| 1. |
- Alexanderson, Karin, 1952-, et al.
(författare)
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Supporting user involvement in child welfare work : a way of implementing evidence-based practice
- 2014
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Ingår i: Evidence & Policy. - Policy Press : Policy Press. - 1744-2648 .- 1744-2656. ; 10:4, s. 541-554
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Tidskriftsartikel (refereegranskat)abstract
- The articel describes and analyses some preliminary working methods for user involvement in child welfare. The models are based on the results of a national project in Sweden where children and young peple have been involved as informants. How experiences and viewpoints from children and young people can be a source of knowledge in child welfare organisatiions is one of the main questions. The performance and the results of the project are analysed in relaton to a theoretical macro-oriented model created to illustrate the need for different kinds of knowledge in supporting the implementation of an evidence-based practice.
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| 2. |
- Corpeno, Rebeca, et al.
(författare)
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Time-course analysis of mechanical ventilation-induced diaphragm contractile muscle dysfunction in the rat
- 2014
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Ingår i: Journal of Physiology. - : Wiley. - 0022-3751 .- 1469-7793. ; 592:17, s. 3859-3880
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Tidskriftsartikel (refereegranskat)abstract
- Controlled mechanical ventilation (CMV) plays a key role in triggering the impaired diaphragm muscle function and the concomitant delayed weaning from the respirator in critically ill intensive care unit (ICU) patients. To date, experimental and clinical studies have primarily focused on early effects on the diaphragm by CMV, or at specific time points. To improve our understanding of the mechanisms underlying the impaired diaphragm muscle function in response to mechanical ventilation, we have performed time‐resolved analyses between 6 h and 14 days using an experimental rat ICU model allowing detailed studies of the diaphragm in response to long‐term CMV. A rapid and early decline in maximum muscle fibre force and preceding muscle fibre atrophy was observed in the diaphragm in response to CMV, resulting in an 85% reduction in residual diaphragm fibre function after 9–14 days of CMV. A modest loss of contractile proteins was observed and linked to an early activation of the ubiquitin proteasome pathway, myosin:actin ratios were not affected and the transcriptional regulation of myosin isoforms did not show any dramatic changes during the observation period. Furthermore, small angle X‐ray diffraction analyses demonstrate that myosin can bind to actin in an ATP‐dependent manner even after 9–14 days of exposure to CMV. Thus, quantitative changes in muscle fibre size and contractile proteins are not the dominating factors underlying the dramatic decline in diaphragm muscle function in response to CMV, in contrast to earlier observations in limb muscles. The observed early loss of subsarcolemmal neuronal nitric oxide synthase activity, onset of oxidative stress, intracellular lipid accumulation and post‐translational protein modifications strongly argue for significant qualitative changes in contractile proteins causing the severely impaired residual function in diaphragm fibres after long‐term mechanical ventilation. For the first time, the present study demonstrates novel changes in the diaphragm structure/function and underlying mechanisms at the gene, protein and cellular levels in response to CMV at a high temporal resolution ranging from 6 h to 14 days.
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| 3. |
- Eklund, Anna Josse, 1968-, et al.
(författare)
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Swedish nurses’ perceptions of influencers on patient advocacy – a phenomenographic study
- 2014
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Ingår i: Nursing Ethics. - : Sage Publications. - 0969-7330 .- 1477-0989. ; 21:6, s. 673-683
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Tidskriftsartikel (refereegranskat)abstract
- Background: A limited number of studies have shown that patient advocacy can be influenced by both facilitators and barriers which can encourage and discourage nurses to act as patient advocates. Objective: This study’s aim was to describe Swedish nurses’ perceptions of influencers on patient advocacy.Research design and context: Interviews with 18 registered nurses from different Swedish clinical contexts were analysed using the phenomenographic method.Ethical considerations: Ethical revisions were made in accordance with national legislation and guidelines by committees for research ethics at Karlstad University. Findings: Three levels of hierarchically related influencers on patient advocacy were found in the descriptive categories. The fundamental influencer, the nurse’s character traits, was described in the perceptions that advocacy is influenced by nurse’s having a moral compass, having control over the care situation, being protective and feeling secure as a nurse. The second most vital influencer, the nurse’s bond with the patient, was expressed in the perceptions of knowing the patient and feeling empathy for the patient. The third level of influencers, the organisational conditions, was described in the perceptions that the organisational structures and organisational culture influence patient advocacy.Discussion: The results correspond with findings from earlier research but add an understanding that influencers on patient advocacy exist at three hierarchically related levels. Conclusion: The nurse’s character traits are the fundamental influencer to patient advocacy, but in order to be comfortable and secure when advocating for patients, nurses also need to be familiar with both the patient and the situation. A supposition could be that all influencers interact, which needs to be further addressed in future studies.
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| 4. |
- Hansen-Pupp, Ingrid, et al.
(författare)
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Postnatal Decrease in Circulating Insulin-Like Growth Factor-I and Low Brain Volumes in Very Preterm Infants.
- 2011
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Ingår i: The Journal of clinical endocrinology and metabolism. - : The Endocrine Society. - 1945-7197 .- 0021-972X. ; 96:4, s. 1129-1135
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Tidskriftsartikel (refereegranskat)abstract
- Context: IGF-I and IGF binding protein-3 (IGFBP-3) are essential for growth and maturation of the developing brain. Objective: The aim of this study was to evaluate the association between postnatal serum concentrations of IGF-I and IGFBP-3 and brain volumes at term in very preterm infants. Design: Fifty-one infants with a mean (sd) gestational age (GA) of 26.4 (1.9) wk and birth weight (BW) of 888 (288) g were studied, with weekly blood sampling of IGF-I and IGFBP-3 from birth until 35 gestational weeks (GW) and daily calculation of protein and caloric intake. Magnetic resonance images obtained at 40 GW were segmented into total brain, cerebellar, cerebrospinal fluid, gray matter, and unmyelinated white matter volumes. Main Outcome Measures: We evaluated brain growth by measuring brain volumes using magnetic resonance imaging. Results: Mean IGF-I concentrations from birth to 35 GW correlated with total brain volume, unmyelinated white matter volume, gray matter volume, and cerebellar volume [r = 0.55 (P < 0.001); r = 0.55 (P < 0.001); r = 0.44 (P = 0.002); and r = 0.58 (P < 0.001), respectively]. Similar correlations were observed for IGFBP-3 concentrations. Correlations remained after adjustment for GA, mean protein and caloric intakes, gender, severe brain damage, and steroid treatment. Protein and caloric intakes were not related to brain volumes. Infants with BW small for GA had lower mean concentrations of IGF-I (P = 0.006) and smaller brain volumes (P = 0.001-0.013) than infants with BW appropriate for GA. Conclusion: Postnatal IGF-I and IGFBP-3 concentrations are positively associated with brain volumes at 40 GW in very preterm infants. Normalization of the IGF-I axis, directly or indirectly, may support normal brain development in very preterm infants.
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| 5. |
- Hedlund, Ann, 1964-, et al.
(författare)
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Studenters, anställdas och företags syn på arbete : En pilotstudie av Turism/Besöksnäring, Material, Energi & Miljö samt IT & Media
- 2014
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Denna rapport redovisar resultaten från ett pilotprojekt om studenters, anställdas och företagsrepresentanters syn på arbete. Rapporten dokumenterar insamlad data, redovisar genomförda inledande analyser, samt ger förslag till fortsatt forskning och samverkan. Syftet med studien är ökad kunskap om synen på arbete inom profilområdena Turism/Besöksnäring, Material, Energi & Miljö samt IT & Media. Därtill förväntas diskussioner kring resultatens användbarhet kunna ge underlag för utvecklingsprojekt för ökad attraktivitet.Studien har genomförts i form av fallstudier på fem företag inom respektive profilområde i Dalarna. Därtill har en enkätundersökning genomförts bland studenter vid Högskolan Dalarna inom motsvarande utbildningsområden på 21 olika utbildningsprogram. Statistiska beräkningar och begreppsanalyser har genomförts på insamlat material.I rapporten redovisas studenters, anställdas och företagsrepresentanters syn på arbete fördelat på de olika profilområdena. Därtill görs jämförelser mellan de olika grupperna.Slutsatser från studien är:Studenter ser arbete inom deras utbildningsområde som i hög grad attraktiva.Anställdas syn på vad som är viktigt för att göra ett arbete attraktivt är likartad oavsett profilområde, där relationer och ledarskap är viktigast.Nuvarande arbete anses som attraktivast av anställda inom Turism/Besöksnäring, därefter kommer Energi & Miljö följt av IT & Media och Material.Erfarenhet och kompetens gör arbetskraften attraktiv enligt arbetsgivarrepresentanter, även personliga egenskaper är av betydelse.Studenter ser arbete som viktigare än vad anställda gör.För samtliga profilområden finns skillnader mellan vad studenter förväntar sig att arbetet innehåller och vad anställda upplever att arbetet innebär.Sammantaget tycker studenter att arbete inom respektive utbildningsområde är attraktivare än vad anställda tycker om nuvarande arbete.Baserat på erfarenheter från denna pilotstudie ges följande förslag på idéer till fortsatt forskning och samverkan. En studie som i sin omfattning är representativ för de olika profilområdena för att stärka pilotstudiens resultat och indikationer. Utifrån behov göra olika analyser på den empiri som är tillgänglig från denna studie. Ett projekt som följer studenter ut i arbetslivet. Samarbetsprojekt mellan forskare, lärare och företag i syfte att förbättra förutsättningarna för ökad samstämmighet mellan utbildning och arbete. Skapa utbildningstillfällen på temana ledarskap och relationer.
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