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- Semb, Gunvor, et al.
(author)
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A Scandcleft randomised trials of primary surgery for unilateral cleft lip and palate: 1. Planning and management.
- 2017
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In: Journal of Plastic Surgery and Hand Surgery. - : Taylor & Francis. - 2000-656X .- 2000-6764. ; 51:1, s. 2-13
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Journal article (peer-reviewed)abstract
- BACKGROUND AND AIMS: Longstanding uncertainty surrounds the selection of surgical protocols for the closure of unilateral cleft lip and palate, and randomised trials have only rarely been performed. This paper is an introduction to three randomised trials of primary surgery for children born with complete unilateral cleft lip and palate (UCLP). It presents the protocol developed for the trials in CONSORT format, and describes the management structure that was developed to achieve the long-term engagement and commitment required to complete the project.METHOD: Ten established national or regional cleft centres participated. Lip and soft palate closure at 3-4 months, and hard palate closure at 12 months served as a common method in each trial. Trial 1 compared this with hard palate closure at 36 months. Trial 2 compared it with lip closure at 3-4 months and hard and soft palate closure at 12 months. Trial 3 compared it with lip and hard palate closure at 3-4 months and soft palate closure at 12 months. The primary outcomes were speech and dentofacial development, with a series of perioperative and longer-term secondary outcomes.RESULTS: Recruitment of 448 infants took place over a 9-year period, with 99.8% subsequent retention at 5 years.CONCLUSION: The series of reports that follow this introductory paper include comparisons at age 5 of surgical outcomes, speech outcomes, measures of dentofacial development and appearance, and parental satisfaction. The outcomes recorded and the numbers analysed for each outcome and time point are described in the series.TRIAL REGISTRATION: ISRCTN29932826.
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| 2. |
- Asp, Margareta, et al.
(author)
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Samvetsstress och dåliga villkor bakom sjuksköterskeflykten
- 2017
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In: Dagens Nyheter.
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Journal article (pop. science, debate, etc.)abstract
- Ge sjuksköterskor utrymme att göra kvalificerade bedömningar av patientens omvårdnadsbehov och låt dem också få gehör för de omvårdnadsinterventioner de föreslår. Det skulle inte bara bidra till att minska samvetsstress och arbetsrelaterad ohälsa hos sjuksköterskor utan också bidra till att de stannar i yrket, skriver sex forskare i vårdvetenskap.
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| 4. |
- Berggren, Daniel Moreno, et al.
(author)
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Prognostic scoring systems for myelodysplastic syndromes (MDS) in a population-based setting : a report from the Swedish MDS register
- 2018
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In: British Journal of Haematology. - : Wiley. - 0007-1048 .- 1365-2141. ; 181:5, s. 614-627
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Journal article (peer-reviewed)abstract
- The myelodysplastic syndromes (MDS) have highly variable outcomes and prognostic scoring systems are important tools for risk assessment and to guide therapeutic decisions. However, few population-based studies have compared the value of the different scoring systems. With data from the nationwide Swedish population-based MDS register we validated the International Prognostic Scoring System (IPSS), revised IPSS (IPSS-R) and the World Health Organization (WHO) Classification-based Prognostic Scoring System (WPSS). We also present population-based data on incidence, clinical characteristics including detailed cytogenetics and outcome from the register. The study encompassed 1329 patients reported to the register between 2009 and 2013, 14% of these had therapy-related MDS (t-MDS). Based on the MDS register, the yearly crude incidence of MDS in Sweden was 2.9 per 100000 inhabitants. IPSS-R had a significantly better prognostic power than IPSS (P < 0001). There was a trend for better prognostic power of IPSS-R compared to WPSS (P=0.05) and for WPSS compared to IPSS (P=0.07). IPSS-R was superior to both IPSS and WPSS for patients aged <= 70years. Patients with t-MDS had a worse outcome compared to de novo MDS (d-MDS), however, the validity of the prognostic scoring systems was comparable for d-MDS and t-MDS. In conclusion, population-based studies are important to validate prognostic scores in a real-world' setting. In our nationwide cohort, the IPSS-R showed the best predictive power.
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| 6. |
- Claesson, Maria, 1971-, et al.
(author)
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What implies registered nurses leadership close to older adults in the municipality home health care?
- 2019
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Conference paper (peer-reviewed)abstract
- Title. What implies registered nurses leadership close to older adults in the municipality home health care?Objective. The objective was to explore how the literature describes the registered nurses’ leadership near to older adults in municipal home care.Background. Home health care in Sweden and world-wide is affected by the increasing number of older adults, 65 years and over. One challenge is that older adults report more health problems compared with health professionals’ needs assessments. The primary task of care is to support and strengthen people’s health processes to as good health as possible by alleviating the effects of disease and suffering. The registered nurse may be the one who contributes or makes a difference to the older adults’ experience of health. According to this; great demands are placed on the registered nurse's leadership close to the patient. There is a common agreement that registered nurses’ leadership is important. However, research is limited of what implies registered nurses’ leadership close to older adults in municipal home care.Method. A systematic literature review. The literature search was performed in CINAHL and PubMed during February to April, 2018. A total of 37 articles were identified and nine articles were screened in full text. Quality valuation and analyses of articles were performed doing qualitative research synthesis based of the PRISMA statement.Results. The results will be presented for the first time at the 9th IAGG-ER Congress, May 23-25, 2019, Gothenburg, Sweden.
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| 8. |
- Danenberg, P. V., et al.
(author)
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Folates as adjuvants to anticancer agents: Chemical rationale and mechanism of action
- 2016
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In: Critical Reviews in Oncology Hematology. - : Elsevier BV. - 1040-8428. ; 106, s. 118-131
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Journal article (peer-reviewed)abstract
- Folates have been used with cytotoxic agents for decades and today they are used in hundreds of thousands of patients annually. Folate metabolism is complex. In the treatment of cancer with 5-fluorouracil, the administration of folates mechanistically leads to the formation of [6R]-5,10-methylene-tetrahydrofolate, and the increased concentration of this molecule leads to stabilization of the ternary complex comprising thymidylate synthase, 2'-deoxy-uridine-5'-monophosphate, and [6R]-5,10-methylene-tetrahydrofolate.The latter is the only natural folate that can bind directly in the ternary complex, with other folates requiring metabolic activation. Modulation of thymidylate synthase activity became central in the study of folate/cytotoxic combinations and, despite wide use, research into the folate component was neglected, leaving important questions unanswered. This article revisits the mechanisms of action of folates and evaluates commercially available folate derivatives in the light of current research. Better genomic insight and availability of new analytical techniques and stable folate compounds may open new avenues of research and therapy, ultimately bringing increased clinical benefit to patients. (C) 2016 The Authors. Published by Elsevier Ireland Ltd.
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| 9. |
- Eskilsson, Camilla, 1963-, et al.
(author)
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Managers’ responsibility to support caring and learning in clinical education units
- 2017
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In: Clinical Nursing Studies. - : Sciedu Press. - 2324-7940 .- 2324-7959. ; 5:3, s. 34-40
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Journal article (peer-reviewed)abstract
- Background: Managers in clinical education units (CEUs) have the responsibility to facilitate evidence-based environments for both caring and learning. Promoting such environments might be challenging in times of financial constraints and organisation changes.Objective: The purpose of this study was to describe how managers experience their responsibility to support the caring and learning environments in CEUs.Methods: The study method followed the principles of Reflective Lifeworld Research (RLR) grounded in a phenomenological approach. The study was conducted at a hospital in Southern Sweden. Ten first- and second-line managers responsible for CEUs were interviewed. The interviews were conducted as reflective dialogues using an open, and bridled approach.Results: The results show that clinical education unit managers regard the responsibility to support caring and learning environments as a challenging experience, elucidated in three themes: (1) to have or to take responsibility; (2) cooperation that supports and challenges; and (3) bringing it all together— a daily struggle.Conclusions: In conclusion, the managers of CEUs need to be aware of the importance of common theoretical grounds for caring and learning. Caring and learning are more likely to be intertwined when responsibility is taken, when collaboration between actors is characterised by respect and when an awareness of the importance of reflection is present. Awareness of the importance of creating opportunities for reflection and mutual collaboration among the different actors involved could lead to improvements in nursing education and, therefore, improved patient care.
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| 10. |
- Eskilsson, Camilla, 1963-
(author)
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Vårdande och lärande sammanflätas i genuina möten : erfarenheter, förutsättningar och ansvar på utbildningsvårdavdelning
- 2016
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Doctoral thesis (other academic/artistic)abstract
- AimThe overall aim of this thesis is to create knowledge about caring and learning as an intertwining phenomenon at a Dedicated Education Unit and how it can be developed.Approach and methodA lifeworld approach, based on the phenomenological philosophies foremost derived from Husserl and Merleau-Ponty was used and carried out in lifeworld interviews and with meaning-oriented analysis in accordance with reflective lifeworld research. The participants were: 13 student nurses (study I), 11 patients (study II), 8 supervisors (study III) all from the same DEU in orthopedic care and 10 managers from various DEUs (study IV).Main findingsIntertwined caring and learning is most evident in genuine encounters between students and patients, supported by supervisors and managers. The intertwining is created in appealing challenges where students feel safe and ready. In the encounter with the patient they gain a sense of the whole where they can find their personal style. Patients, who feel invited to participate, could describe the encounter with students as genuine and a new dimension in nursing care. These encounters are characterized by closeness, thoroughness, accessibility, acknowledgement and sensitivity. When the encounter is less genuine, supervisors constitute an essential support for stabilizing the care. Supervisors constantly move in order to either stay close to or stand back, adjusting to the students’ and patients’ needs. Their demanding task as reflective supervisors requires pauses in order to maintain motivation. The managers’ daily struggle in a stressful and challenging reality is influenced by them either having or taking responsibility. Differences in approaches are shown in terms of more or less involvement and commitment in caring environment and educational issues. ConclusionsGenuine encounters are characterized by the core of both caring and learning and will thereby benefit both the students and the patients. Identifying and supporting genuine encounters is necessary for students, supervisors and managers. It is time to find ways to develop a unified view of how caring and learning can be intertwined.
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