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- Alexeyev, Oleg A, et al.
(författare)
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Direct visualization of Propionibacterium acnes in prostate tissue by multicolor fluorescent in situ hybridization assay.
- 2007
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Ingår i: Journal of Clinical Microbiology. - 0095-1137 .- 1098-660X. ; 45:11, s. 3721-8
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Tidskriftsartikel (refereegranskat)abstract
- Prostate tissues from patients with prostate cancer and benign prostatic hyperplasia (BPH) frequently contain histological inflammation, and a proportion of these patients show evidence of Propionibacterium acnes infection in the prostate gland. We developed a multicolor fluorescent in situ hybridization (FISH) assay targeting P. acnes 23S rRNA along with a 14-kb region of the P. acnes genome. This assay was used to analyze prostate tissues from patients with prostate cancer and BPH. P. acnes infection of the prostate gland was demonstrated in prostatic tissue in 5 of 10 randomly selected prostate cancer patients. FISH analysis and confocal laser microscopy imaging revealed intracellular localization and stromal biofilm-like aggregates as common forms of P. acnes infection in prostate tissues from both prostate cancer and BPH patients. A sequential analysis of prostate tissue from individual patients suggested that P. acnes can persist for up to 6 years in the prostate gland. These results indicate that P. acnes can establish a persistent infection in the prostate gland. Further study is needed to clarify the link between this bacterium and prostatic inflammation which may contribute to the development of BPH and prostate cancer.
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| 2. |
- Eriksson Hallberg, Ulrika, 1973-
(författare)
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A thesis on fire : Studies of work engagement, Type A behavior and burnout
- 2005
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The overall address of the present thesis is the relationship between being ‘on fire’ and burning out. More specifically, the thesis focused largely on two representations of involvement in work (work engagement and Type A behavior) and their respective relationships to burnout. Another pervasive theme was construct validity in assessing burnout and work engagement. These themes were addressed in four empirical studies, conducted in a sample of health-care workers (Study I) and a sample of information communication technology consultants (Studies II, III, and IV). Study I aimed to extend the previously preliminary support for the construct validity of the Swedish version of the Maslach Burnout Inventory (MBI). The objective of Study II was the discriminant validity of the Utrecht Work engagement Scale (UWES) against the theoretically adjacent constructs job involvement and organizational commitment. Another objective was the translation and evaluation of a Swedish version of the UWES. In Study III, the aim was to investigate (cross-sectional) association between Type A behavior, work engagement and burnout. Study III had two foci: 1) whether Type A behavior interacts with job factors to affect burnout and work engagement, and 2) the associations between the main components of Type A behavior (achievement-striving and irritability/impatience) and burnout as well as work engagement. Study IV concerned the longitudinal relationships between Type A behavior and burnout, and between work engagement and burnout. The results presented in this dissertation supported the construct validity of Swedish versions of the MBI and the UWES. It was further indicated that emotional exhaustion and depersonalization (or cynicism) constitute the core aspects of burnout, and that work engagement was more prominently associated with lack of health complaints than job involvement and organizational commitment. Type A behavior was found to be associated with burnout and work engagement in cross-sectional data, however different aspects of Type A behavior appeared to have somewhat different association with burnout and work engagement respectively. The achievement-striving aspect of Type A behavior was related primarily to work engagement, whereas irritability was associated with less engagement and more burnout complaints. No indications of an interaction between Type A behavior and job stress were found. The most important finding of Study IV was that change in Type A behavior was unrelated to change in burnout across time (one-year interval). Furthermore, Study IV supported the notion that work engagement and burnout are bipolar opposites and constitute a work well-being continuum. To conclude, the present thesis suggests that burnout should be viewed as an erosion of intrinsic, affective engagement in work occurring when intrinsic motivation is frustrated by job stress. To avoid conceptual confusion, burnout should be distinguished form exhaustion syndrome however it should be acknowledged that burnout may have negative impact on health. The present study indicated that Type A behavior is unrelated to the specific burnout reaction, a finding that needs to be replicated before generalizability can be assumed. However, it was assumed that Type A behavior represents an instrumental approach to work, further corroborating that burnout is a specific construct referring to the draining of a specific energetic and affective state. This does not imply that Type A behavior is unrelated to health deterioration – most plausibly, Type A behavior generates exhaustion and fatigue from over-exertion of energy. Both research and practice would benefit from exploring how work engagement may best be enhanced using job redesign.
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| 3. |
- Eriksson, Irene, et al.
(författare)
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Preconditions needed for establishing a trusting relationship during health counselling - an interview study
- 2008
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Ingår i: Journal of Clinical Nursing. - : Wiley-Blackwell Publishing Inc.. - 0962-1067 .- 1365-2702. ; 17:17, s. 2352-2359
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Tidskriftsartikel (refereegranskat)abstract
- Aim. To examine the preconditions needed by district nurses to build a trusting relationship during health counselling of patients with hypertension. Background. Trust has been found to be an important aspect of the patient-nurse relationship. Little research has focused on how trust is formed in patient-nurse relationships or the conditions the development process requires when working with health counselling; in particular not in relation to hypertension. Design. Qualitative study. Method. Qualitative data were collected through open-ended interviews with all (10) district nurses from three primary health care districts of western Sweden. All interviewees work with the health counselling of patients with hypertension. A latent content analysis was performed with thematic coding of the content of the interviews. Results. The first theme that emerged from the analysis, the nurses' competence, describes the nurses' consciousness of their method of expression, both oral and non-verbal, as well as their pedagogical competence and their ability to be reliable in their profession. The second theme, the patient meeting, describes the continuity in the patient meeting and creating respectful communication. Conclusion. The results show an awareness of preconditions influencing building a trusting relationship. When creating a trusting relationship the communication and pedagogical competences of district nurses have considerable importance. Despite this awareness they state that it is easy to fall into a routinised way of working. Relevance to clinical practice. The implications of this study might be used as support and guidance for district nurses when developing their competence in health counselling in relations to patients with hypertension. This knowledge is also important when planning for nurse-led clinics for this patient group.
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| 4. |
- Evander, Magnus, et al.
(författare)
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Puumala hantavirus viremia diagnosed by real-time reverse transcriptase PCR using samples from patients with hemorrhagic fever and renal syndrome
- 2007
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Ingår i: Journal of Clinical Microbiology. - : American Society for Microbiology. - 0095-1137 .- 1098-660X. ; 45:8, s. 2491-2497
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Tidskriftsartikel (refereegranskat)abstract
- Puumala virus (PUUV) is the endemic hantavirus in northern Sweden and causes nephropathia epidemica (NE), a milder form of hemorrhagic fever with renal syndrome. There is a need for fast and reliable diagnostics to differentiate the disease from other infections. By aligning virus RNA sequences isolated from 11 different bank voles and one human patient, we designed a real-time reverse transcriptase (RT) PCR method for detection of PUUV RNA. The real-time RT-PCR assay showed linearity from 20 to 2 x 10(6) virus copies with a correlation coefficient above 0.98 to 0.99 for all experiments. The detection threshold for PUUV cDNA was two copies per reaction. A two-step qualitative RT-PCR to detect PUUV RNA showed 100% concordance with the real-time RT-PCR assay. PUUV RNA viremia was detected in 33 of 34 PUUV immunoglobulin M (IgM)-positive patients with typical clinical NE disease from the region of endemicity. One PUUV IgM-negative sample had PUUV RNA, and 4 days later, the patient was IgM positive. Of samples with indeterminate IgM, 43% were PUUV RNA positive. The kinetics of antibody titers and PUUV viremia were studied, and five of six NE patients displayed a decrease in PUUV viremia a few days after disease outbreak coupled with an increase in PUUV IgM and IgG. In one patient with continuously high PUUV RNA levels but low IgM and no IgG response, the infection was lethal. These findings demonstrated that real-time RT-PCR is a useful method for diagnosis of PUUV viremia and for detecting PUUV RNA at early time points, before the appearance of IgM antibodies.
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| 7. |
- Målqvist, Mats, et al.
(författare)
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Unreported births and deaths, a severe obstacle for improved neonatal survival in low-income countries; a population based study
- 2008
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Ingår i: BMC International Health and Human Rights. - 1472-698X. ; 8, s. 4-
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Tidskriftsartikel (refereegranskat)abstract
- ABSTRACT: BACKGROUND: In order to improve child survival there is a need to target neonatal mortality. In this pursuit, valid local and national statistics on child health are essential. We analyze to what extent births and neonatal deaths are unreported in a low-income country and discuss the consequences at local and international levels for efforts to save newborn lives. METHODS: Information on all births and neonatal deaths in Quang Ninh province in Northern Vietnam in 2005 was ascertained by systematic inventory through group interviews with key informants, questionnaires and examination of health facility records. Health care staff at 187 Community Health Centers (CHC) and 18 hospitals, in addition to 1372 Village Health Workers (VHW), were included in the study. Results were compared with the official reports of the Provincial Health Bureau. RESULTS: The neonatal mortality rate (NMR) was 16/1000 (284 neonatal deaths/17 519 births), as compared to the official rate of 4.2/1000. The NMR varied between 44/1000 and 10/1000 in the different districts of the province. The under-reporting was mainly attributable to a dysfunctional reporting system and the fact that families, not the health system, were made responsible to register births and deaths. This under-reporting has severe consequences at local, national and international levels. At a local level, it results in a lack of awareness of the magnitude and differentials in NMR, leading to an indifference towards the problem. At a national and international level the perceived low mortality rate is manifested in a lack of investments in perinatal health programs. CONCLUSION: This example of a faulty health information system is reportedly not unique in low and middle income countries where needs for neonatal health reforms are greatest. Improving reporting systems on births and neonatal deaths is a matter of human rights and a prerequisite for reducing neonatal mortality in order to reach the fourth millennium goal.
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| 9. |
- Rudolfsson, Gudrun, 1948-, et al.
(författare)
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The development of caring in the perioperative culture : Nurse leaders' perspective on the struggle to retain sight of the patient
- 2007
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Ingår i: Nursing Administration Quarterly. - 0363-9568 .- 1550-5103. ; 31:4, s. 312-324
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Tidskriftsartikel (refereegranskat)abstract
- This article focuses on Swedish nurse leaders and is aimed at achieving a more complete and differentiated understanding of what constitutes caring in the perioperative culture as well as their knowledge and responsibility for the development of caring. Interviews with open-ended questions were conducted with 10 nurse leaders, in which they described their experiences of developing perioperative caring. The interpretation process was based on Gadamer's philosophy of hermeneutics. The findings indicate that developing a perioperative caring culture is a struggle to retain sight of the patient, a process that includes the following 6 phases: (1) when the nurse leaders understood perioperative caring as a process, the nurse's and patient's shared world became obvious to them; (2) safeguarding the patient's position as a unique human being; (3) safeguarding the nurse's welfare by creating a compassionate atmosphere; (4) promoting an idea means never giving up; (5) attaching importance to being trustworthy; and (6) being involved in a dynamic interaction, comprising communion and reciprocity. The most important goal of nursing leadership is to safeguard the welfare of the suffering patient and the relationship between the nurse leader and nursing staff, based on the motive of caritas derived from the idea of humanistic caring.
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