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- Klionsky, Daniel J., et al.
(författare)
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Guidelines for the use and interpretation of assays for monitoring autophagy
- 2012
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Ingår i: Autophagy. - : Informa UK Limited. - 1554-8635 .- 1554-8627. ; 8:4, s. 445-544
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Forskningsöversikt (refereegranskat)abstract
- In 2008 we published the first set of guidelines for standardizing research in autophagy. Since then, research on this topic has continued to accelerate, and many new scientists have entered the field. Our knowledge base and relevant new technologies have also been expanding. Accordingly, it is important to update these guidelines for monitoring autophagy in different organisms. Various reviews have described the range of assays that have been used for this purpose. Nevertheless, there continues to be confusion regarding acceptable methods to measure autophagy, especially in multicellular eukaryotes. A key point that needs to be emphasized is that there is a difference between measurements that monitor the numbers or volume of autophagic elements (e.g., autophagosomes or autolysosomes) at any stage of the autophagic process vs. those that measure flux through the autophagy pathway (i.e., the complete process); thus, a block in macroautophagy that results in autophagosome accumulation needs to be differentiated from stimuli that result in increased autophagic activity, defined as increased autophagy induction coupled with increased delivery to, and degradation within, lysosomes (in most higher eukaryotes and some protists such as Dictyostelium) or the vacuole (in plants and fungi). In other words, it is especially important that investigators new to the field understand that the appearance of more autophagosomes does not necessarily equate with more autophagy. In fact, in many cases, autophagosomes accumulate because of a block in trafficking to lysosomes without a concomitant change in autophagosome biogenesis, whereas an increase in autolysosomes may reflect a reduction in degradative activity. Here, we present a set of guidelines for the selection and interpretation of methods for use by investigators who aim to examine macroautophagy and related processes, as well as for reviewers who need to provide realistic and reasonable critiques of papers that are focused on these processes. These guidelines are not meant to be a formulaic set of rules, because the appropriate assays depend in part on the question being asked and the system being used. In addition, we emphasize that no individual assay is guaranteed to be the most appropriate one in every situation, and we strongly recommend the use of multiple assays to monitor autophagy. In these guidelines, we consider these various methods of assessing autophagy and what information can, or cannot, be obtained from them. Finally, by discussing the merits and limits of particular autophagy assays, we hope to encourage technical innovation in the field.
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- Alharbi, Tariq, 1979, et al.
(författare)
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Experiences of person-centred care – patients’ perceptions: qualitative study
- 2014
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Ingår i: BMC Nursing. - : Springer Science and Business Media LLC. - 1472-6955. ; 13:28
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Tidskriftsartikel (refereegranskat)abstract
- Background Patient care models have been implemented and documented worldwide. Many studies have focused on features that hinder and facilitate the shift to such models, including the implementation process, staff involvement, resistance to new models and cultural dimensions. However, few studies have identified the potential effects of such new care models from a patient perspective. The aim of the present study was to investigate whether patients did in fact perceive the intentions of partnership in the new care model 1 year after its implementation. Methods Sixteen participants were interviewed, selected from two wards in a medical department where a new care model had been implemented 1 year earlier. A directed deductive content analysis was selected. The aim of the directed approach to content analysis was to investigate to what extent the new care model had been implemented, using patients’ perspectives to describe the level of implementation. A coding framework was developed based on a theoretical paper that described the key features of the new care model. Results The implementation of person-centred care had clearly occurred to a large degree, even if some patients appeared not to have been exposed to the model at all. Aspects of the newly implemented care model were obvious; however, it was also clear that implementation was not complete. The analysis showed that patients felt listened to and that their own perception of the situation had been noted. Patients spontaneously expressed that they felt that the staff saw them as persons and did not solely focus on their disease. It was also stated that not every ailment or aspect of a patient’s illness needed to be addressed or resolved for open listening to be perceived as a positive experience. Conclusions The findings indicate that even though some patients were not interested in participating and playing an active role in their own care, this might relate to a lack of understanding on how to invite them to do so and to increase their confidence. To change healthcare from a paternalistic system to care where patients are seen as partners may require pedagogical skills.
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3. |
- Alharbi, Tariq, 1979, et al.
(författare)
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Organizational culture and the implementation of person centered care: Results from a change process in Swedish hospital care
- 2012
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Ingår i: Health Policy. - : Elsevier BV. - 0168-8510. ; 108:2-3, s. 294-301
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Tidskriftsartikel (refereegranskat)abstract
- Abstract Sweden has one of the oldest, most coherent and stable healthcare systems in the world. The culture has been described as conservative, mechanistic and increasingly standardized. In order to provide a care adjusted to the patient, person centered care (PCC) has been developed and implemented into some parts of the health care industry. The model has proven to decrease patient uncertainty. However, the impact of PCC has been limited in some clinics and hospital wards. An assumption is that organizational culture has an impact on desired outcomes of PCC, such as patient uncertainty. Therefore, in this study we identify the impact of organizational culture on patient uncertainty in five hospital wards during the implementation of PCC. Data from 220 hospitalized patients who completed the uncertainty cardiovascular population scale (UCPS) and 117 nurses who completed the organizational values questionnaire (OVQ) were investigated with regression analysis. The results seemed to indicate that in hospitals where the culture promotes stability, control and goal setting, patient uncertainty is reduced. In contrast to previous studies suggesting that a culture of flexibility, cohesion and trust is positive, a culture of stability can better sustain a desired outcome of reform or implementation of new care models such as person centered care. It is essential for health managers to be aware of what characterizes their organizational culture before attempting to implement any sort of new healthcare model. The organizational values questionnaire has the potential to be used as a tool to aid health managers in reaching that understanding.
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4. |
- Alharbi, Tariq, 1979, et al.
(författare)
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The impact of organizational culture on the outcome of hospital care: After the implementation of person-centred care
- 2014
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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 42:1, s. 104-110
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Tidskriftsartikel (refereegranskat)abstract
- AIMS: To measure the effect of organizational culture on health outcomes of patients 3 months after discharge. Methods: a quantitative study using Organizational Values Questionnaire (OVQ) and a health-related quality of life instrument (EQ-5D). A total of 117 nurses, 69% response rate, and 220 patients answered the OVQ and EQ-5D, respectively. Results: The regression analysis showed that; 16% (R2 = 0.02) of a decreased health status, 22% (R2 = 0.05) of pain/discomfort and 13% (R2 = 0.02) of mobility problems could be attributed to the combination of open system (OS) and Human Relations (HR) cultural dimensions, i.e., an organizational culture being dominated by flexibility. Conclusions: The results from the present study tentatively indicated an association between an organizational culture and patients' health related quality of life 3 months after discharge. Even if the current understanding of organizational culture, which is dominated by flexibility, is considered favourable when implementing a new health care model, our results showed that it could be hindering instead of helping the new health care model in achieving its objectives.
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5. |
- Carlström, Eric, 1957, et al.
(författare)
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The association between subcultures and resistance to change – in a Swedish hospital clinic
- 2014
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Ingår i: Journal of Health Organisation & Management. - 1477-7266. ; 28:4, s. 458-476
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Tidskriftsartikel (refereegranskat)abstract
- Summary: Purpose: The purpose of this paper was to explore the different subcultures and the employees’ preparedness for change at an orthopaedic clinic in a university hospital in Sweden. The idea was to describe how different working groups might react to the change, in order to discover the possible impact of the model prior to implementation. This approach was based on the fact that costly implementation processes have had disappointing results and limited impacts on some organisations. Design: Surveys were sent out to 179 nurses and physicians. The survey included the two instruments Organisational Values Questionnaire (OVQ) and Resistance to Change Scale (RTC). Findings: The results suggest a dominance of a human relations culture i.e. flexibility, cohesion and trust, in the orthopaedic clinic. These characteristics seemed to decrease resistance to change. Opposite to this, planning, routines and goal setting appeared to increase change-resistant behaviour. Practical implications: By predicting potential obstacles in a certain context prior to a change process, resources can be used in a more optimal way. An instrument that pinpoints the culture of a particular healthcare setting may be a useful tool in order to anticipate the possible outcome of change. Originality/value: The rational goal/internal processes dimension exerted a stronger association with resistance to change than in earlier studies. Deeply rooted standards and routinised care models, governed by work schedules, could be an obstacle to introducing a care model based on the individual needs of the patient. There was, however, a surprisingly low resistance to change. The results are contrary to the accepted understanding of public organisations known to be slow to change. Keywords: Change, Organisational culture, Healthcare, Working groups, Person-centred care, Sweden. Paper type: Research paper
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6. |
- Furenbäck, Ingela, 1963-
(författare)
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Utveckling av samverkan : ett deltagarorienterat aktionsforskningsprojekt inom hälso- och sjukvård
- 2012
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Syfte: Det övergripande vetenskapliga syftet med denna avhandling att nå en ökad förståelse om samverkansprocesser.Ansats och metoder: Studien har bedrivits genom deltagarorienterad aktionsforskning inom hälso- och sjukvården i Hässleholm. Aktörer på verksamhetsfältet har strävat efter att utveckla samverkan för att tillsammans kunna utveckla närsjukvård. Forskningen har genererat kunskap utifrån lokala omständigheter att tjäna som underlag för beslut om att genomföra praktiska förändringar i verksamheten. En kombination av olika metoder har använts för att generera empiriskt material, där den huvudsakliga metoden har varit deltagande observationer med dialog. Därutöver har intervjuer och granskning av dokument använts samt en forskningscirkel, som är en speciell metod inom deltagarorienterad aktionsforskning. Studien har haft en hermeneutisk ansats och tolkningar har gjorts med stöd av olika teoretiska perspektiv och modeller. Kurt Lewins fältteori har utgjort en övergripande teoretisk ram för studien.Resultat: En ökad förståelse om den studerade samverkansprocessen kunde nås genom att beskriva och tolka skeenden som antogs ha påverkat utvecklingen av samverkan. Processen beskrevs både utifrån vertikal och horisontell integrering inom och mellan organisationer. Beskrivningen innefattade komponenter som fanns både inom arbetsprocesser och sociala processer. Den studerade samverkansprocessen delades in i delprocesser där var och en del innehöll en viss typ av aktivitet som genomfördes för att stödja utvecklingen av samverkan. Två olika strategier för utvecklingen av samverkan identifierades och illustrerades genom olika modeller: den linjära hierarkiska modellen respektive den dynamiska modellen. Den sistnämnda utvecklades genom aktionsforskningen.Slutsatser:I ett första skede bedrev deltagarna på fältet samverkan med stöd av den linjära hierarkiska modellen. Denna modell utgör ett tankeschema där samverkan utvecklas i en linjär hierarkisk process. Politiker fattar beslut, chefer planerar och professionella genomför aktiviteterna. Modellen utgår ifrån ett konsensusteoretiskt perspektiv där konflikter betraktas som störande element. Det innebar i detta fall att aktörer inom olika domäner och organisationer undvek varandras olika föreställningsvärldar varpå samverkansprocessen stötte på hinder i utvecklingen. Aktionsforskningen intervenerade i processen genom arrangera kommunikationsarenor med deltagare från olika domäner och organisationer. Samverkan utvecklades på så sätt utifrån den dynamiska modellen. Denna modell innehåller antaganden om att samverkansprocesser är dynamiska och har sin utgångspunkt i ett konfliktteoretiskt perspektiv där konflikter betraktas som naturliga i processen.
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7. |
- Anrup, Roland, et al.
(författare)
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Centrala universitetsvärden hotas av bolagiseringsidén
- 2013
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Ingår i: Dagens nyheter. - 1101-2447.
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Tidskriftsartikel (populärvet., debatt m.m.)abstract
- Högskolestiftelser. Förslaget att driva svenska universitet i stiftelseform öppnar för bolagisering. Men det är ingen riktig utredning, utan en politisk pamflett utan eftertanke. Privatisering av universitet hotar både oberoendet, forskningskvaliteten och samhällsnyttan, skriver 36 forskare vid svenska högskolor och universitet.
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9. |
- Awad, Tarek, et al.
(författare)
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Colloidal Structure and Physical Properties of Gel Networks Containing Anionic Surfactant and Fatty Alcohol Mixture
- 2011
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Ingår i: Journal of Dispersion Science and Technology. - : Informa UK Limited. - 0193-2691 .- 1532-2351. ; 32:6, s. 807-815
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Tidskriftsartikel (refereegranskat)abstract
- We investigated the mechanical properties, thermal behavior, physical state, and colloidal structure of a model gel network formulated with various ratios of sodium dodecyl sulfate polyacrylamide (SDS) and cetyl/stearyl fatty alcohol (FA) mixture in constant amounts of water (89%). The metastable gel, formed by slowly cooling stirred samples from temperatures above the chain melting temperature (Tm) of the long chain FA, has a lamellar structure with a periodic inter bilayer spacing of approximately 30nm. The bilayers remain homogeneous with SDS being immobilized in the FA matrix upon chain freezing. The chain length mismatch leads to an increased structural disorder among the alkyl chains upon SDS incorporation among the FA. As a result, the elastic modulus decreased with increasing SDS content. Conclusions were based on a large number of experiments involving differential scanning calorimetry, rheology, 1H NMR spectroscopy, and small angle x-ray scattering. Results from this work have uncovered the physical nature of these networks and gave insight into the role of anionic surfactants on the assembly, physical state, and mechanical properties of gel networks.
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