| 1. |
- Beausang, Angela, et al.
(författare)
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"Möjligheten att rädda några av dessa kvinnors liv har inte vägts in"
- 2014
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Ingår i: Dagens Medicin. - : Dagens Medicin.
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Tidskriftsartikel (populärvet., debatt m.m.)abstract
- Namnet på Socialstyrelsens vägledning lyder: Hur upptäcka våldsutsatthet? Ja, det kan man verkligen fråga sig efter att ha läst detta föga vägledande dokument, skriver ett stort antal kritiska debattörer.
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| 2. |
- Borgegard, Tomas, et al.
(författare)
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Alzheimers Disease: Presenilin 2-Sparing gamma-Secretase Inhibition Is a Tolerable A beta Peptide-Lowering Strategy
- 2012
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Ingår i: Journal of Neuroscience. - : Society for Neuroscience. - 0270-6474 .- 1529-2401. ; 32:48, s. 17297-17305
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Tidskriftsartikel (refereegranskat)abstract
- gamma-Secretase inhibition represents a major therapeutic strategy for lowering amyloid beta (A beta) peptide production in Alzheimers disease (AD). Progress toward clinical use of gamma-secretase inhibitors has, however, been hampered due to mechanism-based adverse events, primarily related to impairment of Notch signaling. The gamma-secretase inhibitor MRK-560 represents an exception as it is largely tolerable in vivo despite displaying only a small selectivity between A beta production and Notch signaling in vitro. In exploring the molecular basis for the observed tolerability, we show that MRK-560 displays a strong preference for the presenilin 1(PS1) over PS2 subclass of gamma-secretases and is tolerable in wild-type mice but causes dose-dependent Notch-related side effect in PS2-deficient mice at drug exposure levels resulting in a substantial decrease in brain A beta levels. This demonstrates that PS2 plays an important role in mediating essential Notch signaling in several peripheral organs during pharmacological inhibition of PS1 and provide preclinical in vivo proof of concept for PS2-sparing inhibition as a novel, tolerable and efficacious gamma-secretase targeting strategy for AD.
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| 3. |
- Borgegård, Tomas, et al.
(författare)
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Alzheimer's Disease : Presenilin 2-Sparing γ-Secretase Inhibition Is a Tolerable Aβ Peptide-Lowering Strategy
- 2012
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Ingår i: Journal of Neuroscience. - 0270-6474 .- 1529-2401. ; 32:48, s. 17297-17305
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Tidskriftsartikel (refereegranskat)abstract
- γ-Secretase inhibition represents a major therapeutic strategy for lowering amyloid β (Aβ) peptide production in Alzheimer's disease (AD). Progress toward clinical use of γ-secretase inhibitors has, however, been hampered due to mechanism-based adverse events, primarily related to impairment of Notch signaling. The γ-secretase inhibitor MRK-560 represents an exception as it is largely tolerable in vivo despite displaying only a small selectivity between Aβ production and Notch signaling in vitro. In exploring the molecular basis for the observed tolerability, we show that MRK-560 displays a strong preference for the presenilin 1 (PS1) over PS2 subclass of γ-secretases and is tolerable in wild-type mice but causes dose-dependent Notch-related side effect in PS2-deficient mice at drug exposure levels resulting in a substantial decrease in brain Aβ levels. This demonstrates that PS2 plays an important role in mediating essential Notch signaling in several peripheral organs during pharmacological inhibition of PS1 and provide preclinical in vivo proof of concept for PS2-sparing inhibition as a novel, tolerable and efficacious γ-secretase targeting strategy for AD.
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| 4. |
- Karlsson, Oskar, et al.
(författare)
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Neonatal exposure to the cyanobacterial toxin BMAA induces changes in protein expression and neurodegeneration in adult hippocampus.
- 2012
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Ingår i: Toxicological Sciences. - : Oxford University Press (OUP). - 1096-0929 .- 1096-6080. ; 130:2, s. 391-404
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Tidskriftsartikel (refereegranskat)abstract
- The cyanobacterial toxin β-N-methylamino-L-alanine (BMAA) has been proposed to contribute to neurodegenerative disease. We have previously reported a selective uptake of BMAA in the mouse neonatal hippocampus and that exposure during the neonatal period causes learning and memory impairments in adult rats. The aim of this study was to characterize effects in the brain of 6-month-old rats treated neonatally (postnatal days 9-10) with the glutamatergic BMAA. Protein changes were examined using the novel technique Matrix-Assisted Laser Desorption Ionization (MALDI) imaging mass spectrometry (IMS) for direct imaging of proteins in brain cryosections, and histological changes were examined using immunohistochemistry and histopathology. The results showed long-term changes including a decreased expression of proteins involved in energy metabolism and intracellular signaling in the adult hippocampus at a dose (150 mg/kg) that gave no histopathological lesions in this brain region. Developmental exposure to a higher dose (460 mg/kg) also induced changes in the expression of S100β, histones, calcium- and calmodulin-binding proteins, and guanine nucleotide-binding proteins. At this dose, severe lesions in the adult hippocampus including neuronal degeneration, cell loss, calcium deposits, and astrogliosis were evident. The data demonstrate subtle, sometimes dose-dependent, but permanent effects of a lower neonatal dose of BMAA in the adult hippocampus suggesting that BMAA could potentially disturb many processes during the development. The detection of BMAA in seafood stresses the importance of evaluating the magnitude of human exposure to this neurotoxin.
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| 5. |
- Lindskog, Annika, 1982, et al.
(författare)
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Melanocortin 1 receptor agonists reduce proteinuria.
- 2010
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Ingår i: Journal of the American Society of Nephrology : JASN. - 1533-3450 .- 1046-6673. ; 21:8, s. 1290-8
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Tidskriftsartikel (refereegranskat)abstract
- Membranous nephropathy is one of the most common causes of nephrotic syndrome in adults. Recent reports suggest that treatment with adrenocorticotropic hormone (ACTH) reduces proteinuria, but the mechanism of action is unknown. Here, we identified gene expression of the melanocortin receptor MC1R in podocytes, glomerular endothelial cells, mesangial cells, and tubular epithelial cells. Podocytes expressed most MC1R protein, which colocalized with synaptopodin but not with an endothelial-specific lectin. We treated rats with passive Heymann nephritis (PHN) with MS05, a specific MC1R agonist, which significantly reduced proteinuria compared with untreated PHN rats (P < 0.01). Furthermore, treatment with MC1R agonists improved podocyte morphology and reduced oxidative stress. In summary, podocytes express MC1R, and MC1R agonism reduces proteinuria, improves glomerular morphology, and reduces oxidative stress in nephrotic rats with PHN. These data may explain the proteinuria-reducing effects of ACTH observed in patients with membranous nephropathy, and MC1R agonists may provide a new therapeutic option for these patients.
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| 6. |
- Persson, Erik, et al.
(författare)
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Cultural Relict Plants in the Nordic Region
- 2014
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Ingår i: Sources to the history of gardening : Four interdisciplinary seminars 2010-2013 arranged by the Nordic Network for the Archaeology and Archaeobotany of Gardening - Four interdisciplinary seminars 2010-2013 arranged by the Nordic Network for the Archaeology and Archaeobotany of Gardening. - 9789187117862 ; 2014:25, s. 299-312
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Bokkapitel (refereegranskat)
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| 7. |
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| 8. |
- Bazzi, Claudio, et al.
(författare)
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Fractional excretion of IgG in idiopathic membranous nephropathy with nephrotic syndrome: a predictive marker of risk and drug responsiveness.
- 2014
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Ingår i: BMC Nephrology. - : Springer Science and Business Media LLC. - 1471-2369. ; 15
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Treatment of idiopathic membranous nephropathy with nephrotic syndrome is still controversial. There is currently little known about the clinical use of renal biomarkers which may explain contradictory results obtained from clinical trials. In order to assess whether IgG-uria can predict the outcome in membranous nephropathy, we examined the value of baseline EF-IgG in predicting remission and progression of nephrotic syndrome. METHODS: In a prospective cohort of 84 (34 female) idiopathic membranous nephropathy patients with nephrotic syndrome we validated the ability of the clinically available urine biomarker, IgG, to predict the risk of kidney disease progression and the beneficial effect of immunosuppression with steroids and cyclophosphamide. The fractional excretion of IgG (FE-IgG) and α1-microglobulin (FE-α1m), urine albumin/creatinine ratio, and eGFR were measured at the time of kidney biopsy. Primary outcome was progression to end stage kidney failure or kidney function (eGFR) decline ≥ 50% of baseline. Patients were followed up for 7.2 ± 4.1 years (range 1-16.8). RESULTS: High FE-IgG (≥ 0.02) predicted an increased risk of kidney failure (Hazard Ratio, (HR) 8.2, 95%CI 1.0-66.3, p=0.048) and lower chance of remission (HR 0.18, 95%CI 0.09-0.38, p<0.001). The ten-year cumulative risk of kidney failure was 51.7% for patients with high FE-IgG compared to only 6.2% for patients with low FE-IgG. During the study, only 24% of patients with high FE-IgG entered remission compared to 90% of patients with low FE-IgG. Combined treatment with steroids and cyclophosphamide decreased the progression rate (-40%) and increased the remission rate (+36%) only in patients with high FE-IgG. CONCLUSION: In idiopathic membranous nephropathy patients with nephrotic syndrome, FE-IgG could be useful for predicting kidney disease progression, remission, and response to treatment.
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| 9. |
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| 10. |
- Berg, Lena, et al.
(författare)
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Avbrott på akutmottagning
- 2011
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Ingår i: 6:e nationella konferensen om patientsäkerhet. - Stockholm.
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Konferensbidrag (refereegranskat)
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| 11. |
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| 12. |
- Berg, Lena M, et al.
(författare)
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An observational study of activities and multitasking performed by clinicians in two Swedish emergency departments
- 2012
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Ingår i: European journal of emergency medicine. - London : Chapman & Hall. - 0969-9546 .- 1473-5695. ; 19:4, s. 246-251
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To explore the type and frequency of activities and multitasking performed by emergency department clinicians.Methods: Eighteen clinicians (licensed practical nurses, registered nurses and medical doctors), six from each occupational group, at two Swedish emergency departments were followed in their clinical work for 2 h each to observe all their activities and multitasking practices. Data were analysed using qualitative and quantitative content analysis.Results: Fifteen categories of activities could be identified based on 1882 observed activities during the 36 h of observation. The most common activity was information exchange, which was most often performed face-to-face. This activity represented 42.1% of the total number of observed activities. Information exchange was also the most common activity to be multitasked. Registered nurses performed most activities and their activities were multitasked more than the other clinicians. The nurses’ and doctors’ offices were the most common locations for multitasking in the emergency department.Conclusion: This study provides new knowledge regarding the activities conducted by clinicians in the emergency department. The most frequent activity was information exchange, which was the activity most often performed by the clinicians when multitasking occurred. Differences between clinicians were found for activities performed and multitasked, with registered nurses showing the highest frequencies for both.
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| 13. |
- Berg, Lena M, et al.
(författare)
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Interruptions in emergency department work : an observational and interview study
- 2013
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Ingår i: BMJ Quality and Safety. - : BMJ. - 2044-5415 .- 2044-5423. ; 22:8, s. 656-663
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Tidskriftsartikel (refereegranskat)abstract
- Objectiv.e Frequent interruptions are assumed to have a negative effect on healthcare clinicians’ working memory that could result in risk for errors and hence threatening patient safety. The aim of this study was to explore interruptions occurring during common activities of clinicians working in emergency departments.Method. Totally 18 clinicians, licensed practical nurses, registered nurses and medical doctors, at two Swedish emergency departments were observed during clinical work for 2 h each. A semistructured interview was conducted directly after the observation to explore their perceptions of interruptions. Data were analysed using non-parametric statistics, and by quantitative and qualitative content analysis.Results. The interruption rate was 5.1 interruptions per hour. Most often the clinicians were exposed to interruptions during activities involving information exchange. Calculated as percentages of categorised performed activities, preparation of medication was the most interrupted activity (28.6%). Face-to-face interaction with a colleague was the most common way to be interrupted (51%). Most common places for interruptions to occur were the nurses’ and doctors’ stations (68%). Medical doctors were the profession interrupted most often and were more often recipients of interruptions induced by others than causing self-interruptions. Most (87%) of the interrupted activities were resumed. Clinicians often did not regard interruptions negatively. Negative perceptions were more likely when the interruptions were considered unnecessary or when they disturbed the work processes.Conclusions. Clinicians were exposed to interruptions most often during information exchange. Relative to its occurrence, preparation of medication was the most common activity to be interrupted, which might increase risk for errors. Interruptions seemed to be perceived as something negative when related to disturbed work processes.
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| 14. |
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| 15. |
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| 16. |
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| 17. |
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| 18. |
- Hogström, Lars, et al.
(författare)
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Quality of life after adopting compared with childbirth with or without assisted reproduction.
- 2012
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Ingår i: Acta Obstetricia et Gynecologica Scandinavica. - Hoboken, USA : John Wiley & Sons Ltd.. - 0001-6349 .- 1600-0412. ; 91:9, s. 1077-1085
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Tidskriftsartikel (refereegranskat)abstract
- Objective. This study compares quality of life among couples who had adopted a child 4–5.5 years previously with couples whose conception was spontaneous, as well as with couples who had successful or unsuccessful in vitro fertilization (IVF) treatment. Design. Cross-sectional study. Setting. Tertiary level university hospital. Sample. From the following groups, 979 responses were obtained: adoption; successful IVF; unsuccessful IVF–living with children; unsuccessful IVF–living without children; and childbirth after spontaneous conception (controls). Methods. Quality of life was studied with the Psychological General Well Being (PGWB) and Sense of Coherence (SOC) instruments. Demographic, socio-economic and health data were obtained with additional questionnaires. Multiple variance analysis was applied. Main outcome measures. The PGWB and SOC scores. Results. After adjustment for seven confounders, the adoption group had higher PGWB scores than the unsuccessful IVF–living without children and the controls and higher SOC scores than all other groups. The unsuccessful IVF–living without children had lower PGWB and SOC scores than all other groups. The PGWB and SOC scores among controls did not differ from those with successful IVF or unsuccessful IVF–living with children. Conclusions. Adjusted PGWB and SOC scores revealed a high quality of life in the adoption group. However, the group unsuccessful IVF–living without children had low quality of life scores. Quality of life appears to be independent of the outcome of IVF treatment as long as there are children in the family.
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| 19. |
- Jangsten, Elisabeth, 1954, et al.
(författare)
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A comparison of active management and expectant management of the third stage of labour: a Swedish randomised controlled trial.
- 2011
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Ingår i: BJOG : an international journal of obstetrics and gynaecology. - : Wiley. - 1471-0528 .- 1470-0328. ; 118:3, s. 362-9
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Tidskriftsartikel (refereegranskat)abstract
- Please cite this paper as: Jangsten E, Mattsson L, Lyckestam I, Hellström A, Berg M. A comparison of active management and expectant management of the third stage of labour: a Swedish randomised controlled trial. BJOG 2011;118:362-369. Objective To compare blood loss in women actively and expectantly managed in the third stage of labour. Design Randomised controlled trial (RCT). Setting Two delivery units at a Swedish university hospital. Population Healthy women with normal pregnancies, at gestational age 34-43weeks, with singleton cephalic presentation and expected vaginal delivery. Methods The women were randomly allocated to either active (n=903) or expectant (n=899) management of the third stage of labour. Main outcome measures The primary outcome was blood loss>1000ml, and secondary outcomes were mean blood loss, duration of third stage, retained placenta, haemoglobin level and blood transfusion. Results Blood loss>1000ml occurred in 10% of the actively managed group and 16.8% of the expectantly managed group (P<0.001). Mean blood loss was 535ml in the actively managed group and 680ml in the expectantly managed group (P<0.001). A prolonged duration of the third stage was associated with increased blood loss. Increased placenta weight was associated with increased blood loss. The haemoglobin level was 118g/dl in actively managed women and 115g/dl in expectantly managed women (P<0.001) the day after childbirth. The occurrence of retained placenta and the number of blood transfusions did not differ between the groups. Conclusions Active management of the third stage of labour was associated with less blood loss compared with expectant management. It is reasonable to advocate this regime, especially in primiparous women.
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| 20. |
- Jangsten, Elisabeth, 1954, et al.
(författare)
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Afterpains : A Comparison Between Active and Expectant Management of the Third Stage of Labor
- 2011
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Ingår i: Birth. - : Wiley-Blackwell. - 0730-7659 .- 1523-536X. ; 38:4, s. 294-301
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Tidskriftsartikel (refereegranskat)abstract
- Background: Management of the third stage of labor, the period following the birth of the infant until delivery of the placenta, is crucial. Active management using synthetic oxytocin has been advocated to decrease blood loss. It has been suggested, but not studied, that oxytocin may increase afterpains. The aim of this study was to compare womens experience of pain intensity when the third stage of labor was managed actively and expectantly and their experience of afterpains. Methods: A single-blind, randomized, controlled trial was performed at two delivery units in Sweden in a population of healthy women with normal, singleton pregnancies, gestational age of 34 to 43 weeks, cephalic presentation, and expected vaginal delivery. Women (n = 1,802) were randomly allocated to either active management or expectant management of the third stage of labor. Afterpains were assessed by Visual Analog Scale (VAS) and the Pain-o-Meter (POM-WDS) 2 hours after delivery of the placenta and the day after childbirth. Results: At 2 hours after childbirth, women in the actively managed group had lower VAS pain scores than expectantly managed women (p = 0.014). Afterpains were scored as more intense the day after, compared with 2 hours after, childbirth in both groups. Multiparas scored more intense afterpains, compared with primiparas, irrespective of management (p < 0.001). Conclusions: Active management of the third stage of labor does not provoke more intense afterpains than expectant management. (BIRTH 38: 4 December 2011)
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| 21. |
- Jangsten, Elisabeth, 1954, et al.
(författare)
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Management of the third stage of labour - focus group discussions with Swedish midwives.
- 2010
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Ingår i: Midwifery. - : Elsevier BV. - 1532-3099 .- 0266-6138. ; 26:6, s. 609-14
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Tidskriftsartikel (refereegranskat)abstract
- Objective to explore Swedish midwives’ experiences of management of third stage of labour. Design six focus group discussions were performed and the analysis was based on content analysis. Setting the midwives worked at six hospitals: three university hospitals and three provincial hospitals located from the south west to the north of Sweden. Participants 32 midwives with extensive experience of assisting women in childbirth. Findings the analysis generated three categories: ‘bring the process under control’, ‘protect normality and women's birthing experiences’ and ‘maintain midwives’ autonomy’. This study demonstrates that management of the third stage of labour varies greatly. Not all midwives were convinced that administration of prophylactic oxytocin in the third stage of labour was always the best alternative for all women who had a normal birth. Key conclusions and implications for practice the midwives exhibited self-confidence in evaluating the physiological process, and endeavoured to leave the physiological process undisturbed if no other risks were apparent. Their decisions concerning third stage management were based on a combination of previous experience, hospital guidelines, risk assessment and sensitivity to each woman's needs. This study demonstrates that management of the third stage of labour varies greatly. The findings show the importance of reaching a balance between treating birth as a normal process and as a biomedical event.
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| 22. |
- Johansson, Marianne, 1951, et al.
(författare)
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Gender perspective on quality of life, comparisons between groups 4-5.5 years after unsuccessful or successful IVF treatment.
- 2010
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Ingår i: Acta obstetricia et gynecologica Scandinavica. - : Wiley. - 1600-0412 .- 0001-6349. ; 89:5, s. 683-91
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To describe and compare quality of life in men and women who had in vitro fertilization (IVF) within the Swedish public health system 4-5.5 years previously, either unsuccessfully and were subsequently living without children, or successfully, having children aged 4-5.5 years. These groups were compared to a control group of men and women with children born at the same time as in the successful group. DESIGN: Cross-sectional study. SETTING: Reproductive Unit, Sahlgrenska University Hospital, Gothenburg, Sweden. SAMPLE: Twenty-six men and 37 women in the unsuccessful group, 135 men and 154 women in the successful group and 93 men and 118 women in the control group. METHODS: Questionnaire study. The respective gender differences were studied in the control and study groups. MAIN OUTCOME MEASURES: Psychological general well-being (PGWB), sense of coherence (SOC), experience of infertility, demographic-socio-economic, and health characteristics. RESULTS: Men in the unsuccessful IVF group scored lower in total PGWB and SOC indices than the successful group men. They reported more depression, lower PGWB and lower SOC than the control group men. Women in the unsuccessful IVF group reported more anxiety, depression, and lower SOC than the successful group women and more depression and lower SOC indices than control group women. Men and women in the unsuccessful IVF group did not differ in any of the parameters. Men in the successful IVF group had higher PGWB, less signs of depression and more self-confidence than women in that group. CONCLUSION: Quality of life in men seems more negatively affected by involuntary infertility than reported in earlier studies.
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| 23. |
- Johansson, Marianne, et al.
(författare)
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Severe male infertility after failed ICSI treatment-a phenomenological study of men's experiences
- 2011
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Ingår i: Reproductive Health. - : BioMed Central Ltd.. - 1742-4755. ; 8:4
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Tidskriftsartikel (refereegranskat)abstract
- Background Male-factor infertility underlies approximately 30% of infertility in couples seeking treatment; of which 10% is due to azoospermia. The development of assisted reproductive technology (ART), enabling the use of epididymal or testicular sperm for fertilization of the partner's oocytes, has made biological fatherhood possible for men with obstructive azoospermia. There is limited knowledge of men's experience of their own infertility. The aim of this study was to describe men's experiences of obstructive azoospermia infertility. Methods Eight men with obstructive azoospermia, who had terminated Swedish public health system ART treatment two years previously without subsequent childbirth, were interviewed using a descriptive phenomenological method. Results The essence of the phenomenon is expressed with a metaphor: climbing a mountain step by step with the aim of reaching the top, i.e. having a child and thus a family with a child. Four constituents are included (1) inadequacy followed by a feeling of redress (2) marginalisation, (3) chivalry (4) extension of life and starting a family as driving forces. Conclusions Knowledge of men's experiences of their own infertility is important as a supporting measure to increase the quality of care of infertile couples. By adopting this facet of gender perspective in fertility treatment guidelines, care can hopefully be optimized.
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| 24. |
- Josefsson, Ulrika, 1965, et al.
(författare)
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Person-centred web-based support - development through a Swedish multi-case study.
- 2013
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Ingår i: BMC medical informatics and decision making. - : Springer Science and Business Media LLC. - 1472-6947. ; 13:1
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Tidskriftsartikel (refereegranskat)abstract
- Departing from the widespread use of the internet in modern society and the emerging use of web applications in healthcare this project captures persons' needs and expectations in order to develop highly usable web recourses. The purpose of this paper is to outline a multi-case research project focused on the development and evaluation of person-centred web-based support for people with long-term illness. To support the underlying idea to move beyond the illness, we approach the development of web support from the perspective of the emergent area of person-centred care. The project aims to contribute to the ongoing development of web-based supports in health care and to the emerging field of person-centred care.Methods/designThe research design uses a meta-analytical approach through its focus on synthesizing experiences from four Swedish regional and national cases of design and use of web-based support in long-term illness. The cases include children (bladder dysfunction and urogenital malformation), young adults (living close to persons with mental illness), and two different cases of adults (women with breast cancer and childbearing women with type 1 diabetes). All of the cases are ongoing, though in different stages of design, implementation, and analysis. This, we argue, will lead to a synthesis of results on a meta-level not yet described.
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| 25. |
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| 26. |
- Karlsson, Oskar, et al.
(författare)
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Early hippocampal cell death, and late learning and memory deficits in rats exposed to the environmental toxin BMAA (β-N-methylamino-l-alanine) during the neonatal period
- 2011
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Ingår i: Behavioural Brain Research. - : Elsevier BV. - 0166-4328 .- 1872-7549. ; 219:2, s. 310-320
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Tidskriftsartikel (refereegranskat)abstract
- We have reported previously that exposure to the cyanobacterial neurotoxin β-N-methylamino-l-alanine (BMAA) during the neonatal period causes cognitive impairments in adult rats. The aim of this study was to investigate the long-term effects of neonatal BMAA exposure on learning and memory mechanisms and to identify early morphological changes in the neonatal brain. BMAA was injected subcutaneously in rat pups on postnatal days 9-10. BMAA (50 and 200mg/kg) caused distinct deficits in spatial learning and memory in adult animals but no morphological changes. No impairment of recognition memory was detected, suggesting that neonatal exposure to BMAA preferentially affects neuronal systems that are important for spatial tasks. Histopathological examination revealed early neuronal cell death as determined by TUNEL staining in the hippocampus 24h after a high dose (600mg/kg) of BMAA whereas no changes were observed at lower doses (50 and 200mg/kg). In addition, there was a low degree of neuronal cell death in the retrosplenial and cingulate cortices, areas that are also important for cognitive function. Taken together, these results indicate that BMAA is a developmental neurotoxin inducing long-term changes in cognitive function. The risk posed by BMAA as a potential human neurotoxin merits further consideration, particularly if the proposed biomagnifications in the food chain are confirmed.
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| 27. |
- Lundblad, Barbro, 1947, et al.
(författare)
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Children's experiences of attitudes and rules for going to the toilet in school.
- 2010
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Ingår i: Scandinavian journal of caring sciences. - : Wiley. - 1471-6712 .- 0283-9318. ; 24:2, s. 219-23
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Tidskriftsartikel (refereegranskat)abstract
- School children often base their toilet habits on behavioural and social reasons. Bladder emptying problems, urinary tract infections and constipation are common health problems which are also associated with irregular toilet habits. School rules for going to the toilet have been shown to create difficulties for school children with bladder dysfunction. Aim of this study was to describe children's experiences of school rules for going to the toilet and their significance for the children.
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| 28. |
- Mériaux, Benita Gunnarsson, et al.
(författare)
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Everyday experiences of life, body and well-being in children with overweight.
- 2010
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Ingår i: Scandinavian journal of caring sciences. - : Wiley. - 1471-6712 .- 0283-9318. ; 24:1, s. 14-23
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND AND AIMS: Childhood overweight is presented as a complex problem to solve. To elaborate efforts required in striving for normal weight in overweight children healthy signs of life from the child's point of view should be identified and promoted. The aim of the present study is to describe everyday experiences of life, body and well-being in children with overweight. METHOD: A qualitative descriptive design based on lifeworld perspective was used in 16 open-ended interviews with overweight children aged 10-12 years. Child overweight was defined by body mass index (kg/m(2)) for each age. Drawings and body pictograms were used to supplement the interviews. Text was analysed using qualitative content analysis. FINDINGS: The primary finding was the respondents' search for a sense of community in daily life. The respondents yearned to be part of a community but spent a lot of time alone. Parents and other family members were an important source of community but were not present enough in the respondents' daily life. The respondents had a sound body image, were concerned about their bodies and were aware of a healthy lifestyle. Nevertheless, they did not manage to implement this awareness in practice. Unhealthy sleeping, eating and exercise habits along with a sense of victimization were revealed in the interviews. Well-being meant self-esteem, trust and satisfaction and was preserved and improved through exciting relationships and activities. Feeling well was equal to feeling capable, feeling happy and feeling a sense of community. DISCUSSION AND CONCLUSIONS: Findings emphasize the problem of loneliness in the children studied. Their healthy signs of life were not promoted in an acceptable way. They spent too much time alone doing sedentary activities with easy access to junk food. Findings indicate they should be provided with company at all meals and during activities on a daily basis.
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| 29. |
- Parding, Karolina, et al.
(författare)
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New conditions for identities, cultures and governance of welfare sector professionals: The teaching profession
- 2012
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Ingår i: Ephemera. - 2052-1499 .- 1473-2866. ; 12:3, s. 294-308
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Tidskriftsartikel (refereegranskat)abstract
- This paper deals with changes in governance of professional work in relation to the concept of professional identity. Professional work is often depicted as an essential part of today’s society. At the same time, the conditions for professional work are changing – especially in the public sector. These changes can be seen in terms of an on-going interaction between the logic of the profession and the logic of the organisation where the concept of identity can be used to examine the dynamics of the changes and their consequences. In thispaper, the teaching profession is used to illustrate changing conditions for professional work in the public sector. We identify processes of diversification of professional identity and culture, some of which can be described as processes of marginalization. This approach can provide a theoretical point of departure for studying professional work – in the context of changed governance – by focusing on the concept of identity as an analytical point of reference. This approach explains organizational dynamics in terms of what changes are desired and what changes are unintentional.
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| 30. |
- Premberg, Åsa, 1955, et al.
(författare)
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Father for the first time - development and validation of a questionnaire to assess fathers' experiences of first childbirth (FTFQ).
- 2012
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Ingår i: BMC pregnancy and childbirth. - : Springer Science and Business Media LLC. - 1471-2393. ; 12:1
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Tidskriftsartikel (refereegranskat)abstract
- ABSTRACT: BACKGROUND: A father's experience of the birth of his first child is important not only for their birth-giving partner but also for the father himself, his relationship with the mother and the newborn. No validated questionnaire assessing first-time fathers' experiences during childbirth is currently available. Hence, the aim of this study was to develop and validate an instrument to assess first-time fathers' experiences of childbirth. METHOD: Domains and items were initially derived from interviews with first-time fathers, and supplemented by a literature search and a focus group interview with midwives. The comprehensibility, comprehensiveness and relevance of the items were evaluated by four paternity research experts and a preliminary questionnaire was pilot tested in eight first-time fathers. A revised questionnaire was completed by 200 first- time fathers (response rate = 81%) Exploratory factor analysis using principal component analysis with varimax rotation was performed and multitrait scaling analysis was used to test scaling assumptions. External validity was assessed by means of known-groups analysis. RESULTS: Factor analysis yielded four factors comprising 22 items and accounting 48% of the variance. The domains found were Worry, Information, Emotional support and Acceptance. Multitrait analysis confirmed the convergent and discriminant validity of the domains; however, Cronbach's alpha did not meet conventional reliability standards in two domains. The questionnaire was sensitive to differences between groups of fathers hypothesized to differ on important socio demographic or clinical variables CONCLUSIONS: The questionnaire adequately measures important dimensions of first-time fathers' childbirth experience and may be used to assess aspects of fathers' experiences during childbirth. To obtain the FTFQ and permission for its use, please contact the corresponding author.
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| 31. |
- Premberg, Åsa, 1955, et al.
(författare)
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First time fathers´experiences of childbirth
- 2010
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Ingår i: Book of Abstracts. The 18th Congress of the Nordic Federation of Midwives June 2010..
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Konferensbidrag (refereegranskat)abstract
- A description of first time fathers´experience of childbirth
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| 32. |
- Premberg, Åsa, 1955, et al.
(författare)
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First-time Fathers’ Experiences of Childbirth
- 2011
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Ingår i: Book of abstracts, ICM 29th Triennial Congress. International Confederation of Midwives. Durban 18-23 June 2011. ; :ICM 29th Triennial Congress. International Confede
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Konferensbidrag (refereegranskat)abstract
- Abstract for oral presentation at ICM 29th Triennial Congress Durban, South Africa 19 - 23 June 2011 Title: First- time Fathers’ Experiences of Childbirth- a Phenomenological Study. Name and title of all authors: Åsa Premberg; RNM, MSc, Doctoral student, Gunilla Carlsson , RN, PhD, Associate Professor; Anna-Lena Hellström; RN, Phd, Professor ,Marie Berg; RNM, MNSc, MPH, PhD, Associate Professor Contact e-mail: asa.premberg@gu.se Background and Aim: Fathers have become routine participants during labor and delivery, but since the fathers entered the delivery room in the 1970s, their positions have been ambiguous. The aim of the study was to describe fathers’ experiences during childbirth including caregivers’ support. Setting: The study was performed in the Southwest area of Sweden during the autumn 2008. Ten fathers were located at two hospitals and interviewed 4-6 weeks after the childbirth. Ethical approval was obtained from the Regional Ethical Review Board in Gothenburg Methods: A qualitative method with phenomenological life world approach was chosen. The interviews were guided by a re-enactment method and carried out and analyzed in accordance with Dahlberg (2008). Preliminary results: First-time fathers’ experienced childbirth as a mutually shared process for the couple. This means that the man, in cooperation with the midwife, is highly involved in childbirth with engagement in the process of support and care to the woman in her suffering. However, experience of the woman’s pain, fear of the unknown combined with the gendered preconceptions of masculine hegemony can be hard to bear for the father to be. To maintain and strengthen childbirth as a mutually shared experience for the couple, the father needs to be recognised and supported as a parent to be. Midwives and other caregivers have to acknowledge the fathers role as valued participant, but also support a significant position for the father. Further results, discussion and conclusions are going to be presented at the congress. Keywords. First time Fathers, Childbirth, Experience, Support,
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| 33. |
- Premberg, Åsa, 1955, et al.
(författare)
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First-time fathers' experiences of childbirth-A phenomenological study.
- 2011
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Ingår i: Midwifery. - : Elsevier BV. - 1532-3099 .- 0266-6138. ; 27:6, s. 848-853
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: to describe fathers' experiences during childbirth. DESIGN: qualitative method with phenomenological lifeworld approach. A re-enactment interview method, with open-ended questions analysed with a phenomenological method, was used. PARTICIPANTS AND SETTING: 10 first-time fathers from two hospitals were interviewed four to six weeks after childbirth in Southwest Sweden during the autumn of 2008. FINDINGS: the essential meaning of first-time fathers' lived experience of childbirth was described as an interwoven process pendulating between euphoria and agony. The four themes constituting the essence was: 'a process into the unknown', 'a mutually shared experience', 'to guard and support the woman' and 'in an exposed position with hidden strong emotions'. KEY CONCLUSIONS: childbirth was experienced as a mutually shared process for the couple. The fathers' high involvement in childbirth, in cooperation with the midwife, and being engaged in support and care for his partner in her suffering is fulfilling for both partners, although the experience of the woman's pain, fear of the unknown and the gendered preconceptions of masculine hegemony can be difficult to bear for the father-to-be. IMPLICATIONS FOR PRACTICE: in order to maintain and strengthen childbirth as a mutually shared experience for the couple, the father needs to be recognised and supported as a parent-to-be. Midwives have to acknowledge fathers as valued participants and support their significant position.
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| 34. |
- Skärsäter, Ingela, 1952, et al.
(författare)
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Web-based learning and support – a person-centred care approach in long-term illness.
- 2012
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Ingår i: Scandinavian Conference on Health Informatics.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- The poster outlines a research project that aims to develop and evaluate a person-centred model of web-based learning and support for people with long-term illness. Departing from the widespread use of the internet in modern society and the emerg-ing use of web interventions in healthcare 1-3 the multi-case project captures persons’ needs and expectations in order to develop highly usable web recourses. To support the underly-ing idea to move beyond the illness, we approach the develop-ment of web support from the perspective of the emergent area of person-centred care (PCC).
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| 35. |
- Skärsäter, Ingela, 1952-, et al.
(författare)
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Web-based Support in Long-term Illness – a Person-centred Care Approach
- 2013
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Konferensbidrag (refereegranskat)abstract
- Introduction: The abstract outlines a research project that aims to develop and evaluate a person-centred model of web-based learning and support for people with long-term illness. Departing from the widespread use of the internet in modern society and the emerging use of web applications in healthcare the multi-case project captures persons’ needs and expectations in order to develop highly usable web recourses. To support the underlying idea to move beyond the illness, we approach the development of web support from the perspective of the emergent area of person-centred care (PCC).Methods: The research design uses a meta-analytical approach through its focus on synthesizing experiences from four Swedish regional and national cases of design and use of web-based support in long-term illness. The cases include children (bladder dysfunction and uro-genital malformation), young adults (living close to persons with mental illness), and two different cases of adults (women with breast cancer and childbearing women with type 1 diabetes). All of the cases are ongoing, though in different stages of design, implementa-tion, and analysis. An inductive approach characterizes the analysis of the results of the cases. By means of a step-wise analysis a shared knowledge and understanding of each separate case is created followed by the development of central categories (such as types of needs and expectations, types of theories, conceptual framework, etc).Results: To allow valid comparisons between the four cases we explore and problematize them in relation to four main aspects: 1) The use of people’s experiences and needs; 2) The role of use of theories in the design of person-centred web-based supports; 3) The evaluation of the effects of health outcomes for the informants involved and 4) The development of a generic person-centred model for learning and social support for people with long-term illness and their significant others.Discussion and Conclusion: Person-centred web-based support is a new area and no available study focus on how web-based interventions can contribute to the further development of PCC. In the four cases within this project the evaluation model is characterized by evaluation of web support in real settings, and data will be analysed using both within-case and across-case statistical analyses. Therefore, our multiple-case method, in which overlapping results from different contexts will provide comprehensive experiences, will contribute to the design of a more generally applicable, individually modifiable model. However, the multiple case method is also a challenge of validity, as the use of different case experiences and environments, involves an endeavor to understand what types of experiences are actually being captured in the process of developing a web-based support and what this means in relation to PCC. In summary, the main intention of the project outlined here is to contribute with both a synthesis of results on meta-level from four cases and a substantial contribution to the field person centred care.
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| 36. |
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| 37. |
- Sparud-Lundin, Carina, 1964-, et al.
(författare)
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Use of participatory design in the development of person-centred web-based support for persons with long-term illness
- 2013
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Ingår i: European Journal for Person Centered Healthcare. - Buckingham, UK : University of Buckingham Press. - 2052-5648 .- 2052-5656. ; 1:2, s. 369-380
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Tidskriftsartikel (refereegranskat)abstract
- Background: E-health solutions are increasingly being developed to meet patients’ preferences and promote their participation in healthcare. Few studies have explored the participatory design process from the perspective of person-centeredness, including how it becomes materialized in technology. This paper explores how applied participatory approaches and the design of 4 web-based interventions directed towards long-term illness correspond to key areas of person-centeredness. Methods: Data were collected during 2009 to 2012, from 4 Swedish research projects. The analysis followed an inductive approach involving a step-wise cross-case analysis. The purpose was to create shared knowledge and understanding of each separate case and to generate relevant categories.Results: A number of question areas describe the dialogue with the case participants. Results of the dialogue are categorized into 4 support areas: psychological/emotional, personal, information and technical. Person-centeredness becomes visible in the participatory design process as the approach promotes the development of a holistic view of the person and the illness and a partnership between patients and carers. The use of communication technology exemplifies concrete materialization of person-centeredness in the design of the web-based supports. The purpose of the web supports and the shaping of the actual use of the functionalities are more abstract forms of materialization.Conclusions: Our results contribute to a central development area within eHealth involving increased opportunities for patients to contribute actively in real time, obtaining access to information and sometimes interacting with carers. However, neither participatory approaches nor technology for online information and communication, can guarantee person-centeredness in isolation.
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| 38. |
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| 39. |
- Wigert, Helena, 1960, et al.
(författare)
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Parental presence when their child is in neonatal intensive care.
- 2010
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Ingår i: Scandinavian journal of caring sciences. - : Wiley. - 1471-6712 .- 0283-9318. ; 24:1, s. 139-46
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Tidskriftsartikel (refereegranskat)abstract
- When a newborn baby needs care in a neonatal intensive care unit (NICU), the parents are welcome to stay with their child whenever they wish. The aim of the present study was to investigate the time per day parents are present together with their child at the NICU and to identify factors that facilitated and obstructed their presence.
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