| 1. |
- Anrys, Charlotte, et al.
(författare)
-
Independent risk factors for pressure ulcer development in a high-risk nursing home population receiving evidence-based pressure ulcer prevention : Results from a study in 26 nursing homes in Belgium
- 2019
-
Ingår i: International Wound Journal. - : Wiley-Blackwell Publishing Inc.. - 1742-4801 .- 1742-481X. ; 16:2, s. 325-333
-
Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to identify independent risk factors for pressure ulcer (PU) development in a high-risk nursing home population receiving evidence-based PU prevention. This study was part of a randomised controlled trial examining the (cost-)effectiveness of static air support surfaces compared with alternating pressure air mattresses. The sample consisted of 308 residents at a high risk of PU development (presence of non-blanchable erythema, Braden score ≤ 12 or Braden subscale "mobility" ≤ 2). PU incidence was monitored for 14 days. Demographic variables; functional, physical, and psychological characteristics; and data on skin assessment were collected. Independent risk factors were identified using multiple logistic regression analysis. The overall PU incidence (category II-IV) was 8.4% (n = 26), and 1.9% (n = 6) of the residents developed a deep PU (category III-IV). PUs (category II-IV) were significantly associated with non-blanchable erythema, a lower Braden score, and pressure area-related pain in high-risk residents even if preventive care was provided. These results highlight the need of a systematic risk assessment, including pain assessment and skin observations, in order to determine and tailor preventive care to the needs of high-risk individuals.
|
|
| 2. |
|
|
| 3. |
- Butler, Éile, et al.
(författare)
-
A pilot study investigating lactic acid bacterial symbionts from the honeybee in inhibiting human chronic wound pathogens
- 2016
-
Ingår i: International Wound Journal. - Oxford : Blackwell Publishing. - 1742-4801 .- 1742-481X. ; 13:5, s. 729-37
-
Tidskriftsartikel (refereegranskat)abstract
- Treatment and management of chronic wounds is a large burden on the health sector and causes substantial suffering for the patients. We believe that 13 lactic acid bacteria (LAB) symbionts isolated from the honey crop of the honeybee are important players in the antimicrobial action of honey, by producing antimicrobial substances and can be used in combination with heather honey as an effective treatment in wound management. A total of 22 patients with chronic ulcers were included; culture-dependent and molecular-based (MALDI-MS and 16S rRNA gene sequencing) techniques were used to identify bacteria from chronic wounds. These clinical isolates were used for in vitro antimicrobial testing with standardised viable LAB and sterilised heather honey mixture. Twenty of the patients' wounds were polymicrobial and 42 different species were isolated. Patient isolates that were tested in vitro were inhibited by the LAB and honey combination with inhibitory zones comparable with different antibiotics. LAB and heather honey in combination presents a new topical option in chronic wound management because of the healing properties of honey, antimicrobial metabolite production from the LAB and their bactericidal effect on common chronic wound pathogens. This new treatment may be a stepping stone towards an alternative solution to antibiotics.
|
|
| 4. |
- Florin, Jan, 1956-, et al.
(författare)
-
Attitudes towards pressure ulcer prevention : a psychometric evaluation of the Swedish version of the APuP instrument
- 2016
-
Ingår i: International Wound Journal. - : Wiley. - 1742-4801 .- 1742-481X. ; 13:5, s. 655-662
-
Tidskriftsartikel (refereegranskat)abstract
- The primary aim was to conduct a psychometric evaluation of the Attitude towards Pressure ulcer Prevention (APuP) instrument in a Swedish context. A further aim was to describe and compare attitudes towards pressure ulcer prevention between registered nurses (RNs), assistant nurses (ANs) and student nurses (SNs). In total, 415 RNs, ANs and SNs responded to the questionnaire. In addition to descriptive and comparative statistics, confirmatory factor analyses were performed. Because of a lack of support for the instrument structure, further explorative and consecutive confirmatory tests were conducted. Overall, positive attitudes towards pressure ulcer prevention were identified for all three groups, but SNs reported lower attitude scores on three items and a higher score on one item compared to RNs and ANs. The findings indicated no support in this Swedish sample for the previously reported five-factor model of APuP. Further explorative and confirmative factor analyses indicated that a four-factor model was most interpretable: (i) Priority (five items), (ii) Competence (three items), (iii) Importance (three items) and (iv) Responsibility (two items). The five-factor solution could not be confirmed. Further research is recommended to develop a valid and reliable tool to assess nurses' attitudes towards pressure ulcer prevention working across different settings on an international level.
|
|
| 5. |
- Gunningberg, Lena, et al.
(författare)
-
Pressure ulcer knowledge of registered nurses, assistant nurses and student nurses : a descriptive, comparative multicentre study in Sweden
- 2015
-
Ingår i: International Wound Journal. - : Wiley. - 1742-4801 .- 1742-481X. ; 12:4, s. 462-468
-
Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to describe and compare the knowledge of registered nurses (RNs), assistant nurses (ANs) and student nurses (SNs) about preventing pressure ulcers (PUs). PU prevention behaviours in the clinical practice of RNs and ANs were also explored. A descriptive, comparative multicentre study was performed. Hospital wards and universities from four Swedish county councils participated. In total, 415 participants (RN, AN and SN) completed the Pressure Ulcer Knowledge Assessment Tool. The mean knowledge score for the sample was 58·9%. The highest scores were found in the themes 'nutrition' (83·1%) and 'risk assessment' (75·7%). The lowest scores were found in the themes 'reduction in the amount of pressure and shear' (47·5%) and 'classification and observation' (55·5%). RNs and SNs had higher scores than ANs on 'aetiology and causes'. SNs had higher scores than RNs and ANs on 'nutrition'. It has been concluded that there is a knowledge deficit in PU prevention among nursing staff in Sweden. A major educational campaign needs to be undertaken both in hospital settings and in nursing education.
|
|
| 6. |
- Gunningberg, Lena, 1954-, et al.
(författare)
-
Reduced pressure for fewer pressure ulcers : can real-time feedback of interface pressure optimise repositioning in bed?
- 2016
-
Ingår i: International Wound Journal. - : Wiley. - 1742-4801 .- 1742-481X. ; 13:5, s. 774-779
-
Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to (i) describe registered nurses' and assistant nurses' repositioning skills with regard to their existing attitudes to and theoretical knowledge of pressure ulcer (PU) prevention, and (ii) evaluate if the continuous bedside pressure mapping (CBPM) system provides staff with a pedagogic tool to optimise repositioning. A quantitative study was performed using a descriptive, comparative design. Registered nurses (n = 19) and assistant nurses (n = 33) worked in pairs, and were instructed to place two volunteers (aged over 70 years) in the best pressure-reducing position (lateral and supine), first without viewing the CBPM monitor and then again after feedback. In total, 240 positionings were conducted. The results show that for the same person with the same available pressure-reducing equipment, the peak pressure varied considerably between nursing pairs. Reducing pressure in the lateral position appeared to be the most challenging. Peak pressures were significantly reduced, based on visual feedback from the CBPM monitor. The number of preventive interventions also increased, as well as patients' comfort. For the nurses as a group, the knowledge score was 59·7% and the attitude score was 88·8%. Real-time visual feedback of pressure points appears to provide another dimension to complement decision making with respect to PU prevention.
|
|
| 7. |
- Kallman, Ulrika, et al.
(författare)
-
Swedish translation and validation of the international skin tear advisory panel skin tear classification system
- 2019
-
Ingår i: International Wound Journal. - : John Wiley & Sons. - 1742-4801 .- 1742-481X. ; 16:1, s. 13-18
-
Tidskriftsartikel (refereegranskat)abstract
- The aims of this study were to translate the International Skin Tear Advisory Panel (ISTAP) classification system for skin tears into Swedish and to validate the translated system. The research process consisted of two phases. Phase I involved the translation of the classification system, using the forward-back translation method, and a consensus survey. The survey dictated that the best Swedish translation for "skin tear" was "hudfliksskada." In Phase 2, the classification system was validated by health care professionals attending a wound care conference held in the spring of 2017 in Sweden. Thirty photographs representing three types of skin tear were presented to participants in random order. Participants were directed to classify the skin tear types in a data collection sheet. The results indicated a moderate level of agreement on classification of skin tears by type. Achieving moderate agreement for the ISTAP skin tear tool is an important milestone as it demonstrates the validity and reliability of the tool. Skin tear classification typing is a complex skill that requires training and time to develop. More education is required for all health care specialists on the classification of skin tears.
|
|
| 8. |
- Kiwanuka, Elizabeth, 1983-, et al.
(författare)
-
Cdc42 and p190RhoGAP activation by CCN2 regulates cell spreading and polarity and induces actin disassembly in migrating keratinocytes
- 2016
-
Ingår i: International Wound Journal. - : Wiley. - 1742-4801 .- 1742-481X. ; 13:3, s. 372-381
-
Tidskriftsartikel (refereegranskat)abstract
- Cell migration requires spatiotemporal integration of signals that regulate cytoskeletal dynamics. In response to a migration-promoting agent, cells begin to polarise and extend protrusions in the direction of migration. These cytoskeletal rearrangements are orchestrated by a variety of proteins, including focal adhesion kinase (FAK) and the Rho family of GTPases. CCN2, also known as connective tissue growth factor, has emerged as a regulator of cell migration but the mechanism by which CCN2 regulates keratinocyte function is not well understood. In this article, we sought to elucidate the basicmechanism of CCN2-induced cellmigration in human keratinocytes. Immunohistochemical staining was used to demonstrate that treatment with CCN2 induces a migratory phenotype through actin disassembly, spreading of lamellipodia and re-orientation of the Golgi. In vitro assays were used to show that CCN2-induced cell migration is dependent on FAK, RhoA and Cdc42, but independent of Rac1. CCN2-treated keratinocytes displayed increased Cdc42 activity and decreased RhoA activity up to 12 hours post-treatment, with upregulation of p190RhoGAP. An improved understanding of how CCN2 regulates cell migration may establish the foundation for future therapeutics in fibrotic and neoplastic diseases.
|
|
| 9. |
- Kiwanuka, Elizabeth, et al.
(författare)
-
Transforming growth factor beta 1 regulates the expression of CCN2 in human keratinocytes via Smad-ERK signalling
- 2017
-
Ingår i: International Wound Journal. - : WILEY. - 1742-4801 .- 1742-481X. ; 14:6, s. 1006-1018
-
Tidskriftsartikel (refereegranskat)abstract
- Connective tissue growth factor (CCN2/CTGF) and transforming growth factor 1 (TGF-1) are important regulators of skin wound healing, but controversy remains regarding their expression in epithelial cell lineages. Here, we investigate the expression of CCN2 in keratinocytes during reepithelialisation and its regulation by TGF-1. CCN2 was detected in the epidermis of healing full-thickness porcine wounds. Human keratinocytes were incubated with or without 10 ng/ml TGF-1, and signalling pathways were blocked with 10-M SIS3 or 20-M PD98059. Semi-quantitative real-time PCR was used to study CCN2 mRNA expression, and western blot was used to measure CCN2, phosphorylated-ERK1/2, ERK1/2, phosphorylated-Smad3 and Smad2/3 proteins. CCN2 was transiently expressed in neoepidermis at the leading edge of the wound in vivo. In vitro, CCN2 expression was induced by TGF-1 at 2 hours (7amp;lt;boldamp;gt;amp;lt;/boldamp;gt;5 +/- 1amp;lt;boldamp;gt;amp;lt;/boldamp;gt;9-fold mRNA increase and 3amp;lt;boldamp;gt;amp;lt;/boldamp;gt;0 +/- 0amp;lt;boldamp;gt;amp;lt;/boldamp;gt;6-fold protein increase) and 12 hours (5amp;lt;boldamp;gt;amp;lt;/boldamp;gt;4 +/- 1amp;lt;boldamp;gt;amp;lt;/boldamp;gt;9-fold mRNA increase and 3amp;lt;boldamp;gt;amp;lt;/boldamp;gt;3 +/- 0amp;lt;boldamp;gt;amp;lt;/boldamp;gt;6-fold protein increase). Compared with inhibiting the SMAD pathway, inhibiting the mitogen-activated protein kinase (MAPK) pathway was more effective in reducing TGF-1-induced CCN2 mRNA and protein expression. Inhibition of the MAPK pathway had minimal impact on the activity of the SMAD pathway. CCN2 is expressed in keratinocytes in response to tissue injury or TGF-1. In addition, TGF-1 induces CCN2 expression in keratinocytes through the ras/MEK/ERK pathway. A complete understanding of CCN2 expression in keratinocytes is critical to developing novel therapies for wound healing and cutaneous malignancy.
|
|
| 10. |
- Källman, Ulrika, et al.
(författare)
-
Nursing staff induced repositionings and immobile patients' spontaneous movements in nursing care.
- 2016
-
Ingår i: International Wound Journal. - : Wiley-Blackwell. - 1742-4801 .- 1742-481X. ; 13:6, s. 1168-1175
-
Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to investigate nursing staff induced repositionings and the patients' spontaneous movements during the day and night among older immobile patients in nursing care. Furthermore, the aim was to identify factors associated with the nursing staff induced repositionings and the patients' spontaneous movement frequency. An observational cross-sectional design was used. Spontaneous movements among patients (n = 52) were registered continuously using the MovinSense monitoring system. The nursing staff documented each time they repositioned the patient. Patients spontaneous movements were compared with nursing staff induced repositionings. There were large variations in the patients' spontaneous repositioning frequency during both days and nights, which shows that, although immobilised, some patients frequently reposition themselves. Analgesics were positively related to the movement frequency and psycholeptics were negatively related. The nursing staff more often repositioned the patients who were assessed as high risk than those assessed as low risk, but the patients' spontaneous movement frequency was not correlated to the risk score. This may be important when planning repositioning schedules. A monitoring system may be useful in decision making with regard to planning repositioning and positions used in the prevention of pressure ulcers among elderly immobile patients.
|
|
