| 1. |
- Andersson, Lars Gustaf, et al.
(författare)
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Perspektiv på mediepedagogik i skoldebatten
- 2002
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Ingår i: Pyttesmå förändringar - radikala scenbyten. - 1101-7643.
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Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
- Survey over media pedagogy within Swedish education
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| 2. |
- Gunningberg, Lena, et al.
(författare)
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Effect of visco-elastic foam mattresses on the development of pressure ulcers in patients with hip fractures
- 2000
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Ingår i: Journal of Wound Care. - 0969-0700 .- 2052-2916. ; 9:10, s. 455-460
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Tidskriftsartikel (refereegranskat)abstract
- This study had three aims: to investigate if visco-elastic foam mattresses are more effective than standard hospital mattresses in reducing the incidence of pressure ulcers in patients with hip fractures; to compare pressure ulcer grade and location and documented nursing prevention and treatment interventions in patients using the two types of mattresses; and to identify possible predictors of pressure ulcer development. Using a prospective randomised controlled trial design 101 patients (mean age: 84 years) were randomly allocated either a visco-elastic foam mattress or a standard mattress. There was no significant difference in the incidence of pressure ulcers between the two groups, but patients on standard mattresses tended to develop more severe pressure ulcers. Furthermore, according to the documentation, patients with grade I pressure ulcers who were allocated a standard mattress received more preventive interventions, which may have reduced the differences in outcomes between the two groups. The researchers conclude that the results support the use of the test mattress. Significant predictors of pressure ulcer development were long waiting times for surgery and low haemoglobin levels at hospital admission.
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| 3. |
- Gunningberg, Lena, 1954-, et al.
(författare)
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Reduced incidence of pressure ulcers in patients with hip fractures : a 2-year follow-up of quality indicators
- 2001
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Ingår i: International Journal for Quality in Health Care. - : Oxford University Press (OUP). - 1353-4505 .- 1464-3677. ; 13:5, s. 399-407
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Tidskriftsartikel (refereegranskat)abstract
- In the framework of a quality improvement project, where research activities were integrated with practice-based developmental work, the incidence of pressure ulcers was reduced significantly in patients with hip fractures. The best predictor of pressure ulcer development was increased age.
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| 4. |
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| 5. |
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| 6. |
- Jensen, Eva, et al.
(författare)
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Influence of two different perfusion systems on inflammatory response in pediatric heart surgery.
- 2003
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Ingår i: The Annals of thoracic surgery. - 0003-4975. ; 75:3, s. 919-25
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: This study tests the hypothesis that a cardiopulmonary bypass system that combines complete heparin-coating, a centrifugal pump, and a closed circuit in comparison with a conventional system (uncoated system, roller pump, and hard shell venous reservoir) attenuates the inflammatory response in pediatric heart surgery. METHODS: In a prospective randomized controlled clinical study 40 consecutive children weighing 10 kg or less were included and divided into two groups. Concentrations of complement proteins (C3a, sC5b-9, C4d, and Bb), granulocyte degranulation products (polymorphonuclear [PMN] elastase), and proinflammatory cytokines (tumor necrosis factor [TNF]-alpha, interleukin [IL]-6, and IL-8) were measured. RESULTS: C3a and sC5b-9 concentrations were lower (C3a, p < 0.001; sC5b-9, p = 0.01) in the combined (heparin-coated/centrifugal pump/closed reservoir) group, the peak values being 58% and 37% of conventional group values. The Bb- and C4d-fragment values indicated activation of the complement system through the alternative pathway in both groups. PMN elastase concentrations were lower (p = 0.02) in the combined group, the peak values being 43% of conventional group values. There were no significant intergroup differences regarding TNF-alpha, IL-6, or IL-8 concentrations. CONCLUSIONS: The use of a fully heparin-coated system, a centrifugal pump, and a closed circuit during CPB in children (10 kg or less) leads to a lower degree of complement activation and PMN elastase release compared with a conventional system.
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| 7. |
- Lindholm, Lena, et al.
(författare)
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A closed perfusion system with heparin coating and centrifugal pump improves cardiopulmonary bypass biocompatibility in elderly patients.
- 2004
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Ingår i: The Annals of thoracic surgery. - : Elsevier BV. - 1552-6259 .- 0003-4975. ; 78:6
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Cardiopulmonary bypass induces a systemic inflammatory and hemostatic activation, which may contribute to postoperative complications. Our aim was to compare the inflammatory response, coagulation, and fibrinolytic activation between two different perfusion systems: one theoretically more biocompatible with a closed-circuit, complete heparin coating, and a centrifugal pump, and one conventional system with uncoated circuit, roller pump, and a hard-shell venous reservoir. METHODS: Forty-one elderly patients (mean age, 73 +/- 1 years, 66% men) undergoing coronary artery bypass grafting or aortic valve replacement were included in a prospective, randomized study. Plasma concentrations of complement factors (C3a, C4d, Bb, and sC5b-9), proinflammatory cytokines (tumor necrosis factor-alpha, interleukin-6, and interleukin-8), granulocyte degradation products (polymorphonuclear elastase), and markers of coagulation (thrombin-antithrombin) and fibrinolysis (D-dimer, tissue plasminogen activator antigen and tissue plasminogen activator-plasminogen activator inhibitor-1 complex) were measured preoperatively, at bypass during rewarming (35 degrees C), 60 minutes after bypass, and on day 1 after surgery. RESULTS: The mean concentrations of C3a (-39%; p = 0.008), Bb (-38%; p < 0.001), sC5b-9 (-70%; p < 0.001), interleukin-8 (-60%; p = 0.009), polymorphonuclear-elastase (-55%; p < 0.003), and tissue plasminogen activator antigen (-51%; p = 0.012) were all significantly lower in the biocompatible group during rewarming. Sixty minutes after bypass, the mean concentrations of sC5b-9 (-39%; p = 0.006) and polymorphonuclear-elastase (-55%; p < 0.001) were lower in the biocompatible group. CONCLUSIONS: The results suggest that a closed perfusion system with a heparin-coated circuit and a centrifugal pump may improve cardiopulmonary bypass biocompatibility in elderly cardiac surgery patients in comparison with a conventional system.
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| 8. |
- Lindholm, Lena, et al.
(författare)
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Regional oxygenation and systemic inflammatory response during cardiopulmonary bypass: influence of temperature and blood flow variations.
- 2003
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Ingår i: Journal of cardiothoracic and vascular anesthesia. - : Elsevier BV. - 1053-0770. ; 17:2, s. 182-7
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To evaluate the role of target temperature (28 degrees or 34 degrees C) in cardiac surgery on regional oxygenation during hypothermia and rewarming and systemic inflammatory response. DESIGN: Prospective, controlled, and randomized clinical study. SETTING: University hospital. PARTICIPANTS: Elderly patients (mean age 70 +/- 2 years) with acquired heart disease with an anticipated bypass time exceeding 120 minutes (n = 30). INTERVENTIONS: The patients were cooled to either 28 degrees C (n = 15) or 34 degrees C (n = 15). At hypothermia, bypass blood flow was reduced twice from full flow (2.4 L/min/m(2) body surface area [BSA]) to 2.0 L/min/m(2). MEASUREMENTS AND MAIN RESULTS: Hepatic and jugular venous oxygen tension and saturation were higher at 28 degrees C than at 34 degrees C. In comparison with the preoperative values, at 28 degrees C hepatic venous values were higher; whereas at 34 degrees C, they were lower. The reduction of pump blood flow during hypothermia, from 2.4 to 2.0 L/min/m(2)was accompanied by reductions of central, jugular, and hepatic oxygenation at both target temperatures. During rewarming, central and regional venous oxygenation decreased irrespective of the preceding temperature. The decrease was most pronounced in hepatic venous blood, with the lowest individual values <10%. Serum concentrations of C3a and IL-6 increased during hypothermia and increased further during rewarming irrespective of the preceding temperature. CONCLUSION: During cardiopulmonary bypass, hypothermia at 28 degrees C increases regional and central venous oxygenation better than at 34 degrees C. In contrast, venous oxygenation decreases during rewarming irrespective of the preceding temperature. No significant difference in the systemic inflammatory response associated with target temperature was detected.
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| 9. |
- Lindholm, Lena
(författare)
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Regional oxygenation in cardiac surgery. Influence of temperature, pump flow and insulin
- 2002
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Surgical trauma triggers neural, endocrine and inflammatory reactions with subsequent alterations in systemic and regional blood flow, blood pressure and metabolism. These changes are detectable after all major surgical procedures but are often more pronounced after cardiac surgery, probably because of blood exposure to artificial surfaces of the heart lung machine, temperature modulation (e.g. cooling and rewarming) and systemic and/or regional hypoxia. Hypoperfusion may lead to dysfunction in vital organs after cardiac surgery. Regional venous oxygenation reflects oxygen supply/demand balance and marked regional deoxygenation occurs during cardiopulmonary bypass. This thesis addresses two important perspectives of cardiopulmonary bypass (CPB): 1. Central and regional oxygenation, and 2. The systemic inflammatory response.Ninety-three patients, undergoing elective cardiac surgery were included in four prospective, randomized and controlled studies. Three studies were performed during CPB (I-III) and one study (IV) was performed in the early postoperative phase. The relationship between central mixed and regional venous oxygenation was evaluated in Paper I. In Paper II it was investigated if a reduction in CPB flow, within the recommended range, affects central and regional oxygenation and if the degree of hypothermia affects central and regional venous oxygenation and inflammatory activation. In Paper III it was investigated if high dose insulin affects central mixed and hepatic venous oxygenation and inflammatory response and in Paper IV if skeletal muscle luxury perfusion is the sole effect of high dose insulin in cardiac surgery.Regional deoxygenation occurred during cardiopulmonary bypass, despite normal central mixed venous oxygenation. Reduction in pump flow, within the recommended range, reduced oxygenation in both central and regional venous blood. More pronounced hypothermia during CPB resulted in an improved oxygenation, but did not affect the inflammatory response. Insulin infusion improved oxygenation in both central mixed and hepatic venous blood, but did not affect the inflammatory response. The insulin-induced increase in cardiac output in the early phase after cardiac surgery could not be explained solely by a reduction of skeletal muscle vascular resistance.
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| 10. |
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Pyttesmå ändringar - radikala scenbyten
- 2002
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Samlingsverk (redaktörskap) (övrigt vetenskapligt/konstnärligt)abstract
- Baksidestext: Vad gör skolan och lärarutbildningen för att främja verksamhet med film och andra medier i undervisningen? Hur kan lärare, lärarstuderande och lärarutbildare stödja elevers arbete med rörliga bilder? Hur kan ett samverkansprojekt se ut där skola och lärarutbildning tar hjälp av lokala och regionala aktörer som arbetar för att utveckla arbetet med medier i skolan?
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| 11. |
- Wiklund, Lena, et al.
(författare)
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Hermeneutics and narration : a way to deal with qualitative data
- 2002
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Ingår i: Nursing Inquiry. - : Wiley. - 1320-7881 .- 1440-1800. ; 9:2, s. 114-125
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Tidskriftsartikel (refereegranskat)abstract
- This article focuses a hermeneutic approach to the interpretation of narratives. It is based on the French philosopher Paul Ricoeur’s theory of interpretation but modified and used within a caring science paradigm. The article begins with a presentation of the theoretical underpinnings of hermeneutic philosophy and narration, as well as Ricoeur’s theory of interpretation, before going on to describe the interpretationprocess as modified by the authors. The interpretationprocess which consists of several stages is exemplified and discussed using a single case from a larger study on suffering. The results of that study indicate that the struggle of suffering is perceived as a struggle formed between shame and dignity, and that nurses must engage in the process of preserving and restoring the dignity of their suffering patients. The authors suggest that Ricoeur’s theory of interpretation is useful when trying to understand narrative data if the researcher realises that the process of distanciation, although central in Ricoeur’s thinking, is not the goal of the process but rather it is a means to deal with the researcher’s pre-understandings. According to Ricoeur, distanciation is accomplished by putting the context aside and dealing with the text “as text” and thereby explaining its meaning. Explanation thus becomes the dialectic counterpart to understanding in the interpretationprocess. The researchers further argue that distanciation must be followed by reflection where the interpretations are linked back to the empirical context.
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| 12. |
- Zaina, Silvio, et al.
(författare)
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Insulin-like growth factor II plays a central role in atherosclerosis in a mouse model.
- 2002
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Ingår i: Journal of Biological Chemistry. - 1083-351X .- 0021-9258. ; 277:6, s. 4505-4511
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Tidskriftsartikel (refereegranskat)abstract
- Insulin-like growth factor II is a fetal promoter of cell proliferation that is involved in some forms of cancer and overgrowth syndromes in humans. Here, we provide two sources of genetic evidence for a novel, pivotal role of locally produced insulin-like growth factor II in the development of atherosclerosis. First, we show that homozygosity for a disrupted insulin-like growth factor II allele in mice lacking apolipoprotein E, a widely used animal model of atherosclerosis, results in aortic lesions that are approximately 80% smaller and contain approximately 50% less proliferating cells compared with mice lacking only apolipoprotein E. Second, targeted expression of an insulin-like growth factor II transgene in smooth muscle cells, but not the mere elevation of circulating levels of the peptide, causes per se aortic focal intimal thickenings. The insulin-like growth factor II transgenics presented here are the first viable mutant mice spontaneously developing intimal masses. These observations provide the first direct evidence for an atherogenic activity of insulin-like growth factor II in vivo.
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