 nurses’ perceptions of significant factors that contribute to good end-of-life care in the patients own home. The transcribed texts from the interviews’ were analyzed using phenomenological hermeneutical method, which focuses on the life-world of human beings. The results demonstrate that good end-of-life care presupposes that the aim of the caring staff is to provide safety, autonomy and integrity for the patient and family in order to create the respect required for as good and dignified a death as possible.
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| 47. |
- Karlsson, Chatarina, et al.
(författare)
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Kiselalgsundersökning 2020 Jönköpings län
- 2021
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Under år 2020 undersöktes bentiska kiselalger vid 27 lokaler i Jönköpings län. Samtliga lo-kaler ingår i länsstyrelsens regionala miljöövervakning.Proven analyserades av Pelagia Nature & Environment AB med avseende på IPS (näring) och ACID (surhet).Kiselalgsanalysen indikerade God status för lokal Ängån inlopp Nissan och Måttlig status för lokal Ängån Vä och resterande lokaler uppvisade Hög status med avseende på näringsäm-nen och organisk förorening (IPS). Stödparametern %PT som visar andelen kiselalger som är toleranta mot lättnedbrytbar organisk förorening var något förhöjd vid lokal Ängån Vä.Klassificeringen av vattendragens surhet visade på Nära neutrala förhållanden för lokalerna Gagnån Gjutarebron, Gagnån Åsebygd, Nissan Tennisbanor ned Ryd, Närmrebäck nedre, Svanån uppströms Svansjön, Svedån Svedbrotorp, Svedån Tranemaden, Vedabäcken Bro-fors, Vämmesån, Ängån inlopp Nissan, Ängån Tegelbruket, Ängån Vä och Österån Bös-singshult. Måttligt sura förhållanden uppvisade lokalerna Flankabäcken Sprottebo, Flanka-bäcken upp v.26, Radan Sandsebo kvarn, Svanån ned Hagsjön, Älgeå Stenbrohult, Älgån Klerebo, Sura förhållanden noterades för lokalerna Närmrebäck övre, Ruskån Hisinge, Ruskån Klevaberget, Vedabäcken Tjärberget, Älgån Lövrödjan och Mycket sura förhållan-den uppvisade lokalerna Fläskabäcken Gimmarp, Fläskabäcken Gripenberg, Ängån Kulla.Lokalerna Fläskabäcken Gimmarp, Svanån uppströms Svansjön, Vedabäcken Brofors, Äl-gån Lövrödjan, Ängån inlopp Nissan och Ängån Kulla uppvisade ett artantal på under 30 arter, men enbart Ängån Kulla med 20 arter låg på gränsen för riskflaggning. Låg diversitet noterades för lokalerna Fläskabäcken Gimmarp och Svanån uppströms Svansjön.Med hänseende till skaldeformationer uppvisade lokalerna Närmrebäck övre och Veda-bäcken Tjärberget Svag miljöpåverkan, medan resterande lokaler uppvisade Försumbar mil-jöpåverkan.
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| 48. |
- Karlsson, Ingela
(författare)
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Distal movement of maxillary molars. Studies of efficiency and timing of treatment
- 2008
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Licentiatavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Den vanligaste bettavvikelsen som behandlas bland barn och ungdomar är trångställning. När funktionellt och estetiskt störande trångställning i överkäken ska behandlas kan man vanligtvis ta bort tänder eller flytta de första stora kindtänderna (sexårständerna) bakåt för att sedan göra tandraden jämn. Det finns flera vetenskapliga studier som beskriver behandlingseffekterna av olika tandställningar för att flytta de stora kindtänderna bakåt. Det är oklart vilken typ av tandställning som är effektivast och i allmänhet saknas ett evidensbaserat perspektiv. Det är också oklart vid vilken tidpunkt som det är mest effektivt att flytta sexårständerna bakåt, dvs. före eller efter det att de andra stora kindtänderna kommit på plats i tandbågen. Licentiatavhandlingen är baserad på följande studier: Med randomiserad kontrollerad studiedesign var syftet i Studie I att utvärdera behandlingseffekterna av två olika tandställningar för att flytta överkäkens sexårständer bakåt i tandbågen. Fyrtio patienter randomiserades, 20 till en avtagbar tandställning (extraoralt drag) och 20 patienter till en fast tandställning. Studie II hade syftet att analysera när behandlingen var effektivast, dvs. att tandreglera sexårstanden bakåt innan eller efter att den bakomvarande stora kindtanden kommit på plats i tandbågen. I ramberättelsen utfördes dessutom en systematisk litteraturöversikt med syfte att på ett evidensbaserat sätt utvärdera olika metoders effektivitet i att tandreglera de stora kindtänderna bakåt i tandbågen och att göra en kvalitetsbedömning av de utvalda studierna. Översikten omfattade tidsperioden från januari 1966 t o m april 2008 vilket innebar att bedömningen även inkluderade studierna I och II. Konklusioner: • Fast tandställning var effektivare än avtagbar för att flytta de första stora kindtänderna bakåt i tandbågen. • Sidoeffekter i form av 1-2 mm ökat överbett (förankringsförlust) uppstod vid behandling med fast tandställning medan avtagbar tandställning bidrog till minskat överbett. • Det var mest effektivt att tandreglera sexårstanden bakåt innan den bakomvarande stora kindtanden kommit på plats i tandbågen. • I litteraturen fanns det begränsat bevisvärde för att fast tandställning är mer effektiv än avtagbar för bakåtförflyttning av första stora kindtanden i överkäken och att sidoeffekter (1-2 mm ökat överbett) blir följden av den fastsittande apparaturen. • Det är fortfarande svårt att via litteraturen dra några slutsatser om vilken typ av fast tandställning som är mest effektiv och därför behövs det ännu mer forskning om detta.
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| 49. |
- Karlsson, Ingela, et al.
(författare)
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Intraoral maxillary molar distalization
- 2006
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Ingår i: Angle orthodontist. - : The Angle Orthodontist (EH Angle Education & Research Foundation). - 0003-3219 .- 1945-7103. ; 76:6, s. 923-929
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- OBJECTIVE: To evaluate the maxillary molar distalization and anchorage loss in two groups, one before (MD 1 group) and one after (MD 2 group) eruption of second maxillary molars. MATERIALS AND METHODS: After a sample size calculation, 20 patients were recruited for each group from patients who fulfilled the following criteria: no orthodontic treatment before distal molar movement, Class II molar relationship defined by at least end-to-end molar relationship, space deficiency in the maxilla, and use of an intra-arch NiTi coil appliance with a Nance appliance to provide anchorage. Patients in the MD 1 group were without any erupted second molars during the distalization period, whereas in the MD 2 group both the first and second molars were in occlusion at start of treatment. The main outcome measures to be assessed were: treatment time, ie, time in months to achieve a normal molar relation, distal movement of maxillary first molars, and anterior movement of maxillary incisors (anchorage loss). The mean age in the MD 1 group was 11.4 years; in the MD 2 group, 14.6 years. RESULTS: The amount of distal movement of the first molars was significantly greater (P < .01) and the anchorage loss was significantly lower (P < .01) in the group with no second molars erupted. The molar distalization time was also significantly shorter (P < .001) in this group, and thus the movement rate was two times higher. CONCLUSIONS: It is more effective to distalize the first maxillary molars before the second molars have erupted.
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| 50. |
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