| 1. |
- Bergh, Ingrid, 1956, et al.
(författare)
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Comparison of the PainMatcher and the Visual Analogue Scale for assessment of labour pain following administered pain relief treatment.
- 2011
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Ingår i: Midwifery. - : Elsevier BV. - 1532-3099 .- 0266-6138. ; 27:1
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: during childbirth, it is necessary to assess and monitor experienced pain and to evaluate the effect of pain relief treatment. The aim of this study was to compare the PainMatcher((R)) (PM) with the Visual Analogue Scale (VAS) for the assessment of labour pain and the effect of pain relief treatment. DESIGN: randomised controlled trial. SETTING: labour ward with approximately 2500 childbirths per year in western Sweden. PARTICIPANTS: 57 women with labour pain treated with acupuncture or sterile water injections scored their electrical pain threshold and pain intensity with the PM. Pain intensity was also assessed with the VAS. Electrical pain threshold and pain intensity were assessed immediately after a uterine contraction before and 30, 60, 90, 120, 150 and 180minutes after treatment. MEASUREMENTS AND FINDINGS: the results showed a weak correlation (r=0.13, p<0.05) between the pain intensity scores on the PM and the VAS. The PM detected changes (decrease) in pain intensity to a lower degree than the VAS. Surprisingly, in over 10% of sessions, women scored their pain intensity during a uterine contraction lower than their electrical pain threshold with the PM. However, electrical pain thresholds with the PM correlated well throughout all measurements. CONCLUSIONS: the PM is a reliable tool for the assessment of electrical pain threshold; however, the VAS is more sensitive than the PM for recording changes in pain intensity when assessing the effects of treatment on labour pain. IMPLICATIONS FOR PRACTICE: the PM and the VAS are not interchangeable in the case of labour pain, and there is still a need for research in this area to find a more suitable assessment instrument for the evaluation of labour pain.
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| 2. |
- Bergh, Ingrid H. E., et al.
(författare)
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Assessment and documentation of women's labour pain : A cross-sectional study in Swedish delivery wards
- 2015
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Ingår i: Women and Birth. - : Elsevier. - 1871-5192 .- 1878-1799. ; 28:2, s. E14-E18
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Tidskriftsartikel (refereegranskat)abstract
- Background: A woman's pain during labour plays a dominant role in childbirth. The midwife's role is to assess the degree of pain experienced during labour. When professionals respond to labour pain with acknowledgement and understanding, the woman's sense of control and empowerment is increased, which could contribute to a positive experience of childbirth. The aim of this study is to describe how labour pain in Swedish delivery wards is assessed and documented. Methods: This quantitative descriptive study was designed as a national survey performed through telephone interviews with the representatives of 34 delivery wards in Sweden. Results and conclusion: The majority of the participating delivery wards assessed and documented women's labour pain, but in an unstructured manner. The wards differed in how the assessments and documentation were performed. In addition, almost all the delivery wards that participated in the survey lacked guidelines for the assessment and documentation of the degree of pain during labour. The findings also showed that the issue of labour pain was sometimes discussed in the delivery wards, but not in a structured or consistent way. (C) 2015 Australian College of Midwives. Published by Elsevier Australia (a division of Reed International Books Australia Pty Ltd). All rights reserved.
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| 3. |
- Bergh, Ingrid H. E., et al.
(författare)
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Midwifery students attribute different quantitative meanings to "hurt", "ache" and "pain" : A cross-sectional survey
- 2013
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Ingår i: Women and Birth. - : Elsevier. - 1871-5192 .- 1878-1799. ; 26:2, s. 143-146
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Tidskriftsartikel (refereegranskat)abstract
- Background: Assessment of women's labor pain is seldom acknowledged in clinical practice or research. The words "aching" and "hurting" are frequently used by women to describe childbirth pain. The aim of this study was to determine the quantitative meanings midwifery students attribute to the terms "hurt", "ache" and "pain". Data was collected by self-administered questionnaire from students at seven Swedish midwifery programs. A total of 230 filled out and returned a completed questionnaire requesting them to rate, on a visual analog scale, the intensity of "hurt", "ache" or "pain" in the back, as reported by a fictitious parturient. Results: The midwifery students attributed, with substantial individual variation, different quantitative meanings to the studied pain descriptors. Conclusions: To be able to communicate about pain with a woman in labor, it is essential that the midwife be familiar with the value of different words and what they mean to her as this may affect her assessment when the woman describes her pain. © 2012.
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| 4. |
- Bergh, Ingrid, et al.
(författare)
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Reliability and validity of the Acceptance Symptom Assessment Scale in assessing labour pain
- 2012
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Ingår i: Midwifery. - : Elsevier. - 0266-6138 .- 1532-3099. ; 28:5, s. e684-e688
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Tidskriftsartikel (refereegranskat)abstract
- Objective: to investigate the reliability and validity of the Acceptance Symptom Assessment Scale (ASAS) in assessing labour pain.Design: a test-retest approach was used to assess reliability and validity.Setting: labour ward with approximately 2,400 deliveries annually in western part of Sweden.Participants: forty-seven pregnant women in the latent or active phase of labour.Methods: a total of five pain assessments with both the ASAS and the VAS were conducted in three sessions.Main outcome measures: correlation between ASAS and VAS.Findings: both scales demonstrated high and significant test–retest correlations (r=0.83–0.92; p<0.001). High and significant alternative-form reliability correlations (r=0.76–0.93, p<0.001) were found between ASAS and VAS ratings at all five assessments. Construct validity was established when both the ASAS and the VAS identified a pain reduction(p<0.001) 2 hrs after birth, compared to the previous assessment. Over two-thirds of the women preferred the ASAS to the VAS ,mainly(n=30) because the ASAS provided more choices relating to the pain experience, making it possible to label pain acceptable/unacceptable.Conclusions: the ASAS is interchangeable with the VAS for assessing labour pain. Over two-thirds of the women preferred it to the VAS.
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| 5. |
- Blixt, Ingrid, 1968-, et al.
(författare)
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Process-oriented training in breastfeeding for health professionals decreases women’s experiences of breastfeeding challenges
- 2014
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Ingår i: International Breastfeeding Journal. - : BioMed Central. - 1746-4358. ; 9:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: The World Health Organization recommends promoting exclusive breastfeeding for six months. Women much too often end breastfeeding earlier than they planned, but women who continue to breastfeed despite problems more often experience good support and counselling from health professionals. The aim in this study was to evaluate the effects of a process-oriented training in breastfeeding support counselling for midwives and child health nurses, in relation to women’s satisfaction with breastfeeding counselling, problems with insufficient breast milk, pain or nipple sores in relation to exclusive breastfeeding shorter or longer than 3 months.Methods: An intervention through process-oriented training for health professionals regarding support in childbearing and breastfeeding took part in the south west of Sweden. The present study was performed in Sweden, in 2000- 2003. Ten municipalities were paired, and within each pair, one was randomly assigned to the group of five intervention (IG) municipalities and one to the group of five control municipalities. Primiparas (n=540) were asked to participate in a longitudinal study to evaluate the care they received. A survey was distributed at 3 days, 3 months and 9 months postpartum. Data collection for control group A (n=162) started before the intervention was initiated. Data for control group B (n=172) were collected simultaneously with the intervention group (IG) (n=206).Women were also divided into two groups depending on whether they exclusive breastfed < 3 months or ≥ 3 months.Results: Women in IG were more satisfied with the breastfeeding counselling (p=0.008) and felt the breastfeeding counselling was more coherent (p=0.002) compared with control groups, when the exclusively breastfeeding was < 3 months. In addition fewer women in the IG, among the group exclusively breastfeeding < 3 months, had problems with insufficient breast milk compared to the control groups (p=0.01).Conclusion: A process-oriented training for health professionals in support influenced women's ability to solve breastfeeding problems such as the experience of insufficient breast milk production. Women with exclusive breastfeeding lasting ≥ 3 months more often had breastfeeding duration in conformity with their planned breastfeeding duration, compared with women who had breastfeeding duration < 3 months.Trial registration: ACTRN12611000354987
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| 6. |
- Blixt, Ingrid, 1968-, et al.
(författare)
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Utbildning minskar amningsproblem
- 2014
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Ingår i: Amningsnytt. - : Amningshjälpen. - 1102-7207. ; :4, s. 4-5
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Tidskriftsartikel (populärvet., debatt m.m.)
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| 7. |
- Dackert, Ingrid, et al.
(författare)
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Leadership and climate for innovation in teams
- 2004
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Ingår i: Economic and Industrial Democracy. - : Sage Publications. - 0143-831X .- 1461-7099. ; 25:2, s. 301-318
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Tidskriftsartikel (refereegranskat)abstract
- The use of teamworking is common in many organizations. More or less self-directed teams are organized, often with the aim to achieve continuous improvements at work beyond the daily activities. The purpose of the present study was to examine the relation between leader behaviour and team climate for innovation in teams. The Team Climate Inventory devised by Anderson and West and Ekvall and Arvonen’s leadership questionnaire were used to capture the leadership pattern and the team processes characterizing a team climate for innovation in 14 manufacturing teams (N1/4 98). The results indicate a positive relation between a leadership style that combines employee-and change-orientation and a team climate for innovation as a whole. However, innovative team processes such as participation and clarity of objectives were more associated with team membership than leadership in this setting.
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| 8. |
- Dahal, Prabin, et al.
(författare)
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Competing risk events in antimalarial drug trials in uncomplicated Plasmodium falciparum malaria : a WorldWide Antimalarial Resistance Network individual participant data meta-analysis
- 2019
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Ingår i: Malaria Journal. - : BMC. - 1475-2875. ; 18
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Tidskriftsartikel (refereegranskat)abstract
- Background: Therapeutic efficacy studies in uncomplicated Plasmodium falciparum malaria are confounded by new infections, which constitute competing risk events since they can potentially preclude/pre-empt the detection of subsequent recrudescence of persistent, sub-microscopic primary infections.Methods: Antimalarial studies typically report the risk of recrudescence derived using the Kaplan-Meier (K-M) method, which considers new infections acquired during the follow-up period as censored. Cumulative Incidence Function (CIF) provides an alternative approach for handling new infections, which accounts for them as a competing risk event. The complement of the estimate derived using the K-M method (1 minus K-M), and the CIF were used to derive the risk of recrudescence at the end of the follow-up period using data from studies collated in the WorldWide Antimalarial Resistance Network data repository. Absolute differences in the failure estimates derived using these two methods were quantified. In comparative studies, the equality of two K-M curves was assessed using the log-rank test, and the equality of CIFs using Gray's k-sample test (both at 5% level of significance). Two different regression modelling strategies for recrudescence were considered: cause-specific Cox model and Fine and Gray's sub-distributional hazard model.Results: Data were available from 92 studies (233 treatment arms, 31,379 patients) conducted between 1996 and 2014. At the end of follow-up, the median absolute overestimation in the estimated risk of cumulative recrudescence by using 1 minus K-M approach was 0.04% (interquartile range (IQR): 0.00-0.27%, Range: 0.00-3.60%). The overestimation was correlated positively with the proportion of patients with recrudescence [Pearson's correlation coefficient (rho): 0.38, 95% Confidence Interval (CI) 0.30-0.46] or new infection [rho: 0.43; 95% CI 0.35-0.54]. In three study arms, the point estimates of failure were greater than 10% (the WHO threshold for withdrawing antimalarials) when the K-M method was used, but remained below 10% when using the CIF approach, but the 95% confidence interval included this threshold.Conclusions: The 1 minus K-M method resulted in a marginal overestimation of recrudescence that became increasingly pronounced as antimalarial efficacy declined, particularly when the observed proportion of new infection was high. The CIF approach provides an alternative approach for derivation of failure estimates in antimalarial trials, particularly in high transmission settings.
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| 9. |
- Friberg, Ingrid Osika, et al.
(författare)
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Patients' perceptions and factors affecting dialysis modality decisions
- 2018
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Ingår i: Peritoneal Dialysis International. - : SAGE Publications. - 0896-8608. ; 38:5, s. 334-342
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Tidskriftsartikel (refereegranskat)abstract
- Background: Home-based dialysis, including peritoneal dialysis (PD) and home hemodialysis (HHD), has been shown to be associated with tower costs and higher health-related quality of life than in-center HD. However, factors influencing the choice of dialysis modality, including gender, are still not well understood. Methods: A questionnaire was sent out to all dialysis patients in the western region of Sweden in order to investigate factors affecting choice of dialysis modality. Logistic regression was used to analyze the data. Results: Patients were more likelyto have home dialysis if they received predialysis information from 3 or more sources and, to a greater extent, perceived the information as comprehensive and of high quality. In addition, patients had a lower likelihood of receiving home dialysis with increasing age and if they lived closer to a dialysis center. Men had in comparison with women a greater likelihood of receiving home dialysis if they lived with a spouse. In-center dialysis patients more often believed that the social interaction and support provided through in-center HD treatment influenced the choice of dialysis modality. Conclusion: This study highlights the need for increased awareness of various factors that influence the choice of dialysis modality and the importance of giving repeated, comprehensive, high-quality information to dialysis and predialysis patients and their relatives. Information and support must be adapted to the needs of individual patients and their relatives if the intention is to improve patients' well-being and the proportion of patients using home dialysis.
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| 10. |
- Isern, A E, et al.
(författare)
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Risk of recurrence following delayed large flap reconstruction after mastectomy for breast cancer.
- 2011
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Ingår i: British Journal of Surgery. - : Oxford University Press (OUP). - 1365-2168 .- 0007-1323. ; 98, s. 659-666
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The aim of this retrospective matched cohort study was to evaluate the rate of recurrence among women with delayed large flap breast reconstruction after mastectomy for breast cancer. The recurrence rate among women treated at a single hospital was compared with that in an individually matched control group of women with breast cancer who did not have reconstruction after mastectomy. METHODS: Between 1982 and 2001, 125 women with previous invasive breast carcinoma underwent delayed large flap breast reconstruction with pedicled musculocutaneous or microvascular flaps (a median of 32 months after mastectomy). They were matched individually with 182 women with breast cancer who had a mastectomy but did not undergo breast reconstruction. Matching criteria were year of diagnosis, age at diagnosis and treating hospital. Medical records were evaluated until October 2007. Histopathological specimens for all included women were re-evaluated. The endpoint was locoregional or distant breast cancer recurrence. The risk of recurrent disease was calculated using a Cox proportional hazards analysis, adjusted for established prognostic factors. RESULTS: Median follow-up for the entire cohort was 146 months. The reconstruction group had a 2·08 (95 per cent confidence interval 1·07 to 4·06) times higher risk of recurrent disease than the mastectomy only group. CONCLUSION: Women with breast cancer who had delayed reconstruction with a large flap in this study had a higher risk of recurrent disease than those with mastectomy alone. Copyright © 2011 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
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| 11. |
- Kenne Sarenmalm, Elisabeth, et al.
(författare)
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Mindfulness and its efficacy for psychological and biological responses in women with breast cancer
- 2017
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Ingår i: Cancer Medicine. - : Wiley. - 2045-7634. ; 6:5, s. 1108-1122
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Tidskriftsartikel (refereegranskat)abstract
- Many breast cancer survivors have to deal with a variety of psychological and physiological sequelae including impaired immune responses. The primary purpose of this randomized controlled trial was to determine the efficacy of a mindfulness-based stress reduction (MBSR) intervention for mood disorders in women with breast cancer. Secondary outcomes were symptom experience, health status, coping capacity, mindfulness, posttraumatic growth, and immune status. This RTC assigned 166 women with breast cancer to one of three groups: MBSR (8 weekly group sessions of MBSR), active controls (self-instructing MBSR) and non-MBSR. The primary outcome measure was the Hospital Anxiety and Depression Scale. Secondary outcome measures were: Memorial Symptom Assessment Scale, SF-36, Sense of Coherence, Five Facets of Mindfulness Questionnaire, and Posttraumatic Growth Index. Blood samples were analyzed using flow cytometry for NK-cell activity (FANKIA) and lymphocyte phenotyping; concentrations of cytokines were determined in sera using commercial high sensitivity IL-6 and IL-8 ELISA (enzyme-linked immunosorbent assay) kits. Results provide evidence for beneficial effects of MBSR on psychological and biological responses. Women in the MBSR group experienced significant improvements in depression scores, with a mean pre-MBSR HAD-score of 4.3 and post-MBSR score of 3.3 (P = 0.001), and compared to non-MBSR (P = 0.015). Significant improvements on scores for distress, symptom burden, and mental health were also observed. Furthermore, MBSR facilitated coping capacity as well as mindfulness and posttraumatic growth. Significant benefits in immune response within the MBSR group and between groups were observed. MBSR have potential for alleviating depression, symptom experience, and for enhancing coping capacity, mindfulness and posttraumatic growth, which may improve breast cancer survivorship. MBSR also led to beneficial effect on immune function; the clinical implications of this finding merit further research.
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| 12. |
- Kenne Sarenmalm, Elisabeth, 1956, et al.
(författare)
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Mindfulness based stress reduction study design of a longitudinal randomized controlled complementary intervention in women with breast cancer
- 2013
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Ingår i: BMC Complementary and Alternative Medicine. - : BioMed Central (BMC). - 1472-6882. ; 13
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Tidskriftsartikel (refereegranskat)abstract
- Background: The stress of a breast cancer diagnosis and its treatment can produce a variety of psychosocial sequelae including impaired immune responses. Mindfulness Based Stress Reduction (MBSR) is a structured complementary program that incorporates meditation, yoga and mind-body exercises. Despite promising empirical evidence for the efficacy of MBSR, there is a need for randomized controlled trials (RCT). There is also a need for RCTs investigating the efficacy of psychosocial interventions on mood disorder and immune response in women with breast cancer. Therefore, the overall aim is to determine the efficacy of a Mindfulness Based Stress Reduction (MBSR) intervention on well-being and immune response in women with breast cancer.Methods and design: In this RCT, patients diagnosed with breast cancer, will consecutively be recruited to participate. Participants will be randomized into one of three groups: MBSR Intervention I (weekly group sessions + self-instructing program), MBSR Intervention II (self-instructing program), and Controls (non-MBSR). Data will be collected before start of intervention, and 3, 6, and 12 months and thereafter yearly up to 5 years. This study may contribute to evidence-based knowledge concerning the efficacy of MBSR to support patient empowerment to regain health in breast cancer disease.Discussion: The present study may contribute to evidence-based knowledge concerning the efficacy of mindfulness training to support patient empowerment to regain health in a breast cancer disease. If MBSR is effective for symptom relief and quality of life, the method will have significant clinical relevance that may generate standard of care for patients with breast cancer.Trial registration: ClinicalTrials.gov: NCT01591915. © 2013 Kenne Sarenmalm et al.; licensee BioMed Central Ltd.
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| 13. |
- Kjeldgaard, Lisbeth, et al.
(författare)
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Intramolecular vibronic dynamics in molecular solids: C60
- 2005
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Ingår i: Physical Review B (Condensed Matter and Materials Physics). - 1098-0121. ; 72:20
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Tidskriftsartikel (refereegranskat)abstract
- Vibronic coupling in solid C60 has been investigated with a combination of resonant photoemission spectroscopy (RPES) and resonant inelastic x-ray scattering (RIXS). Excitation as a function of energy within the lowest unoccupied molecular orbital resonance yielded strong oscillations in intensity and dispersion in RPES, and a strong inelastic component in RIXS. Reconciling these two observations establishes that vibronic coupling in this core hole excitation leads to predominantly inelastic scattering and localization of the excited vibrations on the molecule on a femtosecond time scale. The coupling extends throughout the widths of the frontier valence bands.
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| 14. |
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| 15. |
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| 16. |
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| 17. |
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| 18. |
- Mårtensson, Lena B., 1958-, et al.
(författare)
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Effect of topical local anaesthesia on injection pain associated with administration of sterile water injections - a randomized controlled trial
- 2022
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Ingår i: BMC Anesthesiology. - : Springer Nature. - 1471-2253 .- 1471-2253. ; 22:1
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundSterile water injections can provide effective pain relief during childbirth, particularly for low back pain related to childbirth. However, the pain associated administering the injections can negatively impact women’s impressions of the procedure. It may discourage women from considering repeat doses despite the quality of analgesia experienced. Determining strategies to reduce the pain related to the administration of sterile water injections would improve the acceptability of the technique. Therefore, the aim of this study was to evaluate the effect of topical local anesthesia on the pain associated with administration of sterile water injections.MethodsThe study was designed as a multi-arm single-blind, randomized, controlled trial and 120 female healthy students were randomly divided according to one of four groups. The Intervention group received sterile water injections with topical local anesthesia. Control group 1 received sterile water injections without topical local anesthesia, control group 2 received injections of isotonic saline 0.9% with topical local anesthesia and control group 3 received injections of isotonic saline 0.9% without topical local anesthesia. Pain Immediately after the injections and subsidence in pain were recorded using a visual analogue scale. Sensations in the injection area were reported 15 min and the day after the injections.ResultsThe main finding of this study was that local anesthesia with EMLA® reduces the pain associated with the administration of intracutaneous sterile water injections. There was a significant difference in the self-assessed pain score immediately following the injections between the control (73.3 mm) and intervention groups (50.0 mm), p = 0.001. No adverse side effects were reported.ConclusionLocal anesthesia with EMLA® reduces the pain associated with intracutaneous administration of sterile water injections.
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| 19. |
- Mårtensson, Lena B., et al.
(författare)
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Midwifery students' conceptions of worst imaginable pain
- 2014
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Ingår i: Women and Birth. - : Elsevier. - 1871-5192 .- 1878-1799. ; 27:2, s. 104-107
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Tidskriftsartikel (refereegranskat)abstract
- Background: The Visual Analogue Scale (VAS) is one of the most widely used pain assessment scales in clinical practice and research. However, the VAS is used less frequently in midwifery than in other clinical contexts. The issue of how people interpret the meaning of the VAS endpoints (i.e. no pain and worst imaginable pain) has been discussed. The aim of this study was to explore midwifery students' conceptions of 'worst imaginable pain'. Methods: A sample of 230 midwifery students at seven universities in Sweden responded to an open-ended question: 'What is the worst imaginable pain for you?' This open-ended question is a part of a larger study. Their responses underwent manifest content analysis. Results: Analysis of the midwifery students' responses to the open-ended question revealed five categories with 24 sub-categories. The categories were Overwhelming pain, Condition-related pain, Accidents, Inflicted pain and Psychological suffering. Conclusions: The midwifery students' conceptions of 'worst imaginable pain' are complex, elusive and diverse. © 2014 Australian College of Midwives.
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| 20. |
- Mårtensson, Lena B., 1958-, et al.
(författare)
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Sterile water injections for childbirth pain : An evidenced based guide to practice
- 2018
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Ingår i: Women and Birth. - : Elsevier. - 1871-5192 .- 1878-1799. ; 31:5, s. 380-385
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Tidskriftsartikel (refereegranskat)abstract
- Background: About 30% of women in labour suffer from lower back pain. Studies of sterile water injectionsfor management of low back pain have consistently shown this approach to be effective. The objective ofthis evidence-based guide is to facilitate the clinical use of sterile water injections to relieve lower backpain in labouring women.Methods: To identify relevant publications our search strategy was based on computerised literaturesearches in scientific databases. The methodological quality of each study was assessed using themodified version of the Jadad scale, 12 studies were included.Findings: Recommendations regarding the clinical use of sterile water injections for pain relief in labourare reported in terms of the location of injection administration, various injection techniques, number ofinjections used, amount of sterile water in each injection and adverse effects.Discussion: Both injection techniques provide good pain relief for lower back pain during labour. Thesubcutaneous injection technique is possibly less painful than the intracutaneous techniqueadministered, but we are unsure if this impacts on effectiveness. The effect seems to be related tothe number of injections and the amount of sterile water in each injection.Conclusion: The recommendation at present, based on the current state of knowledge, is to give fourinjections. Notwithstanding the differences in injection technique and number of injections the methodappears to provide significant levels of pain relief and can be repeated as often as required with noadverse effect (apart from the administration pain) on the woman or her foetus.
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| 21. |
- Mårtensson, Lena, et al.
(författare)
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Effect of treatment for labor pain : Verbal reports versus visual analogue scale scores - A prospective randomized study
- 2011
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Ingår i: International Journal of Nursing and Midwifery. - : Academic Journals. - 2141-2456. ; 3:4, s. 43-47
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Tidskriftsartikel (refereegranskat)abstract
- Assessing pain in relation to childbirth is one of the midwife’s more important tasks. However, pain research shows that health care professionals often assess patients’ pain inaccurately. The Visual Analogue Scale (VAS) is one of the most used instruments for assessing pain and pain relief both in research and clinical practice. On the other hand, a patient’s verbal report is considered to be the single most reliable indicator of how much pain the patient is experiencing. The aim of this study was to compare women’s verbally reported effect of treatment for labor pain with changes in VAS scores. This comparative prospective study was carrying out on a labor ward with approximately 2,500 deliveries annually in western part of Sweden. Women (n=122) at gestational week 37 to 42 with spontaneous onset of labor, requesting pain relief, were randomized to one of two treatments: acupuncture or sterile water injections. Pain was assessed on a VAS before as well as 30, 60, 90, 120, 150 and 180 min after treatment. Within two hours after delivery the women were asked to verbally report the effectiveness with the treatment. Main outcome measure was agreement between VAS scores and verbal reports. Non-parametric tests were used. All tests were two-tailed at the significance level p< 0.05. The distribution of the VAS scores 30 min after administration of pain relief showed that the women verbally responding that treatment was “very effective”, also rated their pain significantly lower (p< 0.001) on the VAS, compared to the women verbally reporting otherwise. A moderate correlation (r = 0.56; p< 0.001) was obtained between VAS-scored pain change after 30 min and verbally reported pain relief effect. The women who stated that treatment was “very effective” also rated their pain significantly lower at 30, 60 and 90 min on the VAS, compared to baseline. This study confirms that verbal reports and changes in VAS scores are reliable indicators of treatment effect for labor pain. It might, however, be valuable to combine VAS scores with verbal reports for a more extensive assessment of treatment effect.
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| 22. |
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| 23. |
- Roghanian, Ali, et al.
(författare)
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Antagonistic Human FcγRIIB (CD32B) Antibodies Have Anti-Tumor Activity and Overcome Resistance to Antibody Therapy In Vivo.
- 2015
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Ingår i: Cancer Cell. - : Elsevier BV. - 1878-3686 .- 1535-6108. ; 27:4, s. 473-488
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Tidskriftsartikel (refereegranskat)abstract
- Therapeutic antibodies have transformed cancer therapy, unlocking mechanisms of action by engaging the immune system. Unfortunately, cures rarely occur and patients display intrinsic or acquired resistance. Here, we demonstrate the therapeutic potential of targeting human (h) FcγRIIB (CD32B), a receptor implicated in immune cell desensitization and tumor cell resistance. FcγRIIB-blocking antibodies prevented internalization of the CD20-specific antibody rituximab, thereby maximizing cell surface accessibility and immune effector cell mediated antitumor activity. In hFcγRIIB-transgenic (Tg) mice, FcγRIIB-blocking antibodies effectively deleted target cells in combination with rituximab, and other therapeutic antibodies, from resistance-prone stromal compartments. Similar efficacy was seen in primary human tumor xenografts, including with cells from patients with relapsed/refractory disease. These data support the further development of hFcγRIIB antibodies for clinical assessment.
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| 24. |
- Rosén, Helena I., et al.
(författare)
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Patients' experiences and perceived causes of persisting discomfort following day surgery
- 2010
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Ingår i: BMC Nursing. - : BioMed Central. - 1472-6955. ; 9, s. artikelnummer 16-
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Tidskriftsartikel (refereegranskat)abstract
- Background: The aim of this study was to describe patients’ experiences and perceived causes of persisting discomfort following day surgery. Earlier research has mainly covered symptoms and signs during a recovery period of up to one month, and not dealt with patients’ perceptions of what causes persisting, longer-term discomfort. Methods: This study is a part from a study carried out during the period May 2006 to May 2007 with a total of 298 day surgery patients. Answers were completed by 118 patients at 48 hours, 110 at seven days and 46 at three months to one open-ended question related to discomfort after day surgery constructed as follows: If you are stillexperiencing discomfort related to the surgery, what is the reason, in your opinion? Data was processed, quantitatively and qualitatively. Descriptive, inferential, correlation and content analyses were performed. Results: The results suggest that patients suffer from remaining discomfort e.g. pain and wound problem, with effects on daily life following day surgery up to three months. Among patients’ perceptions of factors leading to discomfort may be wrongful or suboptimal treatment, type of surgery or insufficient access to provider/information. Conclusions: The results have important implications for preventing and managing discomfort at home followingday surgery, and for nursing interventions to help patients handle the recovery period better.
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| 25. |
- Rosén, Helena I., et al.
(författare)
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Patients´ Experiences of Pain Following Day Surgery - At 48 Hours, Seven Days and Three Months
- 2011
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Ingår i: Open Nursing Journal. - : Bentham Open. - 1874-4346. ; 5, s. 52-59
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Tidskriftsartikel (refereegranskat)abstract
- Recent studies indicate that patients experience pain after day surgery for a longer period than previously known. This requires verification. This was a prospective, descriptive correlational study. A convenience sample of 298 day surgery patients undergoing various surgical procedures was asked to report pain intensity and its interference with daily function 48 hours, seven days and three months after day surgery. Correlation and regression analyses were performed. On a NRS, 55% (n=230) reported pain (≥4) 48 hours after surgery, as did 43% (n=213) at seven days. Pain interfered with normal activities at ≥4 NRS at 48 hours and at seven days, after which it decreased.
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| 26. |
- Rosén, Helena I., et al.
(författare)
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The Recovery Process After Day Surgery Within the Symptom Management Theory
- 2014
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Ingår i: Nursing Forum. - : John Wiley & Sons. - 1744-6198 .- 0029-6473. ; 49:2, s. 100-109
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: The aim was to illustrate two cases in a postoperative situation following day surgery within the framework of the symptom management theory. Method: Template analysis using the symptom management theory. Result: Neither the woman nor the man was able to return to their normal activities, health status or functional status, within a week. Conclusion: The results illustrate how a postoperative situation may involve personal suffering up to 3 months. Practical Implication: To obtain an outcome following day surgery, as optimal as possible, improving clinical practices and routines, such as discharge criteria, guidelines, and care pathways, is necessary. © 2014 Wiley Periodicals, Inc.
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| 27. |
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| 28. |
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| 29. |
- Sonesson, Anders, et al.
(författare)
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Pedagogisk utbildning i ett utvecklingsperspektiv
- 2005
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Ingår i: Utvecklingskonferensen för högre utbildning 2005.
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Konferensbidrag (refereegranskat)abstract
- Behörighetsgivande högskolepedagogisk utbildning har nu blivit verklighet runt om i landet. Det finns från flera håll en stark förhoppning om att sådan utbildning ska bidra till att undervisningen utvecklas. Samtidigt kostar dessa kurser både pengar och tid, något som kanske går ut över andra utvecklingsinitiativ. Det är därför extra viktigt att ha ett utvecklingsperspektiv vid planering och genomförande av dessa kurser. Hur kan ett sådant perspektiv se ut? Det finns idag en ökande medvetenhet om hur det sociala sammanhang lärare befinner sig i kan begränsa alternativt möjliggöra utveckling av undervisningen. Trowler & Cooper (2002) definierar det sociala sammanhanget med en beskrivning av teaching and learning regimes (TLR) bestående av ett antal kulturella komponenter vilka påverkar lärares upplevelser och agerande i och runt undervisningen. Ett utvecklingsperspektiv på högskolepedagogisk utbildning bör därför innebära tankar inte bara om hur individer ska utvecklas utan också om hur kurserna ska bidra till att det sociala sammanhanget och dess TLR kan utvecklas. Vi menar att detta perspektiv lätt förbises. Själva begreppet behörighetsgivande är i detta sammanhang problematiskt. Det signalerar att utbildningen gör någon behörig till ett sammanhang – inte att sammanhanget bör utvecklas! Detta rundabordsamtal syftar till att fördjupa diskussionen kring utmaningen att utveckla både individer och det sammanhang de ingår i. Vi hävdar att högskolepedagogisk utbildning måste ses som en del i en strategi som syftar till utveckling av undervisningen inom den högre utbildningen.
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| 30. |
- Stepniewska, Kasia, et al.
(författare)
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Efficacy of single dose primaquine with artemisinin combination therapy on P. falciparum gametocytes and transmission : A WWARN individual patient meta-analysis.
- 2020
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Ingår i: Journal of Infectious Diseases. - : Oxford University Press (OUP). - 0022-1899 .- 1537-6613. ; 225:7, s. 1215-1226
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Since the World Health Organization recommended single low-dose (0.25mg/kg) primaquine (PQ) in combination with artemisinin-based combination therapies (ACTs) in areas of low transmission or artemisinin-resistant P. falciparum, several single-site studies have been conducted to assess its efficacy.METHODS: An individual patient meta-analysis to assess the gametocytocidal and transmission-blocking efficacy of PQ used in combination with different ACTs was conducted. Random effects logistic regression was used to quantify PQ effect on (i) gametocyte carriage in the first two weeks post-treatment; (ii) the probability of infecting at least one mosquito or of a mosquito becoming infected.RESULTS: In 2,574 participants from fourteen studies, PQ reduced PCR-determined gametocyte carriage on days 7 and 14, most apparently in patients presenting with gametocytaemia on day 0 (Odds Ratio (OR)=0.22; 95%CI 0.17-0.28 and OR=0.12; 95%CI 0.08-0.16, respectively). The rate of decline in gametocyte carriage was faster when PQ was combined with artemether-lumefantrine (AL) compared to dihydroartemisinin-piperaquine (DP) (p=0.010 for day 7). Addition of 0.25mg/kg PQ was associated with near complete prevention of transmission to mosquitoes.CONCLUSION: Primaquine's transmission-blocking effects are achieved with 0.25 mg/kg PQ. Gametocyte persistence and infectivity are lower when PQ is combined with AL compared to DP.
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| 31. |
- Stepniewska, Kasia, et al.
(författare)
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Safety of single-dose primaquine as a Plasmodium falciparum gametocytocide : a systematic review and meta-analysis of individual patient data
- 2022
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Ingår i: BMC Medicine. - : Springer Nature. - 1741-7015. ; 20:1
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Forskningsöversikt (refereegranskat)abstract
- BackgroundIn 2012, the World Health Organization (WHO) recommended single low-dose (SLD, 0.25 mg/kg) primaquine to be added as a Plasmodium (P.) falciparum gametocytocide to artemisinin-based combination therapy (ACT) without glucose-6-phosphate dehydrogenase (G6PD) testing, to accelerate malaria elimination efforts and avoid the spread of artemisinin resistance. Uptake of this recommendation has been relatively slow primarily due to safety concerns.MethodsA systematic review and individual patient data (IPD) meta-analysis of single-dose (SD) primaquine studies for P. falciparum malaria were performed. Absolute and fractional changes in haemoglobin concentration within a week and adverse effects within 28 days of treatment initiation were characterised and compared between primaquine and no primaquine arms using random intercept models.ResultsData comprised 20 studies that enrolled 6406 participants, of whom 5129 (80.1%) had received a single target dose of primaquine ranging between 0.0625 and 0.75 mg/kg. There was no effect of primaquine in G6PD-normal participants on haemoglobin concentrations. However, among 194 G6PD-deficient African participants, a 0.25 mg/kg primaquine target dose resulted in an additional 0.53 g/dL (95% CI 0.17-0.89) reduction in haemoglobin concentration by day 7, with a 0.27 (95% CI 0.19-0.34) g/dL haemoglobin drop estimated for every 0.1 mg/kg increase in primaquine dose. Baseline haemoglobin, young age, and hyperparasitaemia were the main determinants of becoming anaemic (Hb < 10 g/dL), with the nadir observed on ACT day 2 or 3, regardless of G6PD status and exposure to primaquine. Time to recovery from anaemia took longer in young children and those with baseline anaemia or hyperparasitaemia. Serious adverse haematological events after primaquine were few (9/3, 113, 0.3%) and transitory. One blood transfusion was reported in the primaquine arms, and there were no primaquine-related deaths. In controlled studies, the proportions with either haematological or any serious adverse event were similar between primaquine and no primaquine arms.ConclusionsOur results support the WHO recommendation to use 0.25 mg/kg of primaquine as a P. falciparum gametocytocide, including in G6PD-deficient individuals. Although primaquine is associated with a transient reduction in haemoglobin levels in G6PD-deficient individuals, haemoglobin levels at clinical presentation are the major determinants of anaemia in these patients.
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| 32. |
- Veitonmäki, Niina, et al.
(författare)
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A human icam-1 antibody isolated by a function-first approach has potent macrophage-dependent antimyeloma activity in vivo.
- 2013
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Ingår i: Cancer Cell. - : Elsevier BV. - 1878-3686 .- 1535-6108. ; 23:4, s. 502-515
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Tidskriftsartikel (refereegranskat)abstract
- We isolated a tumor B-cell-targeting antibody, BI-505, from a highly diversified human phage-antibody library, using a pioneering "function-first" approach involving screening for (1) specificity for a tumor B cell surface receptor, (2) induction of tumor programmed cell death, and (3) enhanced in vivo antitumor activity compared to currently used treatments. BI-505 bound to intercellular adhesion molecule-1, identifying a previously unrecognized role for this receptor as a therapeutic target in cancer. The BI-505 epitope was strongly expressed on the surface of multiple myeloma cells from both newly diagnosed and relapsed patients. BI-505 had potent macrophage-dependent antimyeloma activity and conferred enhanced survival compared to currently used treatments in advanced experimental models of multiple myeloma.
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| 33. |
- Widäng, Ingrid, et al.
(författare)
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Women patients' conceptions of integrity within health care : a phenomenographic study
- 2008
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Ingår i: Journal of Advanced Nursing. - : John Wiley & Sons. - 0309-2402 .- 1365-2648. ; 61:5, s. 540-548
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to describe how female patients conceive integrity within health care. A phenomenographic approach was chosen to focus on women’s conceptions. The participants were 15 strategically-chosen female patients who were interviewed after discharge from a hospital in Sweden. Three description categories were identified: ‘maintaining the self’, which represented the patient’s relationship to herself; ‘dignity’, which characterized the professional caregivers’ relationship to the patient; and ‘confidence’, which was associated with the relationship between patient and professional caregivers. Integrity implied having courage to set boundaries and have control of the private sphere, but also if necessary changing the boundaries of integrity. It is essential that professional caregivers are knowledgeable about all aspects of integrity and the importance of interactions with patients being characterized by dignity and confidentiality. Professional caregivers should take part in reflective discussions to identify situations in health care with an inherent risk of threatening or violating patients’ integrity, and how best to preserve it. Integrity is an abstract and complex concept that is not well-defined, and further research is needed to clarify its connection with other concepts.
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| 34. |
- Wreiner, Thomas, et al.
(författare)
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Exploring Service Blueprints for Multiple Actors : A Case Study of Car Parking Services
- 2009
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Ingår i: First Nordic Conference on Service Design. - : Linköping University Electronic Press. - 9789175197715
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Konferensbidrag (refereegranskat)abstract
- Service blueprints are usually included in listings of standard methods within service design. Still; little research has been conducted on service blueprints. The case study at hand explores how blueprints can be applied in a situation with three key actors; all with different motives and wishes. The case study is within the domain of car parking; a service which at a first glance may seem simple; but is rather complex when scrutinized. Three ways of blueprinting the situation are presented and discussed in the paper. Finally issues which arose from the blueprinting process are discussed in regard to implications for people creating blueprints.
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