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1.	Roos, Sara, 1979, et al. (författare) Subnormal levels of POLgA cause inefﬁcient initiation of light-strand DNA synthesis and lead to mitochondrial DNA deletions and progressive external ophthalmoplegia 2013 Ingår i: Human Molecular Genetics. - : Oxford University Press (OUP). - 0964-6906 .- 1460-2083. ; 22:12, s. 2411-2422 Tidskriftsartikel (refereegranskat)abstract The POLG1 gene encodes the catalytic subunit of mitochondrial DNA (mtDNA) polymerase γ (POLγ). We here describe a sibling pair with adult-onset progressive external ophthalmoplegia, cognitive impairment and mitochondrial myopathy characterized by DNA depletion and multiple mtDNA deletions. The phenotype is due to compound heterozygous POLG1 mutations, T914P and the intron mutation c.3104 + 3A > T. The mutant genes produce POLγ isoforms with heterozygous phenotypes that fail to synthesize longer DNA products in vitro. However, exon skipping in the c.3104 + 3A > T mutant is not complete, and the presence of low levels of wild-type POLγ explains patient survival. To better understand the underlying pathogenic mechanisms, we characterized the effects of POLγ depletion in vitro and found that leading-strand DNA synthesis is relatively undisturbed. In contrast, initiation of lagging-strand DNA synthesis is ineffective at lower POLγ concentrations that uncouples leading strand from lagging-strand DNA synthesis. In vivo, this effect leads to prolonged exposure of the heavy strand in its single-stranded conformation that in turn can cause the mtDNA deletions observed in our patients. Our findings, thus, suggest a molecular mechanism explaining how POLγ mutations can cause mtDNA deletions in vivo.
2.	Semb, Gunvor, et al. (författare) A Scandcleft randomised trials of primary surgery for unilateral cleft lip and palate: 1. Planning and management. 2017 Ingår i: Journal of Plastic Surgery and Hand Surgery. - : Taylor & Francis. - 2000-656X .- 2000-6764. ; 51:1, s. 2-13 Tidskriftsartikel (refereegranskat)abstract BACKGROUND AND AIMS: Longstanding uncertainty surrounds the selection of surgical protocols for the closure of unilateral cleft lip and palate, and randomised trials have only rarely been performed. This paper is an introduction to three randomised trials of primary surgery for children born with complete unilateral cleft lip and palate (UCLP). It presents the protocol developed for the trials in CONSORT format, and describes the management structure that was developed to achieve the long-term engagement and commitment required to complete the project.METHOD: Ten established national or regional cleft centres participated. Lip and soft palate closure at 3-4 months, and hard palate closure at 12 months served as a common method in each trial. Trial 1 compared this with hard palate closure at 36 months. Trial 2 compared it with lip closure at 3-4 months and hard and soft palate closure at 12 months. Trial 3 compared it with lip and hard palate closure at 3-4 months and soft palate closure at 12 months. The primary outcomes were speech and dentofacial development, with a series of perioperative and longer-term secondary outcomes.RESULTS: Recruitment of 448 infants took place over a 9-year period, with 99.8% subsequent retention at 5 years.CONCLUSION: The series of reports that follow this introductory paper include comparisons at age 5 of surgical outcomes, speech outcomes, measures of dentofacial development and appearance, and parental satisfaction. The outcomes recorded and the numbers analysed for each outcome and time point are described in the series.TRIAL REGISTRATION: ISRCTN29932826.
3.	Andersson, Maria, et al. (författare) Transport av dräktiga djur, transport av unga djur och åldersbestämning av foster 2023 Rapport (övrigt vetenskapligt/konstnärligt)abstract De flesta lantbruksdjur transporteras endast enstaka gånger i livet och har därför sällan möjlighet att vänja sig vid transporter på ett sätt som skulle förebygga stress och bidra till en god transportupplevelse. Att skapa förutsättningar som minimerar påverkan på djuren och underlättar drivning av djuren är därför av stor vikt. Livdjurstransport eller transport till slakt kan vara en mycket stressfylld situation för djur. EFSA har under 2022 publicerat tre olika utlåtanden om transport av nötkreatur, små idisslare och gris. EFSA har i sina utlåtanden identifierat följande relevanta välfärdsrisker: social stress i samband med omgruppering, stress då djuren hanteras av ovarsamma människor eller av människor som de inte är vana vid, stress på grund av värme eller kyla, skador, rörelsestress (orsakat av fordonets rörelser), predationsstress (specifikt hos får som drivs med hund), hunger, törst, respiratoriska problem (specifikt hos nötkreatur), begränsade rörelsemöjligheter, svårigheter att vila och sensorisk överstimulering. Sammantaget kan dessa välfärdsrisker leda till ackumulerad och hög stress, rädsla, smärta, obehag och utmattning hos djuren.Nötkreatur, grisar och får är sociala djur som lätt stressas om de separeras från sin grupp. Att ta hänsyn till deras naturliga flockbeteende genom att t.ex. inte driva djur enskilt utan i grupp (undantag för vuxna handjur som ofta behöver hanteras enskilt) är därför viktigt både före, under och efter transport. Omgrupperingar och social stress riskerar att leda till aggressioner och oönskade beteenden då djuren kan komma att skada sig själva eller varandra.Djurs tidigare erfarenheter av att bli hanterade av människor påverkar deras upplevelse och stressnivå vid hantering i samband med transport. En mer vänlig hantering av djuren tidigt i livet kan underlätta hanteringen i samband med transport. Djurens rädsla utgör en välfärdsrisk, både för djuren själva och för den transportör som ska hantera dem. Utlastningsutrymmen och drivvägar behöver vara väl designade för att få ett bra flöde när djuren lastas respektive lastas av och den som hanterar djuren behöver ha god kunskap om djurens naturliga beteenden.Hunger och törst kan uppstå hos djur under tiden från lastning till transport och urlastning. Risken för att djuren ska uppleva hunger och törst ökar med längre transporttider. Unga djur har ett naturligt tätare födointag vilket man kan behöva ta hänsyn till vid transport genom att erbjuda djuren möjlighet att äta och dricka oftare än äldre djur. I nuläget finns det inga optimala lösningar på hur man ska kunna tillgodose behovet av vatten eller annan utfodring på transport då intaget även påverkas av stress och sociala faktorer utöver vana vid utrustningen.Djurtätheten på transportfordonet är en viktig faktor som påverkar djurens möjligheter att hålla balansen och att kunna ligga ned och vila, men även risken för skador och död. Behovet av att kunna ligga ned under transport ökar med transportens längd och huruvida djuren ligger ned är kopplat till vilket utrymme som ges, där större utrymme leder till att fler djur ligger ned.Sen dräktighet räknas som ett tillstånd då det inte är lämpligt att transportera ett djur eftersom transport under denna period kan leda till negativa konsekvenser för djurets välfärd och risker för avkomman. Dräktighet innebär ökad sårbarhet både fysiskt och fysiologiskt. För dräktiga djur innebär därför den stress som förflyttning, lastning, ny miljö, okända människor, rörlig och ostabil transport, transportfordonets förutsättningar, samt avsaknad av foder och vatten under längre perioder, en större påfrestning med en ökad risk för negativa konsekvenser, än för icke-dräktiga djur. Dräktiga djur har en ökad metabolism och värmeproduktion, framförallt under sen dräktighet, vilket gör dräktiga djur mer känsliga för värmestress än icke-dräktiga djur. Vidare blir fysisk ansträngning jobbigare för det dräktiga djuret beroende både på den ökade tyngden och dess påverkan på rörelseapparaten. Även cirkulationssystemet blir mer ansträngt med en förhöjd hjärtfrekvens som följd. Vid värmestress ökar dessutom andningsfrekvensen påtagligt.Kortisol har en viktig roll i slutet av dräktigheten och för att initiera förlossning. I slutet av dräktigheten stiger kortisolnivåerna i moderdjurets blod till följd av att fostrets kortisolproduktion ökar. Förhöjda kortisolnivåer till följd av stress och fysisk ansträngning i samband med lastning, hantering, omgruppering, transport och nya miljöer kan orsaka abort eller för tidig igångsättning av förlossningen. Flera studier visar att det även finns risker under andra delar av dräktigheten. Transport ökar till exempel risken för embryonala förluster under tidig dräktighet hos gris, framför allt under vecka två till fyra, vilket är en kortisolkänslig period. För nötkreatur finns det risk för embryonala förluster vid transporter under dräktighetens första två månader och studier på får har visat på negativa effekter på lamm och ökad risk för fosterdöd vid förhöjda kortisolnivåer hos tackan. Det finns även en risk för epigenetiska effekter hos fostren vid stress hos moderdjuret, vilka kan komma att påverka avkomman senare i livet.När hondjuren ökar i vikt genom fostertillväxt och ökad volym av fostervätskor, påverkas deras rörlighet och förmåga att hålla balansen vilket kan göra att både lastning och transport försvåras samt innebära en ökad risk för halkskador och fläkningsskador. Eventuella led- och klövproblem kan dessutom förvärras eller försvåra rörelsemöjligheterna, även om uppenbar hälta inte alltid kan ses. Den ökade storleken gör att dräktiga djur kräver större plats under transporten, både för att djuren i sig är större, men också för att de ska kunna parera rörelser och hålla balansen. Dräktiga grisar minskar sin aktivitetsnivå och har större behov av att ligga ned och vila vilket behöver tillgodoses under transport.I slutet av dräktigheten, oklart exakt när, sker en uppmjukning av vävnaderna i bäckenregionen vilket är mer påtagligt för nötkreatur än för små idisslare och suggor. Uppmjukningen kvarstår även en tid efter förlossningen. Uppmjukningen ger försämrad stabilitet vid rörelse, vilket innebär risker vid både lastning och transport. Det är därför viktigt att man tar hänsyn till detta och har god tidsmarginal vid transport av dräktiga eller nyförlösta djur, så att djuren inte riskerar att transporteras under den tid som bäckenet är instabilt.Den vetenskapliga evidensen för EU:s regel om 90 % av den förväntade dräktighetstiden som gräns för transport av dräktiga djur förefaller oklar. Rådet ställer sig bakom konklusionen i EFSA:s utlåtande om transport av nötkreatur, små idisslare och gris, om att vetenskapliga belägg för den exakta nu gällande gränsdragningen saknas, samtidigt som det är tydligt att långt gången dräktighet är en riskfaktor för negativ djurvälfärd under transport. I de aktuella utlåtandena finns dock flera studier citerade som visar på sårbarhet för de dräktiga djuren och deras foster under en period som i många fall är längre än de sista 10 % av dräktighetstiden samt att det finns en ökad sårbarhet även under andra delar av dräktigheten och att både moderdjur och foster kan påverkas negativt av att transporteras.Det finns risk för att den stress som en transport innebär kan leda till att det sent dräktiga djuret aborterar eller att förlossningen sätts igång under eller strax efter transport. Då det således föreligger risker för foster och moderdjur vid transport av dräktiga djur under stora delar av dräktighetsperioden anser Rådet att transport av dräktiga djur (nötkreatur, får och gris) om möjligt bör undvikas.Vid transport av unga kalvar, smågrisar och lamm måste hänsyn tas till flera faktorer, såsom ålder, immunförsvarets utveckling, djurens allmänna hälsostatus, huruvida djuren är avvanda eller inte, social stress, etc. Unga djur är generellt känsligare än vuxna djur, och påverkas än mer av att utsättas för hunger och törst, kalla och varma transporter, och begränsade möjligheter att vila under transport. Under perioden då det passiva immunförsvaret går ned samtidigt som det aktiva immunförsvaret är under uppbyggnad är djuren extra känsliga för infektioner.Hur väl ett ungt djur klarar en transport beror bl.a. på längden på transporten (ju längre transport desto större risk för djurens välfärd), samt djurets ålder och vikt. Tiden mellan två och fyra veckor är en känslig ålder för transport av kalvar. Enligt EFSA bör inte kalvar transporteras tidigare än vid fem veckors ålder och de bör väga minst 50 kg. För lamm rekommenderas att djuren transporteras först efter avvänjning. Vidare behöver hänsyn tas till djurens behov av foder och vatten, så att deras närings- samt vätskebehov tillgodoses. Hänsyn behöver även tas till på vilket sätt de är vana vid att inta foder och vatten, och om djuret hålls på liknande sätt i transporten som de är vana vid, exempelvis i samma grupp eller tillsammans med sin mamma. Det kan vara klokt att utfodra djuren innan transport för att minska risken för hunger under transporten. Vid mjölkgiva till kalv behöver tid ges för digestion innan transport för att minska risken för diarré.Icke avvanda djur upplever en större stress runt transport än avvanda djur (vid transport utan moderdjur) och det är därför bättre att företrädesvis transportera djuren efter avvänjning. Unga djur är heller inte motoriskt färdigutvecklade, vilket kan påverka deras balans under transport samt vid på- och avlastning. Yngre djur ligger ned oc
4.	Asp, Margareta, et al. (författare) Samvetsstress och dåliga villkor bakom sjuksköterskeflykten 2017 Ingår i: Dagens Nyheter. Tidskriftsartikel (populärvet., debatt m.m.)abstract Ge sjuksköterskor utrymme att göra kvalificerade bedömningar av patientens omvårdnadsbehov och låt dem också få gehör för de omvårdnadsinterventioner de föreslår. Det skulle inte bara bidra till att minska samvetsstress och arbetsrelaterad ohälsa hos sjuksköterskor utan också bidra till att de stannar i yrket, skriver sex forskare i vårdvetenskap.
5.	Asp, Margareta, et al. (författare) ”Samvetsstress och dåliga villkor bakom sjuksköterskeflykten” 2017 Ingår i: Dagens nyheter. - 1101-2447. ; :2017-05-04 Tidskriftsartikel (populärvet., debatt m.m.)
6.	Austeng, Dordi, et al. (författare) Incidence of and risk factors for neonatal morbidity after active perinatal care : extremely preterm infants study in Sweden (EXPRESS) 2010 Ingår i: Acta Paediatrica. - : Wiley. - 0803-5253 .- 1651-2227. ; 99:7, s. 978-992 Tidskriftsartikel (refereegranskat)abstract Aims: The aim of this study was to determine the incidence of neonatal morbidity in extremely preterm infants and to identify associated risk factors. Methods: Population based study of infants born before 27 gestational weeks and admitted for neonatal intensive care in Sweden during 2004-2007. Results: Of 638 admitted infants, 141 died. Among these, life support was withdrawn in 55 infants because of anticipation of poor long-term outcome. Of 497 surviving infants, 10% developed severe intraventricular haemorrhage (IVH), 5.7% cystic periventricular leucomalacia (cPVL), 41% septicaemia and 5.8% necrotizing enterocolitis (NEC); 61% had patent ductus arteriosus (PDA) and 34% developed retinopathy of prematurity (ROP) stage >= 3. Eighty-five per cent needed mechanical ventilation and 25% developed severe bronchopulmonary dysplasia (BPD). Forty-seven per cent survived to one year of age without any severe IVH, cPVL, severe ROP, severe BPD or NEC. Tocolysis increased and prolonged mechanical ventilation decreased the chances of survival without these morbidities. Maternal smoking and higher gestational duration were associated with lower risk of severe ROP, whereas PDA and poor growth increased this risk. Conclusion: Half of the infants surviving extremely preterm birth suffered from severe neonatal morbidities. Studies on how to reduce these morbidities and on the long-term health of survivors are warranted.
7.	Berg, Elisabeth Gräslund, et al. (författare) Praktiker som gör skillnad : Om den verb-inriktade metoden 2013 Ingår i: Historisk Tidskrift. - 0345-469X .- 2002-4827. ; 133:3, s. 335-354 Tidskriftsartikel (refereegranskat)abstract This article discusses the so-called verb-oriented method and its role in the research project Gender and Work in early modern Sweden (GaW), which is based at Uppsala University. It provides a presentation of the GaW-database, which has been designed to allow analysis according to the verb-method. Finally, the article points out that this method can be combined with a number of different theoretical approaches as long as the focus is on practices. It is therefore compatible with the approaches of e.g., Judith Butler, Michel de Certeau, and Amartya Sen. Work is defined as "time-use with the purpose of making a living" and the article discusses why data on time-use, or actual work activities, are better suited for research into early modern Swedish working life than other types of data. It shows that activities are usually described in the sources by verb-phrases, and explains how and from what sources verb-phrases are collected and analyzed within the project. In order to allow for generalizations the verb-method presupposes large amounts of data. This is the rationale for the GaW-database, which at present includes around 5000 verb-phrases and 75000 data posts.
8.	Berggren, Daniel Moreno, et al. (författare) Prognostic scoring systems for myelodysplastic syndromes (MDS) in a population-based setting : a report from the Swedish MDS register 2018 Ingår i: British Journal of Haematology. - : Wiley. - 0007-1048 .- 1365-2141. ; 181:5, s. 614-627 Tidskriftsartikel (refereegranskat)abstract The myelodysplastic syndromes (MDS) have highly variable outcomes and prognostic scoring systems are important tools for risk assessment and to guide therapeutic decisions. However, few population-based studies have compared the value of the different scoring systems. With data from the nationwide Swedish population-based MDS register we validated the International Prognostic Scoring System (IPSS), revised IPSS (IPSS-R) and the World Health Organization (WHO) Classification-based Prognostic Scoring System (WPSS). We also present population-based data on incidence, clinical characteristics including detailed cytogenetics and outcome from the register. The study encompassed 1329 patients reported to the register between 2009 and 2013, 14% of these had therapy-related MDS (t-MDS). Based on the MDS register, the yearly crude incidence of MDS in Sweden was 2.9 per 100000 inhabitants. IPSS-R had a significantly better prognostic power than IPSS (P < 0001). There was a trend for better prognostic power of IPSS-R compared to WPSS (P=0.05) and for WPSS compared to IPSS (P=0.07). IPSS-R was superior to both IPSS and WPSS for patients aged <= 70years. Patients with t-MDS had a worse outcome compared to de novo MDS (d-MDS), however, the validity of the prognostic scoring systems was comparable for d-MDS and t-MDS. In conclusion, population-based studies are important to validate prognostic scores in a real-world' setting. In our nationwide cohort, the IPSS-R showed the best predictive power.
9.	Berggren, Daniel Moreno, et al. (författare) Validation Of Prognostic Scoring Systems For Myelodysplastic Syndromes In The Swedish Mds-Register 2016 Ingår i: Haematologica. - 0390-6078 .- 1592-8721. ; 101, s. 243-243 Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
10.	Bernerstedt, Thomas, et al. (författare) 3500 kyrkor : Problem eller möjlighet. 8 Restuareringsexempel 2014 Rapport (populärvet., debatt m.m.)abstract I kyrkorna finner man de högsta kvaliteterna av arkitektur och konst som har stått i mänsklig makt att uppbringa. Kulturarvets värde är högt. Arkitektur är en konstart som förstärker funktionen/verksamheten – på samma sätt som t.ex. musik, poesi, skulptur eller måleri. Konstarterna går utöver funktionerna/verksamheterna, därför finns det alltid nya möjligheter att bearbeta. Restaureringskonstens uppgift är att tillvara arkitekturkvaliteterna, utveckla dem och förhöja dem. Det finns ungefär 3 500 kyrkor inom Svenska kyrkan, en tredjedel medeltida och entredjedel från 1950–60-talen. Sammantaget är det en komplex samling byggnader. Majoriteten av 6,4 miljoner medlemmar i Svenska kyrkan är intresserade av att kyrkobyggnaderna tas om hand. Färre säger sig vara intresserade av att aktivt delta i kyrkans kärnverksamhet. Men kyrkobyggnaden och verksamheten hänger samman; de enda byggnader som haft enoch samma användning i 1000 år är kyrkor. Att vårda och utveckla kyrkobyggnadsmiljöernaingår inte i kyrkans kärnverksamheter. Varför inte? Sedan relationsförändringen år 2000 då kyrkan skildes från staten har inga långsiktiga visioner eller strategier om förvaltningen av Sveriges mest tillgängliga kulturskatt framkommit. Inget drastiskt hände år 2000; antalet gudstjänstbesökare började minska långt tidigare. Varför ska vi vara så oroliga nu när vi inte var det förut? Våra kyrkor är i bättre skick än i något annat land i Europa, vi har aldrig haft det så bra som nu, ändå är det först nu som vi inte anser oss ha råd att sköta denna del av kulturarvet. Andra länder har en mängd olika sätt att finansiera och arbeta med kyrkobyggnader. Sverige har bara ett sätt, statsbidrag. En mängd oprövade möjligheter finns – ett gyllene ägg att förvalta! 20 studenter i Restaureringskonst har arbetat med kunskapsuppbyggnad i teori och praktik under året. Våra studier har innefattat tre innerstadskyrkor och fem andra kyrkor i Stockholms stift, praktiskt nåbara för våra studier. Vi är väl medvetna om de helt olikartade förutsättningar som finns i vårt avlånga land med Europas snabbaste urbaniseringstakt, även om vi haft ett begränsat antal fallstudier när vi tränat arbetsprocess och metodik. Året har förutom projektarbete omfattat föreläsningar, seminarier, workshops och studieresor inom restaureringshistoria, dokumentation med 3D-laserscanning, kulturhistoriskvärdering och analys, material och metoder för restaurering, gestaltning och bevarande,presentation och kommunikation. Av årets studenter är tio arkitekter, en ingenjör, sex antikvarier, två konservatorer och en förvaltare. Tack vare kursens blandade professioner är inledningdiskussionerna och det interna kunskapsutbytet en viktig del av utbildningen, liksom det nätverk som erbjuds genom inbjudna föreläsare och specialister inom praktisk restaurering och i forskningsfronten. Genom studiebesök och studieresor får studenterna kontakter ochintryck av hur restaurering tillämpas och diskuteras i olika sammanhang. I år har vi gjort studieresor till Tyskland och England samt inom Sverige. Kyrkan har i alla tider stått för högsta kvalitet i arkitektur och konst – årets kurs vill visa värdet av denna resurs och hur vi kan arbeta med uppgiften att upprätthålla och gärna öka kulturarvets kvaliteter genomrestaureringskonst.Vi tackar alla som bidragit till genomförandet av vår kurs i år; särskilt Stockholms stift och de församlingar som har gett oss tillgång till sina kyrkor.
11.	Bjerg, Anders, et al. (författare) Shorter time to clinical decision in work-related asthma using a digital tool 2020 Ingår i: ERJ open research. - Lausanne, Switzerland : European Respiratory Society (ERS). - 2312-0541. ; 6:3 Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract PEF curves are a useful but cumbersome tool in diagnosing work-related asthma. Using a digital spirometer and smartphone app, time to clinical decision could be shortened by 6-7 weeks. Physician's time spent analysing PEF data is also shortened.
12.	Blennow, M, et al. (författare) HIGH ONE-YEAR SURVIVAL AFTER ACTIVE PERINATAL CARE : EXTREMELY PRETERM INFANTS IN SWEDEN (EXPRESS) 2009 Ingår i: in ACTA PAEDIATRICA, vol 98. ; , s. 8-8 Konferensbidrag (refereegranskat)abstract n/a
13.	Claesson, Maria, 1971- (författare) Sjuksköterskans ledarskap i det patientnära vårdandet av äldre personer i kommunens hemsjukvård : Att leda i ett mellanrum av närhet och distans 2022 Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract Aim: The overall aim is to develop knowledge about the phenomenon of leading care close to the patient in community home care from the perspectives of older persons (aged 65 years and older), next of kin and registered nurses. Methods: A qualitative, descriptive and interpretative approach guided the methodology of this dissertation. The first study was a systematic literature review with the following research question: What implies registered nurses’ leadership close to older persons in community home care? The review was documented in accordance with the PRISMA reporting guidelines. Nine articles, all with a qualitative research approach, met the quality criteria, and a qualitative research synthesis of the data was performed in four stages. Studies II–III were interview studies consisting of individual interviews with 12 older persons in their own homes (Study II) and telephone interviews with 11 next of kin (Study III), focusing on their experiences of registered nurses’ leadership of the care close to older persons in community home care. The data material in Studies II–III was analysed using qualitative content analysis. Study IV was based on the reflective lifeworld research method, comprising individual interviews with nine registered nurses working in community home care. The data material was analysed with a lifeworld hermeneutic approach. Main Findings: Leading care close to the patient in community home care was found to consist of an ethical demand that came with the responsibility for leading those involved in the care – in a space between closeness and distance. From a caring science perspective, leading care in a space between closeness and distance can be understood as leading between health and illness, between biology and existence and being aware of the older person’s autonomy and integrity, allowing the other to trustingly surrender to care. Leading care can then mean maintaining an ethical approach in the meeting with the patient to safeguard dignified care for older persons in need of home care. Conclusions: The knowledge gained from these studies can help us better understand the prerequisites for leading the care of patients in community home care and contribute to improving the care for patients who are in an existentially vulnerable life situation.
14.	Claesson, Maria, 1971-, et al. (författare) What implies registered nurses leadership close to older adults in the municipality home health care? 2019 Konferensbidrag (refereegranskat)abstract Title. What implies registered nurses leadership close to older adults in the municipality home health care?Objective. The objective was to explore how the literature describes the registered nurses’ leadership near to older adults in municipal home care.Background. Home health care in Sweden and world-wide is affected by the increasing number of older adults, 65 years and over. One challenge is that older adults report more health problems compared with health professionals’ needs assessments. The primary task of care is to support and strengthen people’s health processes to as good health as possible by alleviating the effects of disease and suffering. The registered nurse may be the one who contributes or makes a difference to the older adults’ experience of health. According to this; great demands are placed on the registered nurse's leadership close to the patient. There is a common agreement that registered nurses’ leadership is important. However, research is limited of what implies registered nurses’ leadership close to older adults in municipal home care.Method. A systematic literature review. The literature search was performed in CINAHL and PubMed during February to April, 2018. A total of 37 articles were identified and nine articles were screened in full text. Quality valuation and analyses of articles were performed doing qualitative research synthesis based of the PRISMA statement.Results. The results will be presented for the first time at the 9th IAGG-ER Congress, May 23-25, 2019, Gothenburg, Sweden.
15.	Claesson, Maria, 1971-, et al. (författare) What implies registered nurses’ leadershipclose to older adults in municipal homehealth care? A systematic review 2020 Ingår i: BMC Nursing. - : Springer. - 1472-6955. ; 19:30, s. 1-11 Tidskriftsartikel (refereegranskat)abstract Background: Registered nurses are key figures in municipal home health care for older adults. Thus, registerednurses’ leadership is crucial to a successful and preventive care process as well as a supportive organization in orderto achieve safe care. However, there is limited research on what registered nurses’ leadership implies close to olderadults in municipal home health care. Thus, the aim is to compile and critically evaluate how international researchresults describe registered nurses’ leadership close to older adults in municipal home health care.Methods: A systematic literature review was performed in accordance with a qualitative research study. The mainsearch was conducted on 20 April 2018. The review was reported according to the PRISMA guidelines and is registeredin the PROSPERO database (ID# CRD42019109206). Nine articles from PubMed and CINAHL meet the quality criteria. Asynthesis of data was performed in four stages according to qualitative research synthesis.Results: Ten themes describe what registered nurses’ leadership close to older adults in municipal home health careentails: trust and control; continuous learning; competence through knowledge and ability; nursing responsibility on anorganizational level; application of skills; awareness of the individual’s needs and wholeness; mutual support; mutualrelationships; collaborating on organizational and interpersonal levels; and exposure to challenges.Conclusions: Registered nurses leading close to older adults in municipal home health care implies being multi-artists.Nursing education, including specialist education for registered nurses, should prepare individuals for their unique andcomplex leadership role as a multi-artist. Municipal employers require knowledge about what registered nurses’leadership implies in order to create adequate conditions for their leadership objectives to achieve safe care. Furtherresearch is warranted to explore registered nurses’ leadership close to older adults in municipal home health care fromdifferent perspectives, such as older adults and next of kin.
16.	Creignou, Maria, et al. (författare) Early transfusion patterns improve the Molecular International Prognostic Scoring System (IPSS-M) prediction in myelodysplastic syndromes 2024 Ingår i: Journal of Internal Medicine. - : WILEY. - 0954-6820 .- 1365-2796. Tidskriftsartikel (refereegranskat)abstract Background The Molecular International Prognostic Scoring System (IPSS-M) is the new gold standard for diagnostic outcome prediction in patients with myelodysplastic syndromes (MDS). This study was designed to assess the additive prognostic impact of dynamic transfusion parameters during early follow-up. Methods We retrieved complete transfusion data from 677 adult Swedish MDS patients included in the IPSS-M cohort. Time-dependent erythrocyte transfusion dependency (E-TD) was added to IPSS-M features and analyzed regarding overall survival and leukemic transformation (acute myeloid leukemia). A multistate Markov model was applied to assess the prognostic value of early changes in transfusion patterns. Results Specific clinical and genetic features were predicted for diagnostic and time-dependent transfusion patterns. Importantly, transfusion state both at diagnosis and within the first year strongly predicts outcomes in both lower (LR) and higher-risk (HR) MDSs. In multivariable analysis, 8-month landmark E-TD predicted shorter survival independently of IPSS-M (p < 0.001). A predictive model based on IPSS-M and 8-month landmark E-TD performed significantly better than a model including only IPSS-M. Similar trends were observed in an independent validation cohort (n = 218). Early transfusion patterns impacted both future transfusion requirements and outcomes in a multistate Markov model. Conclusion The transfusion requirement is a robust and available clinical parameter incorporating the effects of first-line management. In MDS, it provides dynamic risk information independently of diagnostic IPSS-M and, in particular, clinical guidance to LR MDS patients eligible for potentially curative therapeutic intervention.
17.	Creignou, M., et al. (författare) Targeted Sequencing of A Cohort Of 385 Patients With Myelodysplastic Syndromes : A Multicenter, Population-Based Study From Sweden 2017 Ingår i: Leukemia Research. - : PERGAMON-ELSEVIER SCIENCE LTD. - 0145-2126 .- 1873-5835. ; 55, s. S138-S139 Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
18.	Creignou, Maria, et al. (författare) Transfusion Patterns during Early Follow-up Predict Overall Survival Independently of IPSS-M in Patients with Myelodysplastic Syndromes 2022 Ingår i: Blood. - : American Society of Hematology. - 0006-4971 .- 1528-0020. ; 140:Suppl. 1, s. 6968-6970 Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
19.	Danenberg, P. V., et al. (författare) Folates as adjuvants to anticancer agents: Chemical rationale and mechanism of action 2016 Ingår i: Critical Reviews in Oncology Hematology. - : Elsevier BV. - 1040-8428. ; 106, s. 118-131 Tidskriftsartikel (refereegranskat)abstract Folates have been used with cytotoxic agents for decades and today they are used in hundreds of thousands of patients annually. Folate metabolism is complex. In the treatment of cancer with 5-fluorouracil, the administration of folates mechanistically leads to the formation of [6R]-5,10-methylene-tetrahydrofolate, and the increased concentration of this molecule leads to stabilization of the ternary complex comprising thymidylate synthase, 2'-deoxy-uridine-5'-monophosphate, and [6R]-5,10-methylene-tetrahydrofolate.The latter is the only natural folate that can bind directly in the ternary complex, with other folates requiring metabolic activation. Modulation of thymidylate synthase activity became central in the study of folate/cytotoxic combinations and, despite wide use, research into the folate component was neglected, leaving important questions unanswered. This article revisits the mechanisms of action of folates and evaluates commercially available folate derivatives in the light of current research. Better genomic insight and availability of new analytical techniques and stable folate compounds may open new avenues of research and therapy, ultimately bringing increased clinical benefit to patients. (C) 2016 The Authors. Published by Elsevier Ireland Ltd.
20.	Ekebergh, Margaretha, et al. (författare) The encounter between Caring Science and the Lifeworld 2012 Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract Scientific knowledge is characterized by abstract descriptions and structures which are not identical to the lived reality. Scientific knowledge cannot directly be applied on the lived existence, without being transformed and adjusted to the individual’s very complex lifeworld. Learning in caring contexts is an encounter between the scientific knowledge of caring and the learner’s lifeworld. This encounter needs a support that has the potential to bring caring science to life and to start an intertwining process with the lifeworld that creates embodied knowledge. Lifeworld didactics are built on an approach about learning as an individual process and that learning takes its point of departure in the learner’s previous experiences, which accompanies the learning process. The challenges within lifeworld didactics is to be open and sensitive to the learner’s lifeworld and with tact support the development of a reflective attitude in the learning process. Lifeworld didactics strategies are of crucial importance in different caring contexts. This paper presents three lifeworld led phenomenological research projects that have focused on acquiring caring science knowledge in caring contexts, more precisely it is the encounter between caring science and the lifeworld. The research is within the framework of lifeworld didactics, but the three projects each have a special focus. The first illustrates how the learning and caring processes merge and become an intertwined phenomenon in nursing students’ learning. The research is carried out in Dedicated Educational Units (DEU), within psychiatric and orthopedic care. Three perspectives are illustrated in the project; that of the students, the supervisors and the patients. The overall aim is to develop a supervision model that has the potential to support the students’ learning processes as well as the patients’ caring processes. The second illustrates how the concepts ‘patient perspective’ and ‘patient participation’ can be implemented in a clinical setting for elderly patients in order to improve the quality of care. This project is inspired by Participatory Action Research and is built on collaboration between the university and the health care services. The aim is to develop reflective educational material in terms of filmed drama episodes, based on the result of two studies about elderly patients’ participation in team meetings. The third illustrates the perspective of lifeworld didactics in two phenomenological studies that focus on Students` learning in an encounter with patients and Students` learning on the way to becoming professional - supported by supervision in pairs of students. The findings show patterns of essential meanings that have specific significance in the art of supporting students` learning in clinical education. These are; the significance of responsibility, its extent and shape in relation to the supervisor’s ability to adopt a reflective supervising attitude and to be supportive enough but at the same time to not assume the responsibility. The learning process shows to be a challenge for students, where safety in pairs of students has a great significance when coping with the challenge to learn and develop.
21.	Ekebergh, Margaretha, et al. (författare) The Encounter between Caring Sciences and the Lifeworld : The Art of Making Knowledge Alive and Embodied 2012 Konferensbidrag (refereegranskat)abstract Scientific knowledge is characterized by abstract descriptions and structures, which are not identical to the lived reality. Scientific knowledge cannot directly be applied on the lived existence, without being transformed and adjusted to the individual’s very complex lifeworld. Learning in caring contexts is an encounter between the scientific knowledge of caring and the learner’s lifeworld. This encounter needs a support that has the potential to bring caring science to life and to start an intertwining process with the lifeworld that creates embodied knowledge. Lifeworld didactics are built on an approach about learning as an individual process and that learning takes its point of departure in the learner’s previous experiences, which accompanies the learning process. The challenges within lifeworld didactics are to be open and sensitive to the learner’s lifeworld and with tact support the development of a reflective attitude in the learning process. Lifeworld didactics strategies are of crucial importance in different caring contexts. This symposium presents three lifeworld led phenomenological research projects that have focused on acquiring caring science knowledge in caring contexts, more precisely it is the encounter between caring science and the lifeworld. The research is within the framework of lifeworld didactics, but the three projects each have a special focus.
22.	Ekebergh, Margaretha, et al. (författare) The interaction between learning and caring - the patient’s narrative as a foundation for lifeworld-led reflection inlearning and caring 2020 Ingår i: Reflective Practice. - : Informa UK Limited. - 1462-3943 .- 1470-1103. Tidskriftsartikel (refereegranskat)abstract In this article, we present a knowledge approach to the interaction between learning and caring, which should play a significant role in the challenge of promoting sustainable healthcare. This knowledge approach requires awareness of the interactions between learning and caring in caring contexts. The intention is to present an exploration of knowledge and theory development based on research with a lifeworld perspective within caring science didactics. We are illuminating issues concerning reflection and learning encounters in a caring context, which include key concepts such as the patient’s narrative. A strategy for reflective learning and caring based on the lifeworld concept is presented. This strategy includes four main components: the encounter between general knowledge and the patient’s lived world, the patient’s narrative, caring relationship creation through interaction with the patient and reflection through supervision. All of these components are permeated by a reflective approach. We are also clarifying what it means to intertwine learning and caring in addition to how this process can be strengthened in caring practices to optimise patient care. Three components are particularly important in facilitating the intertwining of learning and caring in clinical practice, namely genuine meetings, sensitivity towards the patient’s narrative and reflection during interactions.
23.	Eskilsson, Camilla, 1963-, et al. (författare) Managers’ responsibility to support caring and learning in clinical education units 2017 Ingår i: Clinical Nursing Studies. - : Sciedu Press. - 2324-7940 .- 2324-7959. ; 5:3, s. 34-40 Tidskriftsartikel (refereegranskat)abstract Background: Managers in clinical education units (CEUs) have the responsibility to facilitate evidence-based environments for both caring and learning. Promoting such environments might be challenging in times of financial constraints and organisation changes.Objective: The purpose of this study was to describe how managers experience their responsibility to support the caring and learning environments in CEUs.Methods: The study method followed the principles of Reflective Lifeworld Research (RLR) grounded in a phenomenological approach. The study was conducted at a hospital in Southern Sweden. Ten first- and second-line managers responsible for CEUs were interviewed. The interviews were conducted as reflective dialogues using an open, and bridled approach.Results: The results show that clinical education unit managers regard the responsibility to support caring and learning environments as a challenging experience, elucidated in three themes: (1) to have or to take responsibility; (2) cooperation that supports and challenges; and (3) bringing it all together— a daily struggle.Conclusions: In conclusion, the managers of CEUs need to be aware of the importance of common theoretical grounds for caring and learning. Caring and learning are more likely to be intertwined when responsibility is taken, when collaboration between actors is characterised by respect and when an awareness of the importance of reflection is present. Awareness of the importance of creating opportunities for reflection and mutual collaboration among the different actors involved could lead to improvements in nursing education and, therefore, improved patient care.
24.	Eskilsson, Camilla, 1963- (författare) Vårdande och lärande sammanflätas i genuina möten : erfarenheter, förutsättningar och ansvar på utbildningsvårdavdelning 2016 Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract AimThe overall aim of this thesis is to create knowledge about caring and learning as an intertwining phenomenon at a Dedicated Education Unit and how it can be developed.Approach and methodA lifeworld approach, based on the phenomenological philosophies foremost derived from Husserl and Merleau-Ponty was used and carried out in lifeworld interviews and with meaning-oriented analysis in accordance with reflective lifeworld research. The participants were: 13 student nurses (study I), 11 patients (study II), 8 supervisors (study III) all from the same DEU in orthopedic care and 10 managers from various DEUs (study IV).Main findingsIntertwined caring and learning is most evident in genuine encounters between students and patients, supported by supervisors and managers. The intertwining is created in appealing challenges where students feel safe and ready. In the encounter with the patient they gain a sense of the whole where they can find their personal style. Patients, who feel invited to participate, could describe the encounter with students as genuine and a new dimension in nursing care. These encounters are characterized by closeness, thoroughness, accessibility, acknowledgement and sensitivity. When the encounter is less genuine, supervisors constitute an essential support for stabilizing the care. Supervisors constantly move in order to either stay close to or stand back, adjusting to the students’ and patients’ needs. Their demanding task as reflective supervisors requires pauses in order to maintain motivation. The managers’ daily struggle in a stressful and challenging reality is influenced by them either having or taking responsibility. Differences in approaches are shown in terms of more or less involvement and commitment in caring environment and educational issues. ConclusionsGenuine encounters are characterized by the core of both caring and learning and will thereby benefit both the students and the patients. Identifying and supporting genuine encounters is necessary for students, supervisors and managers. It is time to find ways to develop a unified view of how caring and learning can be intertwined.
25.	Fellman, Vineta, et al. (författare) One-year survival of extremely preterm infants after active perinatal care in Sweden. 2009 Ingår i: JAMA : the journal of the American Medical Association. - : American Medical Association (AMA). - 1538-3598 .- 0098-7484. ; 301:21, s. 2225-33 Tidskriftsartikel (refereegranskat)abstract Up-to-date information on infant survival after extremely preterm birth is needed for assessing perinatal care services, clinical guidelines, and parental counseling.
26.	Forsgärde, Elin-Sofie (författare) Pathways for older patients in acute situations and involved actors' experiences of decision-making in ambulatory care 2022 Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract Aim: The overall aim was to describe and compare pathways for older patients and the involved actors’ experiences of decision-making in acute situations in ambulatory care.Methods: The overall three-fold design, comprising exploratory, descriptive as well as comparative ones, was conducted inductively, including a mixed method with a convergent integrated approach to empirical data. The four involved studies were analysed using either quantitative or qualitative analysis methods.Results: Most older patients’ pathways when being assessed by ambulance personnel involved receiving care at hospitals. However, an increasing trend of non-conveyance to hospitals was identified during a five-year period (2014–2018), which means receiving care, for example, at home or primary healthcare (PHC) centres. Decision-making about the level-of-care for older patients was more or less uncertain for all involved actors, i.e. older patients, significant others and healthcare professionals such as ambulance personnel, registered nurses, specialists in general practice at PHC centres and community health nurses. To increase the level of certainty in the decision-making process, all actors was supported by both an individual and external dialogue. Individual dialogue gave support by using own experience and knowledge. For ambulance personnel and community health nurses, support was also partially gained from decision support tools but was regarded as insufficient when older patients had non-specific symptoms. External dialogue provided support through mutuality, and via collaboration, a common goal, trust and responsibility. Mutuality gave support through experience and knowledge being shared with all involved actors, which provided a common comprehensive understanding that facilitated consensus in the decision-making.Conclusion: The increasing level of non-conveyance to hospitals and uncertainty during decision-making highlights the need to develop and extend the availability of dialogue-based collaborations as support in ambulatory care. Dialogue-based support involves all actors contributing to the decision-making. Healthcare professionals need to be aware of the prerequisites and the support that mutuality in external dialogues brings. Healthcare organisations need to develop and extend dialogue-based collaboration in ambulatory care by combining different expertise and providing conditions to increase support in decisions adapted to older patients' needs.
27.	Friberg, Febe, 1950, et al. (författare) Creating Room for Learning at Work: Nurses´ Experiences of Participating in an Educational Program on the Function of Patient Teaching 2008 Ingår i: International Journal for Human Caring. - : International Association for Human Caring. - 1070-4795 .- 1091-5710. ; 12:3, s. 38-46 Tidskriftsartikel (refereegranskat)abstract The aim of this study was to describe an educational program concerning nurses´ patient-teaching work and how it was experienced by the nurses. The program consisted of five sessions, each with a main theme, which explored four main teaching/learning strategies. Interviews were conducted with the nurses and analyzed qualitatively. The analysis revealed three themes: intercollegial learning, increased awareness of pedagogical complexity, and increased preparedness. The study showed that participation in an educational program at work is one strategy by which nurses can become more closely linked with their patient-teaching function, which has direct consequences for practice.
28.	Gil, Jeovanis, et al. (författare) Clinical protein science in translational medicine targeting malignant melanoma 2019 Ingår i: Cell Biology and Toxicology. - : Springer Science and Business Media LLC. - 0742-2091 .- 1573-6822. ; 35:4, s. 293-332 Tidskriftsartikel (refereegranskat)abstract Melanoma of the skin is the sixth most common type of cancer in Europe and accounts for 3.4% of all diagnosed cancers. More alarming is the degree of recurrence that occurs with approximately 20% of patients lethally relapsing following treatment. Malignant melanoma is a highly aggressive skin cancer and metastases rapidly extend to the regional lymph nodes (stage 3) and to distal organs (stage 4). Targeted oncotherapy is one of the standard treatment for progressive stage 4 melanoma, and BRAF inhibitors (e.g. vemurafenib, dabrafenib) combined with MEK inhibitor (e.g. trametinib) can effectively counter BRAFV600E-mutated melanomas. Compared to conventional chemotherapy, targeted BRAFV600E inhibition achieves a significantly higher response rate. After a period of cancer control, however, most responsive patients develop resistance to the therapy and lethal progression. The many underlying factors potentially causing resistance to BRAF inhibitors have been extensively studied. Nevertheless, the remaining unsolved clinical questions necessitate alternative research approaches to address the molecular mechanisms underlying metastatic and treatment-resistant melanoma. In broader terms, proteomics can address clinical questions far beyond the reach of genomics, by measuring, i.e. the relative abundance of protein products, post-translational modifications (PTMs), protein localisation, turnover, protein interactions and protein function. More specifically, proteomic analysis of body fluids and tissues in a given medical and clinical setting can aid in the identification of cancer biomarkers and novel therapeutic targets. Achieving this goal requires the development of a robust and reproducible clinical proteomic platform that encompasses automated biobanking of patient samples, tissue sectioning and histological examination, efficient protein extraction, enzymatic digestion, mass spectrometry–based quantitative protein analysis by label-free or labelling technologies and/or enrichment of peptides with specific PTMs. By combining data from, e.g. phosphoproteomics and acetylomics, the protein expression profiles of different melanoma stages can provide a solid framework for understanding the biology and progression of the disease. When complemented by proteogenomics, customised protein sequence databases generated from patient-specific genomic and transcriptomic data aid in interpreting clinical proteomic biomarker data to provide a deeper and more comprehensive molecular characterisation of cellular functions underlying disease progression. In parallel to a streamlined, patient-centric, clinical proteomic pipeline, mass spectrometry–based imaging can aid in interrogating the spatial distribution of drugs and drug metabolites within tissues at single-cell resolution. These developments are an important advancement in studying drug action and efficacy in vivo and will aid in the development of more effective and safer strategies for the treatment of melanoma. A collaborative effort of gargantuan proportions between academia and healthcare professionals has led to the initiation, establishment and development of a cutting-edge cancer research centre with a specialisation in melanoma and lung cancer. The primary research focus of the European Cancer Moonshot Lund Center is to understand the impact that drugs have on cancer at an individualised and personalised level. Simultaneously, the centre increases awareness of the relentless battle against cancer and attracts global interest in the exceptional research performed at the centre.
29.	Gustafsson, Tanja, PhD student, 1980-, et al. (författare) ACTION: A Person-centred Communication Intervention Targeting Nurse Assistants in Home Care for Older Persons 2019 Konferensbidrag (refereegranskat)abstract Background: The aging population and the number of older persons living at home are increasing. Some have extensive needs for care, which leads to increased demands on professionals in home care settings. Professionals’ need to have sufficient competency to promote health and wellbeing among older persons. For sustainable care, there is a need for efficient educational efforts in the home care context. Person-centred communication may increase the quality of care and improve older persons independence.Aim: To develop, test and evaluate a web based educational intervention on person-centred communication targeting nurse assistants (NA) in home care setting.Method: A stepwise web based education, consisting of eight modules, was developed and tested. The education was evaluated using both quantitative and qualitative data.Results: In all, 23 NAs participated in the education. The majority of the NAs (n=21) participated in five or more modules. Overall, the education was experienced as feasible and accessible. Challenges emerged during the time of the intervention, such as time constrains, technical problems, and participants´ engagement.Conclusion: The web-based education was found to be a feasible way to offer education to home care staff, although successful implementation requires adaptations to the current context. Engagement from managers, especially considering the NAs motivation to complete the education is important for accomplishment by participants.Implications: This study can contribute to the knowledge regarding how to develop, test and evaluate an educational intervention, and considerations found to be important during the implementation process for success.
30.	Gustafsson, Tanja, PhD student, 1980-, et al. (författare) An educational intervention to improve communication skills in home care – a feasibility study 2022 Konferensbidrag (refereegranskat)abstract An educational intervention to improve communication skills in home care – a feasibility studyBackgroundAn educational intervention focused on person-centred communication with older persons in home care was developed. Twenty-three nursing assistants (NAs) from two home care units were offered the intervention. This feasibility study was conducted to capture benefits and pit falls with study processes before large scale interventions, such as acceptability and appropriateness of evaluation methods.AimTo explore the feasibility of proposed methods for evaluating a novel educational intervention on person-centered communication for NAs in home care.MethodFeasibility study with pre- and post-assessments, including evaluation of data collection procedures, completion rates, and missing data for two questionnaires: Self-efficacy Questionnaire measuring communication skills and Measure of Job Satisfaction. Descriptive and statistical analysis was conducted. ResultsThe results showed a completion rate of 83% and 61% in pre- and post-assessment respectively, and a low proportion of missing data. The questionnaires were feasible and acceptable for NAs to complete and understand. Stress due to staff shortages and high workload negatively affected NAs’ participation in data collection. Overall, NAs rated their communication skills as high with a tendency towards higher communication self-efficacy after the intervention, however, this difference was not statistically significant. Job satisfaction remained unchanged pre- and post-intervention.ConclusionLow follow-up rates suggest that the data collection procedures need refinement. Although the outcomes are preliminary at this point, they indicate a ceiling effect in NAs’ self-efficacy ratings. The ceiling effect limits possibilities for improvement and suggests that studies with a larger sample is needed.Implications for caring in a changing worldIn a changing world, where a rapid aging population challenges home care services, there is a need for innovative interventions that support and strengthen health care professionals’ communication skills, aiming at improving older persons’ well-being This study contributes with knowledge to the complexity of developing and evaluating complex interventions on communication in home care.
31.	Gustafsson, Tanja, PhD student, 1980-, et al. (författare) Communication in home care—A feasibility study of an educational intervention in self‐efficacy and job satisfaction 2023 Ingår i: Nursing Open. - : John Wiley & Sons. - 2054-1058. ; 10:3, s. 1375-1382 Tidskriftsartikel (refereegranskat)abstract AimTo explore the feasibility of evaluating a novel educational intervention on person-centered communication for nursing assistants (NAs) in home care.DesignA feasibility study with pre- and post-assessments.MethodsFeasibility was assessed pre- and post-intervention, including evaluation of data collection procedures, completion rates and missing data in two questionnaires: Self-efficacy Questionnaire measuring communication skills and Measure of Job Satisfaction, analysed descriptively and statistically.ResultsThe questionnaires were feasible and acceptable for the NAs to complete and understand. The pre- and post-assessments showed 83% and 61% completion rates, respectively, and a low proportion of missing data. Barriers for not participating in data collection were stress caused by staff shortages and high workload. Preliminary analysis of the questionnaires showed no significant difference pre- and post-intervention, even though an overall tendency of increased communication self-efficacy was observed. The NAs' self-efficacy ratings also revealed a ceiling effect.
32.	Gustafsson, Tanja, PhD student, 1980-, et al. (författare) Development and process evaluation of an educational intervention on communication targeting nurse assistants in home care 2019 Konferensbidrag (refereegranskat)abstract BackgroundPerson-centred communication is important to assure the quality of home care services and to promote older persons´ independence and influence over their lives. Previous research indicates challenges regarding communication between professionals and home care recipients, and how to deliver efficient educational efforts in the home care context.AimThe aim was to describe the development and process evaluation of a web-based education intervention in person-centred communication for nurse assistants (NA) in home care.MethodThe intervention consisted of a step-wise education, with eight modules that included short video based lectures and movies, one group supervision, and reflective assignments. The content was based on previous research on health care communication and person-centred care. Data were collected from multiple sources before, during and after the implementation, and analysed by a combination of quantitative and qualitative approaches.ResultsA complex intervention was conducted to improve the communication competency wanted for person-centred care. The intervention was offered to 23 nurse assistants (NA). Of those, 91% (n=21) participated, in total or in parts, in five or more modules. The findings address participants’ experiences of expectations and worries before the intervention, experiences from the implementation process, and their experiences from taking part of the intervention. During the implementation changes were made according to local circumstances. Overall, the education was experienced as feasible. The web-based design was found to be accessible and the content relevant.ConclusionFrom this study, it can be concluded that the key features for successful implementation of the intervention was the format, educational content, and technical facilities provided. In addition to this, participant involvement, resources and constructive practical circumstances for NAs to participate in the intervention are crucial.
33.	Gustafsson, Tanja, PhD student, 1980-, et al. (författare) Development and process evaluation of an educational intervention on person-centred communication targeting nurse assistants in home care 2020 Konferensbidrag (refereegranskat)abstract BACKGROUNDPerson-centred communication is important to assure the quality of home care services and to promote older persons´ independence and influence over their lives. Previous research indicates challenges regarding communication between professionals and home care recipients, and how to deliver efficient educational efforts in the home care context.AIMThe aim was to describe the development and process evaluation of a web-based education intervention in person-centred communication for nurse assistants (NA) in home care.METHODSThe intervention consisted of a step-wise education, with eight modules that included short video based lectures and movies, one group supervision, and reflective assignments. The content was based on previous research on health care communication and person-centred care. Data were collected from multiple sources before, during and after the implementation, and analysed by a combination of quantitative and qualitative approaches.RESULTSA complex intervention was conducted to improve the communication competency wanted for person-centred care. The intervention was offered to 23 nurse assistants (NA). Of those, 91% (n=21) participated, in total or in parts, in five or more modules. The findings address participants’ experiences of expectations and worries before the intervention, experiences from the implementation process, and their experiences from taking part of the intervention. During the implementation changes were made according to local circumstances. Overall, the education was experienced as feasible. The web-based design was found to be accessible and the content relevant. CONCLUSIONOur findings show that the benefits of the web-based educational intervention included the short and focused lectures as well as its accessibility. Challenges with the implementation process included gaining access to the NAs and motivating and involving the NAs. This study emphasizes the environmental support needed to successfully conduct complex interventions, including physical, organizational and cultural aspects.
34.	Gustafsson, Tanja, PhD student, 1980-, et al. (författare) Nurse assistants´ perceptions of developing person-centred communication 2021 Konferensbidrag (refereegranskat)abstract Background: Communication is important for nurse assistants (NAs) when caring for older persons. There is limited research about how to improve the communication competence of NAs in home care. The aim was to describe NAs perception on learning in relation to an educational intervention on person-centred communication.Methods: A qualitative descriptive study was conducted. Data consisted of four group interviews, five individual in-depth interviews and written reflection assignments from participants gathered during the web-based intervention. In total 23 NAs at two home care units participated. The data were analysed using a phenomenographic approach. This is a qualitative method for analysis developed from Nordic traditions of phenomenology. Phenomenography aims to describe individual perceptions of a certain phenomenon.Preliminary findings points to the nurse assistants perceiving that the education supported their development of person-centred communication. They pointed out self-reflections as important for their learning as well as to get confirmation on what was already known. The NAs described that the intervention added to their knowledge and skills. Even though, there was more to learn and challenges that remained regarding communication in challenging situations such as caring for persons in end-of-life and supporting their relatives, caring for persons being aggressive or violent.Preliminary implications of research: This study can provide knowledge on participants’ perspective on their learning process, which may be important to consider when conducting educational interventions in home care as well as other health care contexts.
35.	Gustafsson, Tanja, PhD student, 1980-, et al. (författare) Process evaluation of the ACTION programme : a strategy for implementing person‐centred communication in home care 2021 Ingår i: BMC Nursing. - : Springer Nature. - 1472-6955. ; 20:1 Tidskriftsartikel (refereegranskat)abstract Background: There is currently a strong emphasis on person-centred care (PCC) and communication; however, little research has been conducted on how to implement person-centred communication in home care settings. Therefore, the ACTION (A person-centred CommunicaTION) programme, which is a web-based education programme focusing on person-centred communication developed for nurse assistants (NAs) providing home care for older persons, was implemented. This paper reports on the process evaluation conducted with the aim to describe and evaluate the implementation of the ACTION programme. Methods: A descriptive design with a mixed method approach was used. Twenty-seven NAs from two units in Sweden were recruited, and 23 of them were offered the educational intervention. Quantitative and qualitative data were collected from multiple sources before, during and after the implementation. Quantitative data were used to analyse demographics, attendance and participation, while qualitative data were used to evaluate experiences of the implementation and contextual factors influencing the implementation. Results: The evaluation showed a high degree of NA participation in the first five education modules, and a decrease in the three remaining modules. Overall, the NAs perceived the web format to be easy to use and appreciated the flexibility and accessibility. The content was described as important. Challenges included time constraints; the heavy workload; and a lack of interaction, space and equipment to complete the programme. Conclusions: The results suggest that web-based education seems to be an appropriate strategy in home care settings; however, areas for improvement were identified. Our findings show that participants appreciated the web-based learning format in terms of accessibility and flexibility, as well as the face-to-face group discussions. The critical importance of organizational support and available resources are highlighted, such as management involvement and local facilitation. In addition, the findings report on the implementation challenges specific to the dynamic home care context. Trial registration: This intervention was implemented with nursing assistants, and the evaluation only involved nursing staff. Patients were not part of this study. According to the ICMJE, registration was not necessary (). © 2021, The Author(s).
36.	Gustafsson, Tanja, PhD student, 1980-, et al. (författare) ‘Sometimes you need an eye-opener’: A qualitative study on nursing assistants' experiences of developing communication skills through an educational intervention on person-centred communication 2023 Ingår i: Nursing Open. - : John Wiley & Sons. - 2054-1058. Tidskriftsartikel (refereegranskat)abstract AimTo explore nursing assistants' (NAs') experiences of developing communication skills while participating in an educational intervention on person-centred communication.DesignA descriptive qualitative study was conducted.MethodsData were collected from interviews and written assignments before, during and after an educational intervention on person-centred communication targeting NAs in home care services. The data were analysed using a phenomenological approach. A total of 25 NAs participated in the study.ResultsThe findings describe NAs' experiences concerning the communication skills needed for building relationships with older persons and handling emotionally challenging situations. The educational intervention increased their knowledge and awareness of the importance of communication skills and how such skills are developed and refined.
37.	Gustafsson, Tanja, PhD student, 1980-, et al. (författare) The Development and Process Evaluation of the ACTION Study. A Person-centred Communication Intervention Targeting Nursing Staff in Home Care for Older Persons 2019 Konferensbidrag (refereegranskat)abstract Background: Person-centred communication is important to assure the quality of home care services and to promote older persons independence and influence over their lives. Previous research indicates challenges regarding communication between professionals and home care recipients, and how to deliver efficient educational efforts in the home care context. Hitherto, research on design and implementation of this type of intervention is scarce.Aims and objectives: To describe the development and process evaluation of an education intervention in person-centred communication for nursing staff (NS) in home care.Method: The web-based education consisted of eight modules, including short video based lectures and movies, one group supervision, and reflective assignments. The content was based on previous research of health care communication and person-centred care. Data was collected from multiple sources (web analytics, interviews, evaluation forms, and field notes), before, during and after the implementation, and analysed by a combination of quantitative and qualitative approaches.Results: In all, 23 NS participated in the education. Initial analysis indicate that a majority of the participants completed six or more modules. Overall, the content was experienced as relevant and interesting. The flexibility and accessibility of the web-based format was appreciated, as well as the mix of lectures, short movies, reflective assignments and group supervision. Challenges included developing content relevant to work teams with diverse competence levels and individual differences (e.g. age, language, motivation). Furthermore, time constrains and structure of work emerged as barriers for implementing the education, in some cases adding stress and fragmentation to NS´ work.Conclusions: This type of intervention seems to be a feasible approach for flexible educations in person-centred communication for NS. Engagement and commitment from managers and team leaders may be key factors in succeeding, with impact on participants´ motivation to fulfil the education.
38.	Gustafsson, Tanja, PhD student, 1980-, et al. (författare) Walk a fine line between meaningfulness or discomfort : the complexity of emotional communication 2022 Konferensbidrag (refereegranskat)abstract Background: The home care of older persons includes inter-personal interactions and communication needed to care for and respond to diverse needs of older people. Previous research has focused on emotional expressions of older persons and responses by nursing staff. Research on the meaning of the interaction in these sequences is sparse. Therefore, the aim of this study was to illuminate the meaning attached to sequences of emotional communication and the interaction during these sequences between older persons and nursing assistants during home care visits.Methods: A descriptive observational design was used. The data consisted of 44 audio recordings of real-life conversations between older persons and nursing assistants during home care visits. A hermeneutic phenomenological analysis was conducted.Findings: Preliminary results indicate sequences of emotional communication being a window of opportunities. The interaction that followed were linked to dual and sometimes incongruent meanings. Expressions being actively blocked or ignored could cause an increase of unpleasant emotions or distract away from negative feelings. Simultaneously, such conversations could both ease or add to the complexity of the interaction and communication. Conversations elaborating on the older persons’ emotions seemed to instill trust and create meaningfulness, at the same time as these situations contained unpleasant moments with sad or angry feelings. The risk for discomfort in these sequences could threaten the trust in the relationship.Discussion: Conversations on older persons worries can be complex: the findings point to a fine line between meaningfulness and distress in these sequences. Unpleasant emotions call for attention and caution, these may need to be noticed at the same time as they cannot be forced out.
39.	Hall, Michael, et al. (författare) Structural basis for glutathione-mediated activation of the virulence regulatory protein PrfA in Listeria 2016 Ingår i: Proceedings of the National Academy of Sciences of the United States of America. - : Proceedings of the National Academy of Sciences. - 0027-8424 .- 1091-6490. ; 113:51, s. 14733-14738 Tidskriftsartikel (refereegranskat)abstract Infection by the human bacterial pathogen Listeria monocytogenes is mainly controlled by the positive regulatory factor A (PrfA), a member of the Crp/Fnr family of transcriptional activators. Published data suggest that PrfA requires the binding of a cofactor for full activity, and it was recently proposed that glutathione (GSH) could fulfill this function. Here we report the crystal structures of PrfA in complex with GSH and in complex with GSH and its cognate DNA, the hly operator PrfA box motif. These structures reveal the structural basis for a GSH-mediated allosteric mode of activation of PrfA in the cytosol of the host cell. The crystal structure of PrfAWT in complex only with DNA confirms that PrfAWT can adopt a DNA binding-compatible structure without binding the GSH activator molecule. By binding to PrfA in the cytosol of the host cell, GSH induces the correct fold of the HTH motifs, thus priming the PrfA protein for DNA interaction.
40.	Hrastinski, Stefan, et al. (författare) Mer om nätbaserad utbildning : Presentation av en bok 2012 Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract Boken “Mer om nätbaserad utbildning: fördjupning och exempel” riktar sig till de som vill veta mer om nätbaserad utbildning. Den ger möjlighet till fördjupning inom olika sätt att använda nätet för utbildning och innehåller många exempel. Kapitlen går bland annat in på ämnen som sociala medier i undervisningen samt dialog, kamratgranskning, bedömning och handledning via nätet.Författarna har haft som målsättning att förmedla sin erfarenhet och aktuella forskningsresultat på ett lättbegripligt sätt. Däremot tror vi inte att det finns enkla lösningar. Utveckling av nätbaserad utbildning är komplext och innebär en mängd tekniska och pedagogiska utmaningar. Därför har vi snarare lagt fokus på att bidra till fördjupad förståelse och reflektion. Denna bok bygger till stor del på forskning men är även nära kopplad till författarnas erfarenhet och praktik.Boken vänder sig till lärare, studenter och andra som arbetar med utveckling av nätbaserad utbildning. Den kan läsas som en fortsättning till den mer grundläggande boken “Nätbaserad utbildning: en introduktion” och riktar sig således till läsare med förkunskaper i området. Till boken hör en webbplats med ytterligare material samt länkar för inspiration och vidare läsning.Stefan Hrastinski är redaktör. Bokens kapitel är skrivna av Fredrik Andersson, Olle Bälter, Anneli Edman, Agneta Hult, Jimmy Jaldemark, Tanvir Kawnine, Christina Keller, Ola J Lindberg, Monica Liljeström, Jörgen Lindh, Marie Mörndal, Anders D Olofsson, Ulf Olsson, Linda Reneland-Forsman, Eva Rydberg Fåhræus, Elisabeth Saalman och Johan Thorbiörnson.
41.	Hrastinski, Stefan, et al. (författare) Mer om nätbaserad utbildning : Presentation av en bok 2012 Ingår i: NU2012, Gränslöst lärande, Proceedings. ; , s. 122-123 Konferensbidrag (refereegranskat)
42.	Höglander, Jessica, et al. (författare) Implementing A person-centred CommunicaTION (ACTION) educational intervention for in-home nursing assistants – a study protocol 2023 Ingår i: BMC Geriatrics. - : BioMed Central (BMC). - 1471-2318. ; 23:1 Tidskriftsartikel (refereegranskat)abstract Background: In this study, the focus is on how to support the competence development needed for nursing assistants in home care. Home care services for older persons can be challenging concerning the nature of the interpersonal interaction and communication needed to care for and respond to the diverse needs of older people who seek to live well in our communities. This implies a need to offer more person-centred care (PCC) to older persons. However, there is a lack of knowledge on how to develop such competence. We, therefore, developed A Person-centred CommunicaTION (ACTION) programme, which is a web-based educational intervention aimed at supporting competence development for nursing assistants. The research objective is to evaluate the ACTION programme with respect to participants’ responses to and the effect of the intervention. Methods: A multicentre case–control study with pre- and post-assessments was designed. The ACTION programme will be implemented at home care units, in two different geographic areas in Sweden. A total of 300 nursing assistants will be recruited: 150 for the intervention group and 150 for the control group. We will evaluate the impact measures and the process. Pre- and post-assessments will be performed with data collected via a) audio recordings of communication, b) a questionnaire on self-efficacy communication skills, PCC, empathy and job satisfaction, c) user data, evaluation forms, field notes and observations, and d) interviews. The data will be analysed with descriptive and analytic statistics and/or qualitative methods for meanings. Discussion: This study has the potential to contribute to the evidence supporting competence development required to offer person-centred and quality home care to older persons and to meet upcoming needs for flexible and easily accessible competence development. Trial registration: ISRCTN64890826. Registered 10 January 2022, https://www.isrctn.com/ISRCTN64890826
43.	Hörberg, Ulrica, 1968-, et al. (författare) Philosophical examination of empirical findings in the context of caring science 2018 Ingår i: Presented at the 37th International Human Science Research Conference (IHSRC): "Phenomenology and dialogue - exploring questions of language, inclusivity, and accessibility", Wofford College, Spartanburg, USA, June 24–28, 2018. Konferensbidrag (refereegranskat)
44.	Israelsson-Skogsberg, Åsa, et al. (författare) A scoping review of older patients' health-related quality of life, recovery and well-being after intensive care 2023 Ingår i: Nursing Open. - 2054-1058. ; 10:9, s. 5900-5919 Forskningsöversikt (refereegranskat)abstract Aims: In the present study, we aimed to determine how Health-Related Quality of Life (HRQoL), recovery (function and capacity in daily life) and well-being are followed up and characterised in persons ≥65 years of age who were being cared for in an intensive care unit (ICU). Design: A scoping review. Methods: CINAHL, MEDLINE (Ovid) and PsycINFO databases were searched in October 2021. 20 studies met the inclusion criteria. The scoping review followed the principles outlined by Arksey and O'Malley, and the Preferred Reporting Items for Systematic Review and Meta-analyses (PRISMA) checklist and Joanna Briggs Institute (JBI) framework were used. Results: Results are presented under five subheadings: Study characteristics, Type of studies, Methods for follow-up, health-related quality of life, and Recovery. Time seems to be an important factor regarding HRQoL among older patients being cared for in an ICU, with most elderly survivors perceiving their HRQoL as acceptable after 1 year. Nevertheless, several studies showed patients' willingness to be readmitted to the ICU if necessary, indicating that life is worth fighting for. Patient or Public Contribution: Due to the design of the study, this study involves no patient or public contribution.
45.	Jackson, James, et al. (författare) Varieties of central banking : the Nordic Model beyond a fiscal-centric approach 2024 Ingår i: New Political Economy. - : Routledge. - 1356-3467 .- 1469-9923. Tidskriftsartikel (refereegranskat)abstract Since policymakers and scholars coined the term in the 1930s, the Nordic Model has often been considered to denote a homogeneous political entity in which the constituent countries are ostensibly interchangeable. As a result, seldom attention has been afforded to what fundamentally differentiates Denmark, Finland, Norway, and Sweden. By going beyond traditional ‘fiscal-centric’ accounts of the Nordic model, and instead focusing on the role of central banks and monetary policy, we show that each country bares far less similarities than has often been assumed in the literature. We trace this heterogeneity back to variegated responses to the 1970s crises of Fordist capitalism and draw on growth model theory to explain this divergent trajectory. We show how these differences shaped how each country responded to the Global Financial Crisis and the COVID-19 pandemic, where a variegated array of monetary measures was employed to uphold their own distinct growth model. By accounting for the role of central banks within the Nordic Model, we propose that it is better understood as a series of models, drawing attention to the function of monetary policy within the growth models perspective in the political economy literature.
46.	Karlsson, P, et al. (författare) Den äldre patientens delaktighet 2011 Konferensbidrag (refereegranskat)
47.	Keresi, Zuzana, et al. (författare) A caring relationship as a prerequisite for patient participation in a psychiatric care setting: A qualitative study from the nurses’ perspective 2019 Ingår i: Nordic journal of nursing research. - : SAGE Publications. - 2057-1585 .- 2057-1593. Tidskriftsartikel (refereegranskat)abstract The participation of patients in their treatment and care is perceived as desirable; however, patients with mental illnesses experience limited opportunities to participate in their own care. As nurses play a key role in taking care of patients with mental illnesses, this study aimed to investigate how nurses within psychiatric care settings experience patients’ participation and howthey act to increase it. Semi-structured interviews were conducted with eight registered nurses, four of whom worked in apsychiatric institutional care setting and four of whom worked with outpatients. Data were analysed using a qualitative content analysis approach. The analysis identified a theme: a caring relationship is a prerequisite for patient participation. This theme wa sfurther developed through five subthemes. The findings illustrate critical aspects of the caring relationship by which the nurse–patient relationship can either facilitate or impede patient participation. A caring relationship builds trust and increases the patient’s sense of responsibility for their own condition. Because patients with mental illness are cared for in many different contexts, the results of the present study have implications for a broad range of healthcare environments.
48.	Knowles, Charles H., et al. (författare) Gastrointestinal neuromuscular pathology: guidelines for histological techniques and reporting on behalf of the Gastro 2009 International Working Group 2009 Ingår i: Acta Neuropathologica. - : Springer Science and Business Media LLC. - 1432-0533 .- 0001-6322. ; 118:2, s. 271-301 Tidskriftsartikel (refereegranskat)abstract The term gastrointestinal neuromuscular disease describes a clinically heterogeneous group of disorders of children and adults in which symptoms are presumed or proven to arise as a result of neuromuscular, including interstitial cell of Cajal, dysfunction. Such disorders commonly have impaired motor activity, i.e. slowed or obstructed transit with radiological evidence of transient or persistent visceral dilatation. Whilst sensorimotor abnormalities have been demonstrated by a variety of methods in these conditions, standards for histopathological reporting remain relatively neglected. Significant differences in methodologies and expertise continue to confound the reliable delineation of normality and specificity of particular pathological changes for disease. Such issues require urgent clarification to standardize acquisition and handling of tissue specimens, interpretation of findings and make informed decisions on risk-benefit of full-thickness tissue biopsy of bowel or other diagnostic procedures. Such information will also allow increased certainty of diagnosis, facilitating factual discussion between patients and caregivers, as well as giving prognostic and therapeutic information. The following report, produced by an international working group, using established consensus methodology, presents proposed guidelines on histological techniques and reporting for adult and paediatric gastrointestinal neuromuscular pathology. The report addresses the main areas of histopathological practice as confronted by the pathologist, including suction rectal biopsy and full-thickness tissue obtained with diagnostic or therapeutic intent. For each, indications, safe acquisition of tissue, histological techniques, reporting and referral recommendations are presented.
49.	Knowles, Charles H., et al. (författare) The London Classification of gastrointestinal neuromuscular pathology: report on behalf of the Gastro 2009 International Working Group 2010 Ingår i: Gut. - : BMJ. - 1468-3288 .- 0017-5749. ; 59:7, s. 882-887 Tidskriftsartikel (refereegranskat)abstract Objective Guidelines on histopathological techniques and reporting for adult and paediatric gastrointestinal neuromuscular pathology have been produced recently by an international working group (IWG). These addressed the important but relatively neglected areas of histopathological practice of the general pathologist, including suction rectal biopsy and full-thickness intestinal tissue. Recommendations were presented for the indications, safe acquisition of tissue, histological techniques, reporting and referral of such histological material. Design Consensual processes undertaken by the IWG and following established guideline decision group methodologies. Results and conclusion This report presents a contemporary and structured classification of gastrointestinal neuromuscular pathology based on defined histopathological criteria derived from the existing guidelines. In recognition of its origins and first presentation in London at the World Congress of Gastroenterology 2009, this has been named 'The London Classification'. The implementation of this classification should allow some diagnostic standardisation, but should necessarily be viewed as a starting point for future modification as new data become available.
50.	Knutsson, Susanne, 1967-, et al. (författare) Participating in reflection seminars : Progressing towards a deeper understanding of caring science described by nursing students 2018 Ingår i: Nordic journal of nursing research. - : Sage Publications. - 2057-1585 .- 2057-1593. ; 38:2, s. 111-116 Tidskriftsartikel (refereegranskat)abstract Few studies focus on how reflection seminars can support the learning of knowledge in caring science when inserted throughout the curriculum. The aim of this study was to describe students’ experiences of participating in reflection seminars, using lifeworld theory and focusing on caring science. A qualitative descriptive study based on interviews was carried out, and ten students between 21 and 33 years of age volunteered to participate. A reflective lifeworld research approach was used. Reflection seminars contribute to developing students’ ability to relate to caring and life. A deeper understanding is obtained when reflection sessions are spread over a longer period and when reflection becomes a process. The process helps caring science to become more natural and useful. Reflective seminaries based on a theoretical foundation contribute to facilitate learning more readily. A good atmosphere pervaded by a lifeworld perspective characterized by openness and thoughtfulness contributes to learning.

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