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Sökning: WFRF:(Lindholm Lena)

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2.
  • Suleman Khan, Muhammad, et al. (författare)
  • Pharmacogenetics, Plasma Concentrations, Clinical Signs and EEG During Propofol Treatment
  • 2014
  • Ingår i: Basic & Clinical Pharmacology & Toxicology. - : Wiley. - 1742-7835 .- 1742-7843. ; 115:6, s. 565-570
  • Tidskriftsartikel (refereegranskat)abstract
    • A variety of techniques have been developed to monitor the depth of anaesthesia. Propofols pharmacokinetics and response vary greatly, which might be explained by genetic polymorphisms. We investigated the impact of genetic variations on dosage, anaesthetic depth and recovery after total intravenous anaesthesia with propofol. A total of 101 patients were enrolled in the study. The plasma concentration of propofol during anaesthesia was measured using high-performance liquid chromatography. EEG was monitored during the surgical procedure as a measure of anaesthetic depth. Pyrosequencing was used to determine genetic polymorphisms in CYP2B6, CYP2C9, the UGTIA9-promotor and the GABRE gene. The correlation between genotype and to plasma concentration at the time of loss of consciousness (LOC), the total induction dose, the time to anaesthesia, eye opening and clearance were investigated. EEG monitoring showed that the majority of the patients had not reached a sufficient level of anaesthetic depth (subdelta) at the time of loss of consciousness despite a high induction dose of propofol. Patients with UGT1A9-331C/T had a higher propofol clearance than those without (p=0.03) and required a higher induction dose (p=0.03). The patients with UGT1A9-1818T/C required a longer time to LOC (p=0.03). The patients with CYP2C9*2 had a higher concentration of propofol at the time of LOC (p=0.02). The polymorphisms in the metabolizing enzymes and the receptor could not explain the large variation seen in the pharmacokinetics of propofol and the clinical response seen. At LOC, the patients showed a large difference in EEG pattern.
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3.
  • Andersson, Lars Gustaf, et al. (författare)
  • Perspektiv på mediepedagogik i skoldebatten
  • 2002
  • Ingår i: Pyttesmå förändringar - radikala scenbyten. - 1101-7643.
  • Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
    • Survey over media pedagogy within Swedish education
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5.
  • Beeckman, Dimitri, et al. (författare)
  • EPUAP classification system for pressure ulcers : european reliability study
  • 2007
  • Ingår i: Journal of Advanced Nursing. - 0309-2402 .- 1365-2648. - 0309-2402 ; 60:6, s. 682-691
  • Tidskriftsartikel (refereegranskat)abstract
    • Aim. This paper is a report of a study of the inter-observer reliability of the European Pressure Ulcer Advisory Panel pressure ulcer classification system and of the differential diagnosis between moisture lesions and pressure ulcers. Background. Pressure ulcer classification is a valuable tool to provide a common description of ulcer severity for the purposes of clinical practice, audit and research. Despite everyday use of the European Pressure Ulcer Advisory Panel system, its reliability has been evaluated in only a limited number of studies. Methods. A survey was carried out between September 2005 and February 2006 with a convenience sample of 1452 nurses from five European countries. Respondents classified 20 validated photographs as normal skin, blanchable erythema, pressure ulcers (four grades), moisture lesion or combined lesion. The nurses were familiar with the use of the European Pressure Ulcer Advisory Panel classification scale. Results. Pressure ulcers were often classified erroneously (kappa = 0.33) and only a minority of nurses reached a substantial level of agreement. Grade 3 lesions were regularly classified as grade 2. Non-blanchable erythema was frequently assessed incorrectly as blanchable erythema. Furthermore, the differential diagnosis between moisture lesions and pressure ulcers appeared to be complicated. Conclusion. Inter-observer reliability of the European Pressure Ulcer Advisory Panel classification system was low. Evaluation thus needs to focus on both the clarity and complexity of the system. Definitions and unambiguous descriptions of pressure ulcer grades and the distinction between moisture lesions will probably enhance clarity. To simplify the current classification system, a reduction in the number of grades is suggested.
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6.
  • Beeckman, D., et al. (författare)
  • EPUAP classification system for pressure ulcers : European reliability study
  • 2007
  • Ingår i: Journal of Advanced Nursing. - : Wiley. - 0309-2402 .- 1365-2648. ; 60:6, s. 682-691
  • Tidskriftsartikel (refereegranskat)abstract
    • AIM: This paper is a report of a study of the inter-observer reliability of the European Pressure Ulcer Advisory Panel pressure ulcer classification system and of the differential diagnosis between moisture lesions and pressure ulcers. BACKGROUND: Pressure ulcer classification is a valuable tool to provide a common description of ulcer severity for the purposes of clinical practice, audit and research. Despite everyday use of the European Pressure Ulcer Advisory Panel system, its reliability has been evaluated in only a limited number of studies. METHODS: A survey was carried out between September 2005 and February 2006 with a convenience sample of 1452 nurses from five European countries. Respondents classified 20 validated photographs as normal skin, blanchable erythema, pressure ulcers (four grades), moisture lesion or combined lesion. The nurses were familiar with the use of the European Pressure Ulcer Advisory Panel classification scale. RESULTS: Pressure ulcers were often classified erroneously (kappa = 0.33) and only a minority of nurses reached a substantial level of agreement. Grade 3 lesions were regularly classified as grade 2. Non-blanchable erythema was frequently assessed incorrectly as blanchable erythema. Furthermore, the differential diagnosis between moisture lesions and pressure ulcers appeared to be complicated. CONCLUSION: Inter-observer reliability of the European Pressure Ulcer Advisory Panel classification system was low. Evaluation thus needs to focus on both the clarity and complexity of the system. Definitions and unambiguous descriptions of pressure ulcer grades and the distinction between moisture lesions will probably enhance clarity. To simplify the current classification system, a reduction in the number of grades is suggested.
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7.
  • Berghammer, Malin, et al. (författare)
  • The impact of anxiety in relation to COVID-19 on the life-situation of young people in Sweden
  • 2021
  • Ingår i: Quality of Life Research. - : SPRINGER. - 0962-9343 .- 1573-2649. ; 30:SUPPL 1, s. S4-S4
  • Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
    • Aims: In general, COVID-19 symptoms are milder in children than inadults, but the experience of the pandemic could increase anxiety andsignificantly affect the life situation of children and adolescents. Itcould also lead to a long-term negative effect on their health. To studyhow the corona pandemic affected the life situation of children andadolescents in Sweden. Methods: A self-reported online survey wasperformed July–November 2020. Cross-sectional data were collectedusing non-probability and convenience sampling methods. The sample consisted of children 6–14 years and their guardians, and adolescents 15–19 years. The questionnaire covered items regarding the life situation including demographics, school situation, social isolation, and an open-ended question to provide a subjective expression of the living situation. A standardized measurement of anxiety was collected using the Children’s Anxiety Questionnaire (CAQ) (scores range 4–12) and the Numeric Rating Scale (NRS)(scores range 0–10). Data were analyzed by descriptive statistics andwith qualitative manifest content analysis. Results: In total, 1487 participants, 768 children with guardians and 719 adolescents participated. Most of the participants, 754 children (97.2%) and 634 adolescents (89.2%) attended school where a mixture of physical attendance and distance learning was reported by 79 children (10.2%)and 261 adolescents (36.7%). Two children (0.3%) and 298 adolescents (41.9%) reported only having distance learning. A larger proportion of children (n = 339, 43.9%) and adolescents (n = 420,59.2%) reported abstaining from leisure activities, while a minority ofchildren (n = 103, 13%) and adolescent (n = 135, 19%) reportedexperiencing a feeling of ‘social isolation’. These experiences ofchanges in daily routine were prominent in the qualitative result. Social restrictions and loss of contact with older relatives led to fear and anxiety. However, for young children, their lives continued torevolve around the everyday things in life rather than the coronapandemic, for the adolescents; however, their life situation was negatively affected by isolation from peer groups and the loss ofschool routine. Conclusion: The experiences by children due toCOVID-19 in Sweden highlight the importance that children continue living their lives as unchanged as possible and that particularly adolescents need receiving greater support with the maintenance of an educational routine.
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8.
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9.
  • Brorsson, Anna Lena, 1964-, et al. (författare)
  • A multicentre randomized controlled trial of an empowerment-inspired intervention for adolescents starting continuous subcutaneous insulin infusion : a study protocol
  • 2013
  • Ingår i: BMC Pediatrics. - : BioMed Central. - 1471-2431. ; 13
  • Tidskriftsartikel (refereegranskat)abstract
    • Background. Continuous subcutaneous insulin infusion (CSII) treatment among children with type 1 diabetes is increasing in Sweden. However, studies evaluating glycaemic control in children using CSII show inconsistent results. Omitting bolus insulin doses using CSII may cause reduced glycaemic control among adolescents. The distribution of responsibility for diabetes self-management between children and parents is often unclear and needs clarification. There is much published support for continued parental involvement and shared diabetes management during adolescence. Guided Self-Determination (GSD) is an empowerment-based, person-centred, reflection and problem solving method intended to guide the patient to become self-sufficient and develop life skills for managing difficulties in diabetes self-management. This method has been adapted for adolescents and parents as Guided Self-Determination-Young (GSD-Y). This study aims to evaluate the effect of an intervention with GSD-Y in groups of adolescents starting on insulin pumps and their parents on diabetes-related family conflicts, perceived health and quality of life (QoL), and metabolic control. Here, we describe the protocol and plans for study enrolment.Methods. This study is designed as a randomized, controlled, prospective, multicentre study. Eighty patients between 12-18 years of age who are planning to start CSII will be included. All adolescents and their parents will receive standard insulin pump training. The education intervention will be conducted when CSII is to be started and at four appointments in the first 4 months after starting CSII. The primary outcome is haemoglobin A1c levels. Secondary outcomes are perceived health and QoL, frequency of blood glucose self-monitoring and bolus doses, and usage of carbohydrate counting. The following instruments will be used to evaluate perceived health and QoL: Disabkids, 'Check your health', the Diabetes Family Conflict Scale and the Swedish Diabetes Empowerment Scale. Outcomes will be evaluated within and between groups by comparing data at baseline, and at 6 and 12 months after starting treatment.Results and discussion. In this study, we will assess the effect of starting an insulin pump together with the model of Guided Self-Determination to determine whether this approach leads to retention of improved glycaemic control, QoL, responsibility distribution and reduced diabetes-related conflicts in the family.Trial registration: Current controlled trials: ISRCTN22444034
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10.
  • Brorsson, Anna Lena, 1964-, et al. (författare)
  • A person-centered education for adolescents with type 1 diabetes - a randomized controlled trial
  • 2019
  • Ingår i: Pediatric Diabetes. - : Hindawi Limited. - 1399-543X .- 1399-5448. ; 20:7, s. 986-996
  • Tidskriftsartikel (refereegranskat)abstract
    • INTRODUCTION: Young people with type 1 diabetes and their parents need to receive person-centred education to be able to manage their diabetes. Guided Self-Determination-Young (GSD-Y) is a person-centred communication and reflection education model that can be used in educational programmes for young people with type 1 diabetes.OBJECTIVE: To evaluate whether GSD-Y leads to improved glycaemic control, increased self-perceived health and health-related quality of life, fewer diabetes-related family conflicts, and improved self-efficacy in a group-based intervention for adolescents starting continuous subcutaneous insulin infusion (CSII) and their parents.METHODS: This randomized controlled trial included 71 adolescents starting CSII. Participants were followed for twelve months. The intervention group (n=37) attended seven group training sessions over a period of five months, using the GSD-Y model, the control group received standard care. Variables evaluated were HbA1c, self-perceived health, health-related quality of life, family conflicts, self-efficacy, and usage of continuous glucose monitoring.RESULTS: When adjusted for sex and family conflicts, there was a difference in glycaemic control between the groups at twelve months, favouring the intervention group (62 vs. 70 mmol/mol, p=0.009). When analyses were performed on boys and girls separately and adjusted for family conflicts, the only difference detected was for boys after twelve months (p=0.019). The intervention showed no effect on self-perceived health, health-related related quality of life, family conflicts, or self-efficacy.CONCLUSIONS: An intervention with GSD-Y may have an effect on glycaemic control. The content of the GSD-Y groups may serve as a model for person-centred care in adolescents with type 1 diabetes. This article is protected by copyright. All rights reserved.
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11.
  • Brorsson, Anna Lena, 1964-, et al. (författare)
  • Adolescents’ perceptions of participation in group education using the Guided Self-Determination-Young method : a qualitative study
  • 2017
  • Ingår i: BMJ Open Diabetes Research & Care. - : BMJ. - 2052-4897. ; 5:1
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective Guided Self-Determination (GSD) is a person-centered communication and reflection method. Education in groups may have a greater impact than the content of the education, and constructive communication between parents and adolescents has been shown to be of importance. The purpose of this study was to describe adolescents’ perceptions of participation in group education with the Guided Self-Determination-Young (GSD-Y) method, together with parents, in connection with the introduction of continuous subcutaneous insulin infusion.Research design and methods In the present qualitative interview study, 13 adolescents with type 1 diabetes were included after completing a GSD-Y group education program in connection with the introduction of continuous subcutaneous insulin infusion at three hospitals located in central Sweden. The adolescents were interviewed individually, and qualitative content analysis was applied to the interview transcripts.Results Two categories that emerged from the analysis were the importance of context and growing in power through the group process. An overarching theme that emerged from the interviews was the importance of expert and referent power in growing awareness of the importance of self-management as well as mitigating the loneliness of diabetes.Conclusions GSD-Y has, in various ways, mitigated experiences of loneliness and contributed to conscious reflection about self-management in the group (referent power) together with the group leader (expert power). Overall, this highlights the benefits of group education, and the GSD method emphasizes the person-centered approach.
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12.
  • Brorsson, Anna Lena, 1964-, et al. (författare)
  • Does treatment with an insulin pump improve glycaemic control in children and adolescents with type 1 diabetes? : A retrospective case-control study
  • 2015
  • Ingår i: Pediatric Diabetes. - : Hindawi Limited. - 1399-543X .- 1399-5448. ; 16:7, s. 546-553
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVE: To investigate long-term effects on glycaemic control, ketoacidosis, serious hypoglycaemic events, insulin requirements, and body mass index standard deviation scores (BMI-SDS) in children and adolescents with type 1 diabetes starting on continuous subcutaneous insulin infusion (CSII) compared with children and adolescents treated with multiple daily injections (MDI).METHODS: This retrospective case-control study compares 216 patients starting CSII with a control group on MDI (n = 215), matched for glycated hemoglobin (HbA1c), sex, and age during a 2-yr period. Variables collected were gender, age, HbA1c, insulin requirement, BMI, BMI-SDS, ketoacidosis, and serious hypoglycaemic events.RESULTS: In the CSII group there was an improvement in HbA1c after 6 and 12 months compared with the MDI group. For boys and girls separately the same effect was detected after 6 months, but only for boys after 12 months. The incidence of ketoacidosis was higher in the CSII group compared with the MDI group (2.8 vs. 0.5/100 person-yr). The incidences of severe hypoglycaemic episodes per 100 person-yr were three in the CSII group and six in the MDI group (p < 0.05). After 6, 12, and 24 months, the insulin requirement was higher in the MDI group.CONCLUSIONS: This study shows that treatment with CSII resulted in an improvement in HbA1c levels up to 1 yr and decreased the number of severe hypoglycaemic events, but the frequency of ketoacidosis increased. The major challenge is to identify methods to maintain the HbA1c improvement, especially among older children and teenagers, and reduce the frequency of ketoacidosis.
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13.
  • Brorsson, Anna Lena, 1964-, et al. (författare)
  • Parent's perception of their children's health, quality of life and burden of diabetes : testing reliability and validity of 'Check your Health' by proxy.
  • 2017
  • Ingår i: Scandinavian Journal of Caring Sciences. - : Wiley. - 0283-9318 .- 1471-6712. ; 31:3, s. 497-504
  • Tidskriftsartikel (refereegranskat)abstract
    • AIM: To test the validity and reliability of the 'Check your Health by proxy' instrument in parents to children with diabetes aged 8-17 years.METHODS: One hundred and ninety-one caregivers and their children, aged 8-17 years, were included. All completed the 'Check your Health' questionnaire measuring quality of life and burden of diabetes, DISABKIDS self- or proxy version, and 45 completed the same questionnaires 2 weeks later.RESULTS: Test-retest reliability on the 'Check your Health' questionnaire by proxy was moderate to strong (r = 0.48-0.74), p < 0.002). Convergent validity was weak to moderate (r = 0.15-0.49, p < 0.05). The instrument showed acceptable discriminant validity. Parents reported lower scores than the children on emotional health and social relations and higher scores on physical and emotional burden and higher burden on quality of life. Poorer social relationships and quality of life were associated with higher reported disease severity. The diabetes burden domain of the questionnaire correlated to perceived severity of diabetes and to perceived health. Discriminant validity showed that poorer social relationships and quality of life were associated with higher severity of the disease. The diabetes burden domain of 'Check your Health' by proxy showed discriminant validity on perceived severity of diabetes.CONCLUSIONS: The instrument 'Check your Health' by proxy showed acceptable psychometric characteristics in parents to young people (8-17 years of age) with diabetes. We also concluded that parents reported that their children had lower health and higher burden of diabetes than the children did, and it correlated to reported disease severity.
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14.
  • Eriksson, Johan, et al. (författare)
  • Productivity in relation to organization of a surgical department : a retrospective observational study
  • 2022
  • Ingår i: BMC Surgery. - : BioMed Central (BMC). - 1471-2482. ; 22:1
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Responsible and efficient resource utilization are important factors in healthcare. The aim of this study was to investigate how total case time differs between two differently organized surgical departments. Methods: This is a retrospective observational study of a cohort of patients undergoing elective surgery for breast cancer or malignant melanoma in a university hospital setting in Sweden. All patients were operated on by the same set of surgeons but in two different surgical departments: a general surgery (GS) and a cardiothoracic (CT) surgery department. Patients were selected to the two departments from a waiting list in the order of referral for surgery. The effect of being operated on at the CT department compared to the GS department was estimated by linear regression. Results: The final study cohort comprised 349 patients in the GS department and 177 patients in the CT department. Both groups were similar regarding surgical procedures, American Society of Anesthesiologists' score, body mass index, age, sex, and the skill level of the operating surgeon. These covariates were included in the linear regression model. The total case time, defined by the Procedural Time Glossary as room set-up start to room clean-up finish, was significantly shorter for the patients who underwent a surgical procedure at the CT department compared to the GS department, even after adjusting for the background characteristics of the patients and surgeon. After adjusting for the selected covariates, the average difference in total case time between the two departments was − 30.67 min (p = 0.001). Conclusions: A significantly shorter total case time was measured for operations in the CT department. Plausible explanations may be more beneficial organizational factors, such as staffing ratio, skill mix in the operating room team, and working behavioral aspects regarding resource utilization.
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15.
  • Eriksson, Siw, et al. (författare)
  • Three-dimensional multilayer fabric structures for interactive textiles
  • 2011
  • Ingår i: 3rd World Conference on 3D Fabrics and Their Applications; Wuhan; China; 20 April 2011 through 21 April 2011. - 9781846260490 ; , s. 63-67
  • Konferensbidrag (refereegranskat)abstract
    • Abstract. The integration of performances in interactive textile fabric system has so far been rather complicated since they are based on multilayer or three-dimensional principles. These structures are today mainly put together by means of several processes, which is laborious and time consuming. In this interdisciplinary study we have combined the principle of a three-dimensional multilayer weaving process and interactive textiles structures in order to enable the manufacturing of interactive textile structure in one process. The process is investigated using a manual reconstructed loom and the approach has been to use the 3D structures in order to integrate and organize conductive and compressive spacer layers as a textile capacitive structure. Measurements on such a structure was done by construction a first order passive high pass filter and using the fabric sample as the capacitor and a 1MΩ resistor. The behavior of the measurement of the capacitive sensor is quite close to the theoretical calculation and already at this stage the structure might be used to indicate the presence of a pressure. In this project we have shown that a three-dimensional structure enables the development of interactive textiles in one process. Further the concept of using a rebuilt manual loom has shown great potential in early research stages. It is considerable saving time and resources since, in this case, it is easy to reconstruct the loom design compared to performing similar reconstruction on a machine. Future research will focus on developing other types of interactive structures. Another issue will be to scale down the size of the structures in order to get thinner and more flexible qualities.
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16.
  • Eriksson, Siw, et al. (författare)
  • Tredimensionell vävteknik med möjliga tillämpningar inom medicinsk teknik
  • 2011
  • Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
    • Integreringen av interaktiva egenskaper i teknisk textil har rönt stort intresse inom textil-forskningen de senaste åren. Med interaktiva textila strukturer avses textila system som interagerar med sin omgivning i någon mening. Ett sätt att åtadkomma dessa interaktiva strukturer är att foga samman lager av olika struktur eller material där varje lager tillför textilen/det textila systemet olika egenskaper. Det typiska tillvägagångssättet för att sammanfoga olika lager av textila material är att använda någon form av lamineringsteknik. Föreliggande projekt rör en ny vävteknik som möjliggör att flera textila lager med olika egenskaper vävs samman i en och samma process utan de tillsatser eller extra hantering som krävs vid laminering. Utöver de uppenbara produktionstekniska fördelarna möjliggör kombinationen av olika egenskaper i en lagerstruktur också att speciella krav på slutprodukten lättare kan tillgodoses. Det medicintekniska området förväntas ha stor nytta av textila strukturer som kan utformas i tre dimensioner eller kombinera olika egenskaper i en och samma struktur. Syftet är att demonstrera hur en nyutvecklad vävteknik för tredimensionella strukturer kan tillämpas för att tillverka interaktiva textila strukturer i en och samma tillverkningsprocess. I detta delprojekt har den tredimensionella tekniken använts för att utveckla en kapacitiv struktur utformad helt i textil. Genom mindre modifieringar av och tillägg till en 16-skaftad datorstyrd manuell prototypvävstol har två ledande och ett isolerande skikt kombinerats för att realisera en textilbaserad kondensator. I ett första test realiserades ett enkelt högpassfilter med den kapacitiva textila strukturen som kondensator. Filtrets egenskaper visade sig väl följa den förväntade filterkarakteristiken. Den nyutvecklade tredimensionella vävtekniken förväntas ha stora tillämpningsmöjligheter inom det medicintekniska området.
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17.
  • Gunningberg, Lena, et al. (författare)
  • Effect of visco-elastic foam mattresses on the development of pressure ulcers in patients with hip fractures
  • 2000
  • Ingår i: Journal of Wound Care. - 0969-0700 .- 2052-2916. ; 9:10, s. 455-460
  • 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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18.
  • Gunningberg, Lena, 1954-, et al. (författare)
  • Implementation of risk assessment and classification of pressure ulcers as quality indicators for patients with hip fractures
  • 1999
  • Ingår i: Journal of Clinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 8:4, s. 396-406
  • Tidskriftsartikel (refereegranskat)abstract
    • The aims of the study were (i) to investigate the prevalence of pressure ulcers in patients with hip fracture, on arrival at a Swedish hospital, at discharge, and two weeks post-surgery; (ii) to test whether clinical use of the Modified Norton Scale (MNS) could identify patients at risk for development of pressure ulcers; and (iii) to compare the reported prevalence of pressure ulcer in the experimental group, where risk assessment and classification of pressure ulcers was performed on a daily basis, with that of the control group, where it was not. The study design was prospective, with an experimental and a control group. The intervention in the experimental group consisted of risk assessment, risk alarm and skin observation performed by the nurse on duty, in the A & E Department, and daily throughout the hospital stay. To facilitate the nurse's assessment, a 'Pressure Ulcer Card' was developed, consisting of the MNS and descriptions of the four stages of pressure ulcers. On arrival at the hospital, approximately 20% of patients in both groups had pressure ulcers. At discharge, the rate had increased to 40% (experimental) and 36% (control). Clinical use of the MNS made it possible to identify the majority of patients at risk for development of pressure ulcers. Patients who were confused on arrival developed significantly more pressure ulcers than patients who were orientated to time and place. No significant difference was found in the reported prevalence of pressure ulcers between the experimental and control groups.
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19.
  • Gunningberg, Lena, 1954-, et al. (författare)
  • Reduced incidence of pressure ulcers in patients with hip fractures : a 2-year follow-up of quality indicators
  • 2001
  • Ingår i: International Journal for Quality in Health Care. - : Oxford University Press (OUP). - 1353-4505 .- 1464-3677. ; 13:5, s. 399-407
  • 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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22.
  • Göthesson, Johanna, et al. (författare)
  • Children's and adolescent's narratives about pain and negative experiences in diabetes treatment
  • 2023
  • Ingår i: Journal for Specialists in Pediatric Nursing. - : John Wiley & Sons. - 1539-0136 .- 1744-6155. ; 28:1
  • Tidskriftsartikel (refereegranskat)abstract
    • Pain and fear associated with needle procedures have been found to be more common among children and adolescents treated for type 1 diabetes (T1D) than among others in their age group. Furthermore, high glycated haemoglobin (HbA1c) values are associated with needle-related fear.Aim: To describe negative experiences of needle procedures in childhood diabetes treatment from children's and adolescents' own perspectives. Methods: Short written narratives (n = 83) and drawings (n = 2) from children and adolescents treated for T1D, aged 7–18 years, were subjected to inductive qualitative content analysis.Results: Negative experiences with needle procedures had many facets, such as pain and fear, changing over time and affecting everyday life. All kinds of needle procedures caused difficulties, but venipunctures were described as the worst.Conclusion: All needle procedures involved in diabetes treatment are potentially experienced as creating pain and fear, but the negative experiences are multifaceted and vary between individuals. These experiences create suffering for children and adolescents, and influence their daily lives. Besides finding techniques to decrease the number of needle procedures in the treatment, research should focus on implementing methods to decrease pain, fear, and other negative experiences as well as to promote self-coping. This is urgent, since needle-related fear has an impact on glycaemic control and therefore increases the risk of long-term complications. Clinical Implications: When caring for children and adolescents with diabetes, their previous experiences with needle procedures need to be considered.
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23.
  • Haas, Josephine, et al. (författare)
  • Guided self-determination-young versus standard care in the treatment of young females with type 1 diabetes : study protocol for a multicentre randomized controlled trial
  • 2017
  • Ingår i: Trials. - : Springer Science and Business Media LLC. - 1745-6215. ; 18:1
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Female adolescents with type 1 diabetes mellitus (T1DM) have the most unsatisfactory glycaemic control of all age groups and report higher disease burden, poorer perceived health, and lower quality of life than their male counterparts. Females with T1DM face an excess risk of all-cause mortality compared with men with T1DM. New methods are needed to help and support young females with T1DM to manage their disease. A prerequisite for successful diabetes management is to offer individualized, person-centred care and support the patient's own motivation. Guided self-determination (GSD) is a person-centred reflection and problem-solving method intended to support the patient's own motivation in the daily care of her diabetes and help develop skills to manage difficulties in diabetes self-management. GSD has been shown to improve glycaemic control and decrease psychosocial stress in young women with T1DM. The method has been adapted for adolescents and their parents, termed GSD-young (GSD-Y). The aim of this study was to evaluate whether an intervention with GSD-Y in female adolescents with T1DM leads to improved glycaemic control, self-management, treatment satisfaction, perceived health and quality of life, fewer diabetes-related family conflicts, and improved psychosocial self-efficacy.METHODS/DESIGN: This is a parallel-group randomized controlled superiority trial with an allocation ratio of 1:1. One hundred female adolescents with T1DM, 15-20 years of age, and their parents (if < 18 years of age), will be included. The intervention group will receive seven individual GSD-Y education visits over 3 to 6 months. The control group will receive standard care including regular visits to the diabetes clinic. The primary outcome is level of glycaemic control, measured as glycosylated haemoglobin (HbA1c). Secondary outcomes include diabetes self-management, treatment satisfaction, perceived health and quality of life, diabetes-related family conflicts, and psychosocial self-efficacy. Data will be collected before randomization and at 6 and 12 months.DISCUSSION: Poor glycaemic control is common in female adolescents and young adults with T1DM. Long-standing hyperglycaemia increases the risks for severe complications and may also have an adverse impact on the outcome of future pregnancies. In this study, we want to evaluate if the GSD-Y method can be a useful tool in the treatment of female adolescents with T1DM.TRIAL REGISTRATION: Current controlled trials, ISRCTN57528404 . Registered on 18 February 2015.
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24.
  • Haas, Josephine, et al. (författare)
  • Treatment satisfaction correlated with glycaemic control and burden of diabetes in Swedish adolescents with type 1 diabetes
  • 2020
  • Ingår i: Acta Paediatrica. - : WILEY. - 0803-5253 .- 1651-2227. ; 109:3, s. 573-580
  • Tidskriftsartikel (refereegranskat)abstract
    • Aim: To assess treatment satisfaction and perceived discomfort or pain from the treatment, and potential associations with glycaemic control, type of treatment, perceived burden of diabetes, sex and age, in adolescents with type 1 diabetes.Methods: A cross-sectional study was performed at one paediatric and at one adult diabetes clinic in Sweden, preceded by a translation of 'Diabetes Treatment Satisfaction Questionnaire (DTSQ) Teen'. Adolescents with type 1 diabetes (15-20 years) participated. The questionnaires 'DTSQ Teen' and 'Check your health' were used. Data on glycosylated haemoglobin (HbA1c), type of treatment, sex and age were collected.Results: One hundred and thirty-eight adolescents (70 females, mean age 17.3, mean HbA1c 64.0 mmol/mol) participated. Treatment satisfaction correlated inversely with HbA1c (r = -.352, P < .001) and with all types of burden of diabetes (r = -.342 to -0.467, P < .001), but did not differ with type of treatment, sex and age. Perceived pain correlated inversely with burden on physical health (r = -.265, P = .002), mental health (r = -.237, P = .006) and quality of life (r = -.246, P = .004) but not with HbA1c, age or burden on social relations. Females perceived more discomfort or pain.Conclusion: In Swedish adolescents with type 1 diabetes, treatment satisfaction correlated with both glycaemic control and perceived burden of diabetes.
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25.
  • Hanberger, Lena, et al. (författare)
  • Needle-Related Pain, Affective Reactions, Fear, and Emotional Coping in Children and Adolescents With Type 1 Diabetes : A Cross-Sectional Study
  • 2021
  • Ingår i: Pain Management Nursing. - : Elsevier. - 1524-9042 .- 1532-8635. ; 22:4, s. 516-521
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: The self-care of type 1 diabetes (T1D) includes undergoing procedures with needles several times daily, which may cause pain and fear.Aims: The aim was to identify the degree of perceived pain, affective reactions, fear, and emotional coping among children and adolescents with T1D.Design: A cross-sectional survey was performed.Methods: Children and adolescents 7-18 years of age (n = 197) and their parents (n = 123) completed the Coloured Analogue Scale (CAS), the Facial Affective Scale (FAS), the Diabetes Fear of Injection Questionnaire (D-FISQ), and the Faces Emotional Coping Scale (FECS) in relation to needle procedures.Results: The higher the values of the CAS, FAS and D-FISQ scores, the lower values for coping were reported by children and adolescents regarding treatment with insulin pen or pump, blood glucose test, and venipuncture (p < .001). Patients reported strong negative affect regarding insulin injections (35%) and blood glucose tests (32%), as well as negative affect (48%, 69%) and substantial pain (27%, 50%) for inserting a pump needle and venipuncture, respectively. Parents reported significantly higher values than children on all scales and procedures except D-FISQ (blood glucose tests) and FECS (venipuncture).Conclusions: Children and adolescents who perceive greater pain during needle-related procedures have poorer coping ability. Pediatric diabetes teams need to identify those in need of extra support to develop pain coping strategies.
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26.
  • Hirvikoski, Tatja, et al. (författare)
  • Deficient cardiovascular stress reactivity predicts poor executive functions in adults with attention-deficit/hyperactivity disorder
  • 2011
  • Ingår i: Journal of Clinical and Experimental Neuropsychology. - : Informa UK Limited. - 1380-3395 .- 1744-411X. ; 33:1, s. 63-73
  • Tidskriftsartikel (refereegranskat)abstract
    • Associations between cardiovascular stress markers, subjective stress reactivity, and executive functions were studied in 60 adults (30 with attention-deficit/hyperactivity disorder, ADHD, and 30 controls) using the Paced Auditory Serial Addition Test (PASAT, a test of executive functions) as a cognitive stressor. Despite higher self-perceived stress, the adults with ADHD showed lower or atypical cardiovascular stress reactivity, which was associated with poorer performance on PASAT. Using cardiovascular stress markers, subjective stress, and results on PASAT as predictors in a logistic regression, 83.3% of the ADHD group and 86.9% of the controls could be classified correctly.
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27.
  • Hirvikoski, Tatja, et al. (författare)
  • High self-perceived stress and many stressors, but normal diurnal cortisol rhythm, in adults with ADHD (attention-deficit/hyperactivity disorder).
  • 2009
  • Ingår i: Hormones and Behavior. - : Elsevier B. V.. - 0018-506X .- 1095-6867. ; 55:3, s. 418-424
  • Tidskriftsartikel (refereegranskat)abstract
    • Attention-deficit/hyperactivity disorder (ADHD) in adults is associated with significant impairment in many life activities and may thus increase the risk of chronic stress in everyday life. We compared adults with a DSM-IV ADHD diagnosis (n=28) with healthy controls (n=28) regarding subjective stress and amounts of stressors in everyday life, diurnal salivary cortisol in the everyday environment and salivary cortisol before and after cognitive stress in a laboratory setting. The association between cortisol concentrations and impulsivity was also investigated. Consistent with assumptions, individuals with ADHD reported significantly more self-perceived stress than controls, and subjective stress correlated with the amount of stressors in everyday life. The two groups were comparable with respect to overall diurnal cortisol levels and rhythm, as well as in pre- and post-stress cortisol concentrations. Post-stress cortisol (but not baseline cortisol) concentration was positively correlated with impulsivity. The group with high post-stress cortisol also reported more symptoms of depression and anxiety, as well as self-perceived stress and stressors in everyday life. The diagnosis of ADHD significantly increased the risk of belonging to the group with high post-stress cortisol levels. The results in this study warrant a focus not only on the primary diagnosis of ADHD, but also calls for a broader assessment of stressors and subjective stress in everyday life, as well as support comprising stress management and coping skills.
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28.
  • Hurtig, Per, et al. (författare)
  • Analys av trafiksäkerhetsutvecklingen 2022 : Målstyrning av trafiksäkerhetsarbetet mot etappmålen 2030
  • 2023
  • Rapport (övrigt vetenskapligt/konstnärligt)abstract
    • Det svenska trafiksäkerhetsarbetet utgår från Nollvisionen och etappmål på vägen dit. Det nuvarande etappmålet för vägtrafiken innebär en halvering av antalet omkomna, från 266 (medelvärde 2017­2019), till max 133 omkomna år 2030. Etappmålet innebär också att antalet allvarligt skadade i vägtrafiken ska reduceras med 25 procent utifrån ett motsvarande utgångsvärde.I denna rapport redovisas och analyseras utvecklingen av säkerheten i vägtrafiken utifrån utpekade indikatorer och antalet omkomna. Antalet allvarligt skadade redovisas inte då en ny metod för bortfallsuppräkning av antalet allvarligt skadade tas fram under 2023. Utöver beslutade nationella etappmål finns även ett etappmål på EU­nivå som innebär en halvering av antalet omkomna till 2030, jämfört med 2019.
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29.
  • Hurtig, Per, et al. (författare)
  • Analysis of road safety trends 2022 : Management by objectives for road safety work towards the 2030 interim targets
  • 2023
  • Rapport (övrigt vetenskapligt/konstnärligt)abstract
    • Swedish road safety work is based on Vision Zero and designated interim targets to track progress towards its achievement. The current interim target for road safety is to halve the number of fatalities from 266 (the average annual number 20172019) to a maximum of 133 fatalities in 2030. The interim target also specifies that the number of seriously injured on the roads is to be reduced by 25 per cent from a corresponding number.This report describes and analyses current road safety trends in terms of road safety performance indicators and the numbers of fatalities. The number of seriously injured is not reported, as a new method for non-response compensation of the number of seriously injured is being developed in 2023. In addition to the adopted national interim targets there is also an interim target at the EU level that specifies a halving, by 2030, of the number of fatalities recorded in 2019. 
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30.
  • Jensen, Eva, et al. (författare)
  • Influence of two different perfusion systems on inflammatory response in pediatric heart surgery.
  • 2003
  • Ingår i: The Annals of thoracic surgery. - 0003-4975. ; 75:3, s. 919-25
  • 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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31.
  • Lexén, Jenny, et al. (författare)
  • Rekommendationer för utsortering av textilier med farliga ämnen ur kretsloppet
  • 2016
  • Rapport (övrigt vetenskapligt/konstnärligt)abstract
    • I textilier som finns på marknaden idag finns en stor mängd kemiska ämnen. För att åstadkomma kretslopp som både är resurseffektiva och så långt som möjligt fria från farliga ämnen behöver risken för att särskilt farliga ämnen och ämnen med andra oönskade egenskaper recirkuleras klargöras.I den här rapporten har en litteratursammanställning gjorts och utifrån den befintliga informationen presenteras olika förslag till rekommendationer/scenarier för utsortering av textilier. Syftet med projektet var att identifiera om det finns specifika produktgrupper inom textil på marknaden som inte bör materialåtervinnas efter att de har samlats in på grund av att de innehåller farliga ämnen. Projektet syftar även till att ta fram förslag till konkreta rekommendationer för hur de identifierade produktgrupperna ska sorteras. Projektet har även haft en referensgrupp med representanter från branschen som bland annat har kommit med kommentarer på de föreslagna scenarierna.Kemikalier i textil kan delas in i grupper beroende på vilken funktion ämnena avser att uppfylla. På grundval av hälso- och miljöfarliga egenskaper och potential att föras vidare vid återvinning av textil har ett antal grupper identifierats som särskilt viktiga att beakta, till exempel färgämnen, antibakteriella ämnen och mjukgörare.I dagsläget finns det inte tillräckligt med information tillgängligt kring innehåll av farliga ämnen i enskilda textilier som når avfallsledet för att det ska gå att göra välgrundade beslut kring vilka textilier som bör sorteras ut på grund av dess innehåll av farliga ämnen. Vissa av ämnena kan också förekomma i ett mycket brett spektra av textilier vilket i princip gör en utsortering omöjlig.Vid fiberåtervinning vill man ha olika typer av fiber separat sorterade, därför är det önskvärt att sortera utefter fibertyp och möjligtvis sedan efter användningsområde (produkttyp) (Norlin, Re:newcell 2015). Det spelar också in vad den återvunna råvaran ska användas till. Olika användning ställer olika krav på innehållet i materialet. En generell svårighet dock är att alla produkter av samma fiber och för samma användningsområde inte behöver innehålla samma kemikalier.I rapporten beskrivs fem olika rekommendationer/scenarier för utsortering av textil baserat på olika stort fokus på giftfrihet respektive resurseffektivitet. Samtliga förslag baseras på att det är produktgrupper som kan antas innehålla farliga ämnen som sorteras ut i olika utsträckning. Stort fokus på giftfrihet innebär utsortering av en stor mängd produktgrupper vilket ger en begränsad mängd textil till återvinning och troligtvis utsortering av sådant som ur andra synpunkter skulle ha kunnat återvinnas. Scenarierna baseras till stor del på utsorteringsbehov vid mekanisk återvinning av textil.
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32.
  • Lindholm, Anna, et al. (författare)
  • Utvärdering av förståelse på skriftlig tentamen
  • 2011
  • Konferensbidrag (refereegranskat)abstract
    • I tidigare studier har det visats att examinationen i hög grad styr hur studenterna kommer att studera under en kurs. Därför är det viktigt att examinationen inte bara testar ytliga kunskaper och beräkningsförmåga, utan även förståelse. I denna artikel diskuteras olika sätt att utvärdera studenternas förståelse genom att analysera resultaten på skriftliga tentamina. En fallstudie på Institutionen för reglerteknik vid Lunds tekniska högskola presenteras och möjliga åtgärder för att öka förståelsen hos studenterna diskuteras.
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33.
  • Lindholm, Christina, 1942-, et al. (författare)
  • Hip fracture and pressure ulcers : the Pan-European Pressure Ulcer Study: intrinsic and extrinsic risk factors
  • 2008
  • Ingår i: International Wound Journal. - 1742-4801 .- 1742-481X. ; 5:2, s. 315-28
  • Tidskriftsartikel (refereegranskat)abstract
    • Pressure ulcers (PU) in patients with hip fracture remain a problem. Incidence of between 8.8% and 55% have been reported. There are few studies focusing on the specific patient-, surgery- and care-related risk indicators in this group. The aims of the study were: - to investigate prevalence and incidence of PU upon arrival and at discharge from hospital and to identify potential intrinsic and extrinsic risk factors for development of PU in patients admitted for hip fracture surgery, - to illuminate potential differences in patient logistics, surgery, PU prevalence and incidence and care between Northern and Southern Europe. Consecutive patients with hip fracture in six countries, Sweden, Finland, UK (North) and Spain, Italy and Portugal (South), were included. The patients were followed from Accident and Emergency Department and until discharge or 7 days. Prevalence, PU at discharge and incidence were investigated, and intrinsic and extrinsic risk indicators, including waiting time for surgery and duration of surgery were recorded. Of the 635 patients, 10% had PU upon arrival and 22% at discharge (26% North and 16% South). The majority of ulcers were grade 1 and none was grade 4. Cervical fractures were more common in the North and trochanteric in the South. Waiting time for surgery and duration of surgery were significantly longer in the South. Traction was more common in the South and perioperative warming in the North. Risk factors of statistical significance correlated to PU at discharge were age >or=71 (P = 0.020), dehydration (P = 0.005), moist skin (P = 0.004) and total Braden score (P = 0.050) as well as subscores for friction (P = 0.020), nutrition (P = 0.020) and sensory perception (P = 0.040). Comorbid conditions of statistical significance for development of PU were diabetes (P = 0.005) and pulmonary disease (P = 0.006). Waiting time for surgery, duration of surgery, warming or non warming perioperatively, type of anaesthesia, traction and type of fracture were not significantly correlated with development of PU.
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34.
  • Lindholm, Christina, et al. (författare)
  • Hip fracture and pressure ulcers - the Pan-European Pressure Ulcer Study : intrinsic and extrinsic risk factors
  • 2008
  • Ingår i: International Wound Journal. - : Wiley-Blackwell Publishing Ltd. - 1742-4801 .- 1742-481X. ; 5:2, s. 315-328
  • Tidskriftsartikel (refereegranskat)abstract
    • Pressure ulcers (PU) in patients with hip fracture remain a problem. Incidence of between 8.8% and 55% have been reported. There are few studies focusing on the specific patient-, surgery- and care-related risk indicators in this group. The aims of the study were: - to investigate prevalence and incidence of PU upon arrival and at discharge from hospital and to identify potential intrinsic and extrinsic risk factors for development of PU in patients admitted for hip fracture surgery, - to illuminate potential differences in patient logistics, surgery, PU prevalence and incidence and care between Northern and Southern Europe. Consecutive patients with hip fracture in six countries, Sweden, Finland, UK (North) and Spain, Italy and Portugal (South), were included. The patients were followed from Accident and Emergency Department and until discharge or 7 days. Prevalence, PU at discharge and incidence were investigated, and intrinsic and extrinsic risk indicators, including waiting time for surgery and duration of surgery were recorded. Of the 635 patients, 10% had PU upon arrival and 22% at discharge (26% North and 16% South). The majority of ulcers were grade 1 and none was grade 4. Cervical fractures were more common in the North and trochanteric in the South. Waiting time for surgery and duration of surgery were significantly longer in the South. Traction was more common in the South and perioperative warming in the North. Risk factors of statistical significance correlated to PU at discharge were age >or=71 (P = 0.020), dehydration (P = 0.005), moist skin (P = 0.004) and total Braden score (P = 0.050) as well as subscores for friction (P = 0.020), nutrition (P = 0.020) and sensory perception (P = 0.040). Comorbid conditions of statistical significance for development of PU were diabetes (P = 0.005) and pulmonary disease (P = 0.006). Waiting time for surgery, duration of surgery, warming or non warming perioperatively, type of anaesthesia, traction and type of fracture were not significantly correlated with development of PU.
  •  
35.
  • Lindholm, Christina, et al. (författare)
  • Hip fracture and pressure ulcers – the Pan-European Pressure Ulcer Study – intrinsic and extrinsic risk factors
  • 2008
  • Ingår i: International Wound Journal. - : John Wiley & Sons. - 1742-4801 .- 1742-481X. ; 5:2, s. 315-328
  • Tidskriftsartikel (refereegranskat)abstract
    • Pressure ulcers (PU) in patients with hip fracture remain a problem. Incidence of between 8·8% and 55% have been reported. There are few studies focusing on the specific patient-, surgery- and care-related risk indicators in this group. The aims of the study wereto investigate prevalence and incidence of PU upon arrival and at discharge from hospital and to identify potential intrinsic and extrinsic risk factors for development of PU in patients admitted for hip fracture surgery.to illuminate potential differences in patient logistics, surgery, PU prevalence and incidence and care between Northern and Southern Europe. Consecutive patients with hip fracture in six countries, Sweden, Finland, UK (North) and Spain, Italy and Portugal (South), were included. The patients were followed from Accident and Emergency Department and until discharge or 7 days. Prevalence, PU at discharge and incidence were investigated, and intrinsic and extrinsic risk indicators, including waiting time for surgery and duration of surgery were recorded. Of the 635 patients, 10% had PU upon arrival and 22% at discharge (26% North and 16% South). The majority of ulcers were grade 1 and none was grade 4. Cervical fractures were more common in the North and trochanteric in the South. Waiting time for surgery and duration of surgery were significantly longer in the South. Traction was more common in the South and perioperative warming in the North. Risk factors of statistical significance correlated to PU at discharge were age ≥71 (P = 0·020), dehydration (P = 0·005), moist skin (P = 0·004) and total Braden score (P = 0·050) as well as subscores for friction (P = 0·020), nutrition (P = 0·020) and sensory perception (P = 0·040). Comorbid conditions of statistical significance for development of PU were diabetes (P = 0·005) and pulmonary disease (P = 0·006). Waiting time for surgery, duration of surgery, warming or non warming perioperatively, type of anaesthesia, traction and type of fracture were not significantly correlated with development of PU.
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36.
  • Lindholm, Jessica, 1971, et al. (författare)
  • Digitala lärresurser i lärosätenas öppna arkiv. Slutrapport från OERIIR-projektet
  • 2009
  • Rapport (övrigt vetenskapligt/konstnärligt)abstract
    • Arbetet i projektet ”OER i öppna digitala arkiv” har utförts i samarbete mellan Göteborgs universitet, Högskolan i Borås, Malmö högskola, Stockholms universitet, Uppsala universitet och Metamatrix AB under perioden mars 2008 - april 2009. Projektet har finansierats av Kungl. Bibliotekets program OpenAccess.se. Vid sidan om denna slutrapport, har vi tidigare publicerat rapporten Kartläggning av produktion och användning av OER vid några svenska lärosäten. De frågeställningar vi har arbetat med är - Hur ser möjligheterna ut att i lärosätenas öppna arkiv för e-publicering av forskning och uppsatser, också rymma de lokalt producerade lärresurserna? - I vilken omfattning använder och producerar lärarna vid lärosätena fritt tillgängliga lärresurser (OER, Open Educational Resources) idag? Vi har velat belysa dessa frågeställningar genom att ta fram unika empirisk data från de deltagande lärosätena.
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37.
  • Lindholm, Jessica, et al. (författare)
  • Digitala lärresurser i lärosätenas öppna arkiv. Slutrapport från OERIIR-projektet
  • 2009
  • Rapport (övrigt vetenskapligt/konstnärligt)abstract
    • Arbetet i projektet "OER i öppna digitala arkiv" har utförts i samarbete mellan Göteborgs universitet, Högskolan i Borås, Malmö högskola, Stockholms universitet, Uppsala universitet och Metamatrix AB under perioden mars 2008 - april 2009. Projektet har finansierats av Kungl. Bibliotekets program OpenAccess.se. Vid sidan om denna slutrapport, har vi tidigare publicerat rapporten Kartläggning av produktion och användning av OER vid några svenska lärosäten. De frågeställningar vi har arbetat med är -Hur ser möjligheterna ut att i lärosätenas öppna arkiv för e-publicering av forskning och uppsatser, också rymma de lokalt producerade lärresurserna? -I vilken omfattning använder och producerar lärarna vid lärosätena fritt tillgängliga lärresurser (OER, Open Educational Resources) idag? Vi har velat belysa dessa frågeställningar genom att ta fram unika empirisk data från de deltagande lärosätena. Under våren 2008 genomfördes vår inventering av existerande digitala lärresurser och kartläggning av bruket av digitala lärresurser vid fem svenska lärosäten. Enkätstudien och intervjuerna visar att begreppet OER och även begreppet digitala lärresurser fortfarande är nytt för många, men själva företeelserna används av över hälften av de lärare som ingått i studierna. Även produktionen och viljan att dela med sig av det som produceras är relativt hög. Det är förhållandevis många lärare som då och då använder sig av OER (50 % av respondenterna) och betydligt färre som använder sig av OER dagligen (6 %). Av de lärare som inte använder sig av OER är det mer än hälften som inte vet vad det är, eller hur man gör. Närmare 70 procent av den undervisande personalen som besvarat enkäten uppger att de producerar eget material. Produktion av egna digitala lärresurser är således mer vanligt än användning av andras material. De starkaste drivkrafterna att ta fram eget material är, enligt enkätsvaren, att ha som komplement till föreläsningar och för att det ska vara återanvändbart i andra kurser. PowerPoint-presentationer, PDF-format och Word-filer (eller motsvarande) är de vanligaste formaten på det som produceras. Andelen som väljer att dela med sig av sitt material är högre än förväntat, närmare 50 %. Här anges den främsta anledningen att man vill att informationen ska kunna vara till nytta för andra, följt av åsikten att information ska vara fritt tillgänglig. Som kontrast till detta visar intervjuerna på en lite mer nyanserad bild. Dels framhålls nyttan med digitalt undervisningsmaterial och möjligheter till nya pedagogiska grepp och metoder. Flera av våra respondenter är överens om att lärosätena skulle gynnas av att ge en möjlighet att publicera lärresurser öppet. Med kartläggningen som stöd har vi därefter arbetat vidare med dess resultat för att utveckla och undersöka praktisk funktionalitet i projektets befintliga öppna arkiv. Vi pekar på att det finns behov av mer kvalificerad användning av OER än de öppna arkiven medger, t.ex. inbyggda viewers och redigerbarhet. Samtidigt, har vi också sett att dessa öppna arkiv är överlägsna på att möjliggöra spridning och synlighet för dess innehåll, även för annat material än student- och forskarpubliceringen. Vi ser alltså både för- och nackdelar med att göra OER tillgängliga via de öppna arkiven, men för att undvika att bygga nya system eller låsa in lärresurserna i LMS:er, så kan arkivens öppna gränssnitt (ex. via XML Web services och OAI-PMH) användas för att sprida OER till andra system där användbarheten bättre kan erhållas, samtidigt som lärosätena kan behålla överblick och marknadsföring av sin intellektuella output i en samlande tjänst. Framtida system Inom projektet har vi därefter, med stöd från kartläggning, praktiska tester och faktisk funktionalitet i två publiceringsplattformar (Diva och DSpace) slutligen inom ramarna för denna slutrapport levererat beslutsstöd och prototyper med den funktionalitet som en sådan tjänst, eller det öppna arkivet, bör innehålla. Strategiska frågor Såväl i kartläggningen som i de praktiska testerna erfar vi många närliggande frågor av såväl kunskapsmässig som mer praktisk natur, där det behövs mer information och goda exempel på hur arbetet kan läggas upp, som är viktiga både för undervisande personal och ledning: upphovsrättsliga frågor; stöd och incitament för användning och utveckling av digitalt undervisningsmaterial; samt nytto- kostnadsanalyser. En fråga vi berört ett flertal gånger i rapporten är balansen mellan den forskning och utbildning som bedrivs. Det är en relativt komplicerad fråga som handlar om ledningens prioriteringar och hur man ska profilera lärosätets varumärke. Det är i sammanhanget en känslig fråga att forskning traditionellt alltid har meriterats högre än undervisning. Genom intervjuerna framgår att det inte finns några policies eller riktlinjer runt användande och producerande av digitalt material. Ett antal punkter till dem i ledningsposition på institutioner och lärosäten som vill öka användandet av digitala lärresurser och öppet material har framkommit: respondenterna uppfattar varken sin undervisning och produktion av material som prioriterat eller meriterande - om det är önskvärt, menar man, behövs det dels -stödinsatser och mer information och utbildning inom dessa områden; samt -synlighet för arbete med OER i policies, riktlinjer och som grund för karriär- och löneutvecklingen Incitament kan komma från andra håll än den egna ledningen, det vore intressant att se goda exempel premieras och lyftas fram, för att skapa såväl motivation som ökade kunskaper.
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38.
  • Lindholm, Lena, et al. (författare)
  • A closed perfusion system with heparin coating and centrifugal pump improves cardiopulmonary bypass biocompatibility in elderly patients.
  • 2004
  • Ingår i: The Annals of thoracic surgery. - : Elsevier BV. - 1552-6259 .- 0003-4975. ; 78:6
  • 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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39.
  • Lindholm, Ljubica, et al. (författare)
  • Effect of lipid bilayer properties on the photocycle of green proteorhodopsin
  • 2015
  • Ingår i: Biochimica et Biophysica Acta - Bioenergetics. - : Elsevier BV. - 0005-2728 .- 1879-2650. ; 1847:8, s. 698-708
  • Tidskriftsartikel (refereegranskat)abstract
    • The significance of specific lipids for proton pumping by the bacterial rhodopsin proteorhodopsin (pR) was studied. To this end, it was examined whether pR preferentially binds certain lipids and whether molecular properties of the lipid environment affect the photocycle. pR's photocyde was followed by microsecond flash-photolysis in the visible spectral range. It was fastest in phosphatidylcholine liposomes (soy bean lipid), intermediate in 3-[(3-cholamidopropyl) dimethylammonio] propanesulfonate (CHAPS): 1,2-dioleoyl-sn-glycero-3-phosphocholine (DOPC) bicelles and in Triton X-100, and slowest when pR was solubilized in CHAPS. In bicelles with different lipid compositions, the nature of the head groups, the unsaturation level and the fatty acid chain length had small effects on the photocycle. The specific affinity of pR for lipids of the expression host Eschetichia coil was investigated by an optimized method of lipid isolation from purified membrane protein using two different concentrations of the detergent N-dodecyl-beta-D-maltoside (DDM). We found that 11 lipids were copurified per pR molecule at 0.1% DDM, whereas essentially all lipids were stripped off from pR by 1% DDM. The relative amounts of copurifled phosphatidylethanolamine, phosphatidylglycerol, and cardiolipin did not correlate with the molar percentages normally present in E. coil cells. The results indicate a predominance of phosphatidylethanolamine species in the lipid annulus around recombinant pR that are less polar than the dominant species in the cell membrane of the expression host E. coli.
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40.
  • Lindholm, Lena, et al. (författare)
  • Endogenous gas formation : an in vitro study with relevance to gas microemboli during cardiopulmonary bypass
  • 2012
  • Ingår i: The Journal of extra-corporeal technology. - 0022-1058. ; 44:3, s. 126-133
  • Tidskriftsartikel (refereegranskat)abstract
    • Gas embolism is an identified problem during cardiopulmonary bypass (CPB). Our aim was to analyze the potential influence from gas solubility based on simple physical laws, here called endogenous gas embolism. Gas solubility decreases at higher temperature and gas bubbles are presumably formed at CPB warming. An experimental model to measure gas release was designed. Medium (water or blood retrieved from mediastinal drains, 14.6 mL) was incubated and equilibrated with gas (air, 100% oxygen, or 5% carbon dioxide in air) at low temperature (10 degrees C or 23 degrees C). At warming to 37 degrees C, gas release was digitally measured. Also, the effect of fluid motion was evaluated. At warming, the medium became oversaturated with dissolved gas. When fluid motion was applied, gas was released to form bubbles. This was exemplified by a gas release of .45% (.31/.54, medians and quartile range, volume percent, p = .007) and 1.26% (1.14/ 1.33, p = .003) when blood was warmed from 23 degrees C or 10 degrees C to 37 degrees C, respectively (carbon dioxide 5% in air). Consistent findings were seen for water and with the other types of gas exposure. The theory of endogenous gas embolization was confirmed with gas being released at warming. The endogenous gas formation demonstrated a dynamic pattern with oversaturation and with rapid gas released at fluid motion. The gas release at warming was substantial, in particular when the results were extrapolated to full-scale CPB conditions. The interference from endogenous gas formation should be considered in parallel to external sources of gas microemboli.
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41.
  • Lindholm, Lena, et al. (författare)
  • Endogenous gas formation of carbon dioxide used for wound flooding : an experimental study with implications regarding gas microembolism during cardiopulmonary bypass
  • 2014
  • Ingår i: Perfusion. - : SAGE Publications. - 0267-6591 .- 1477-111X. ; 29:3, s. 242-248
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Gas microembolisation is an identified risk in cardiac surgery. Flooding the wound with carbon dioxide is a method proposed to reduce this problem. The high solubility of carbon dioxide is beneficial, but may also cause problems. The gas solubility diminishes at warming and endogenous bubbles are formed when cold blood saturated with carbon dioxide is returned by cardiotomy suction.METHODS: The release of endogenous gas was measured at high resolution in an experimental digital model. A medium (water or blood) was incubated and equilibrated with gas (100% carbon dioxide or air) at a low temperature (10°C or 23°C). The temperature was increased to 37°C and the gas release was measured, at rest and at fluid motion.RESULTS: The amount of carbon dioxide released at warming was substantial for both water and blood (both p=0.005). The effect was more pronounced when the temperature differential increased (p=0.005). However, blood and water differed in these terms: with water, the release of carbon-dioxide started instantly at warming; with blood, carbon dioxide remained dissolved and was released at fluid motion. When blood was warmed from 10°C to 37°C, the gas release corresponded to 44.4% (40.6/46.5) of the medium volume (median with quartile range).CONCLUSION: Gas dissolved in a medium becomes released at warming, as confirmed here. Blood exposed to carbon dioxide became heavily oversaturated at warming, with the gas instantly released at fluid motion. The amount of contained gas increased with a higher temperature differential. Our study has relevance to wound flushing, using carbon dioxide, in cardiac surgery. The clinical consequences of these findings remain to be answered.
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42.
  •  
43.
  • Lindholm, Lena, et al. (författare)
  • Regional oxygenation and systemic inflammatory response during cardiopulmonary bypass: influence of temperature and blood flow variations.
  • 2003
  • Ingår i: Journal of cardiothoracic and vascular anesthesia. - : Elsevier BV. - 1053-0770. ; 17:2, s. 182-7
  • 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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44.
  • Lindholm, Lena (författare)
  • Regional oxygenation in cardiac surgery. Influence of temperature, pump flow and insulin
  • 2002
  • 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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45.
  • Lindholm, Maria, et al. (författare)
  • Occupational safety and health challenges of home care personnel
  • 2019
  • Ingår i: Proceedings of the Vision Zero Summit 2019. ; , s. 160-163
  • Konferensbidrag (refereegranskat)abstract
    • Care personnel often have musculoskeletal disorders and sleep disturbances. In this study, aquestionnaire was utilized to identify occupational safety and health (OSH) challenges andassociations with possible sleep disturbances among home care personnel. The questionnairewas given to 19 workplaces in the Stockholm County in 2017, and 469 employees answered.Preliminary results show that among identified OSH challenges were high psychosocial andphysical workload, and dissatisfaction with the leadership. Lack of satisfaction with the work,dissatisfaction with the leadership, high qualitative demands and pain disorders were significantlyassociated with sleep disturbances. The results support the importance of promoting a goodorganizational work environment in the home care services.
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46.
  • Lindholm, Marina, et al. (författare)
  • Personal assistants' conceptions of their cooperation in the rehabilitation of disabled persons.
  • 2005
  • Ingår i: Scandinavian journal of occupational therapy. - London : Informa Healthcare. - 1103-8128 .- 1651-2014. ; 12:2, s. 72-80
  • Tidskriftsartikel (refereegranskat)abstract
    • Personal assistants assist persons with severe disability in the performance of their daily activities. The law that covers the right to personal assistance is intended to strengthen the disabled individual's position as a member of society. The aim of the study was to describe personal assistants' conceptions of their cooperation in the rehabilitation of disabled persons. A qualitative method with a phenomenographic approach was used. Six personal assistants were interviewed. Strategic selection of the participants was carried out in order to obtain as wide a variation in conceptions as possible. The results showed that, apart from the factors related to the assistants, factors related to the disabled persons and the environment were of major significance for rehabilitation. The conceptions generated by the study were presented in the form of main categories and subcategories. Four main categories were developed: the meaning of will; the professional role; to consider ability; and awareness of the environment.
  •  
47.
  • Lindholm, Maria, et al. (författare)
  • Sleep-Related Problems and Associations with Occupational Factors among Home Care Personnel
  • 2020
  • Ingår i: Nordic Journal of Working Life Studies. - : Det Kgl. Bibliotek/Royal Danish Library. - 2245-0157.
  • Tidskriftsartikel (refereegranskat)abstract
    • Recent demographic developments in Europe have increased the demand for home care. Working in other people’s home environment is challenging. Home care personnel’s musculoskeletal disorders are common, and care personnel overall often have sleep disturbances. In this study, associations between occupational physical and psychosocial factors and possible sleep-related problems among home care personnel were explored using a questionnaire. The questionnaire was distributed to 19 workplaces in Stockholm County in 2017–2019, and 665 home care personnel answered. Several factors, including job contentment, physical burden of care, client-related burnout, quantitative demands, and pain, were significantly associated with sleep-related problems. The results highlight the need for implementing measures to improve psychosocial and organizational working conditions in home care service.
  •  
48.
  • Lindholm, Ola, 1957- (författare)
  • Ögonblick i klassrummet : Samtal och interaktion om elevers fotografier på gymnasiet
  • 2014
  • Licentiatavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • En kamera fångar ögonblick av det ljus som människan kan uppfatta, eller verkligheten som det ibland kallas. Dessa ögonblick i form av fotografier, arbetar de elever och den lärare med, som Ola Lindholm har följt på gymnasiet. Läsaren kan följa hur eleverna interagerar, hur det sociala samspelet organiseras under lektioner och redovisningar, vad som görs viktigt samt hur bildteoretiska- och yrkesmässiga kunskaper framträder i interaktionen.I studien framträder ett arbetssätt som ger eleverna ansvar och möjlighet att visa vad de kan i interaktionerna och vid redovisningarna av deras fotografier. Resultatet visar hur läraren försöker få eleverna att se skillnader i fotografiets uttryck, skärpedjup, bildbeskärning etcetera. Ibland gör eleverna motstånd och förhandlar med läraren där eleverna hävdar sin kunskap och sina åsikter om sina bilder. I bildanalysen av ett elevfotografi framträder två olika intentioner med de förslag som läraren och eleven förhandlar om. Studien visar att bildteorier, bildspråket och vad bilden kan berätta, inte är lika framträdande i interaktionen som frågor om teknik och process.Ola Lindholm, är bild- och medielärare på Sundstagymnasiet i Karlstad. Licentiatavhandlingen har skrivits inom Forskarskolan i yrkesämnenas didaktik.
  •  
49.
  • Malmborg, Petter, et al. (författare)
  • Presentation and progression of childhood-onset inflammatory bowel disease in northern Stockholm County
  • 2015
  • Ingår i: Inflammatory Bowel Diseases. - : Wolters Kluwer. - 1078-0998 .- 1536-4844. ; 21:5, s. 1098-1108
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Some studies have suggested that childhood-onset inflammatory bowel disease (IBD) is characterized by extensive intestinal involvement and rapid progression to complications. Here, we report the presentation and progression of patients diagnosed with IBD during childhood in a population-based cohort from northern Stockholm County.Methods: Medical records for all 280 patients diagnosed in the period 1990-2007 with childhood-onset IBD in northern Stockholm County were followed until 2011 (median follow-up time, 8.8 yr). Disease phenotypes were classified according to the Paris pediatric IBD classification.Results: Among the 74 patients with ulcerative colitis, 72% presented with pancolitis. Among the 200 patients with Crohn's disease (CD), 75% presented with colitis. Complicated disease behavior was observed in 18% of patients with CD by end of follow-up. Extension of the disease territory was observed in 22% of patients with ulcerative colitis and 15% of patients with CD. The cumulative risk of intra-abdominal surgery after 10 years was 8% (95% confidence interval, 4%-20%) for ulcerative colitis and 22% (95% confidence interval, 15%-28%) for patients with CD. Nonmucosal healing at 1 year was associated with a complicated disease course in patients with CD (hazard ratio = 14.56; 95% confidence interval, 1.79-118.68; P = 0.01).Conclusions: Patients with childhood-onset IBD were characterized by extensive colitis that was relatively stable over time and associated with a relatively low risk of complications and abdominal surgery. Our findings confirm the more extensive disease location in pediatric IBD but did not identify the proposed dynamic and aggressive nature of the childhood-onset phenotype. The association of nonmucosal healing with a complicated disease course suggests that endoscopy should guide treatment intensity in childhood-onset CD.
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50.
  • Martinsson, Gunilla, et al. (författare)
  • Being altruistically egoistic : Nursing aides’ experiences of caring for older persons with mental disorders
  • 2011
  • Ingår i: International Journal of Qualitative Studies on Health and Well-being. - : Informa UK Limited. - 1748-2623 .- 1748-2631. ; 6:4, s. 7530-
  • Tidskriftsartikel (refereegranskat)abstract
    • Older persons with mental disorders, excluding dementia disorders, constitute a vulnerable group of people. With the future international increase in the older population, mental disorders will increase as well, thus entailing new challenges for their caregivers. These older persons often remain in their own homes, and in Sweden they are cared for by nursing aides. With little previous research, an increased workload and facing new strenuous situations, it is important to make use of the knowledge the nursing aides possess and to deepen the understanding of their experiences. The study aimed at illuminating the meaning of caring for older persons with mental disorders as experienced by nursing aides in the municipal home help service. Interviews with nine female nursing aides were performed and analysed with a phenomenological hermeneutical research method inspired by the philosophy of Paul Ricoeur. Being altruistically egoistic emerged as a main theme in the nursing aides’ narratives. The nursing aides’ experiences could be interpreted as a movement between being altruistic and egoistic. The findings revealed a continuous distancing by the nursing aides and their struggle to redress the balance between their altruistic and egoistic actions. Caring for these older persons constitutes a complex situation where distancing functions as a recourse to prioritize oneself and to diminish the value of caring. The study suggests that an increased knowledge base on older persons with mental disorders, followed by continuous supervision, is necessary for the nursing aides to improve the quality of the care given
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