his.sePublikasjoner
Endre søk
Begrens søket
2122232425 1151 - 1200 of 1212
RefereraExporteraLink til resultatlisten
Permanent link
Referera
Referensformat
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Annet format
Fler format
Språk
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Annet språk
Fler språk
Utmatningsformat
  • html
  • text
  • asciidoc
  • rtf
Treff pr side
  • 5
  • 10
  • 20
  • 50
  • 100
  • 250
Sortering
  • Standard (Relevans)
  • Forfatter A-Ø
  • Forfatter Ø-A
  • Tittel A-Ø
  • Tittel Ø-A
  • Type publikasjon A-Ø
  • Type publikasjon Ø-A
  • Eldste først
  • Nyeste først
  • Skapad (Eldste først)
  • Skapad (Nyeste først)
  • Senast uppdaterad (Eldste først)
  • Senast uppdaterad (Nyeste først)
  • Disputationsdatum (tidligste først)
  • Disputationsdatum (siste først)
  • Standard (Relevans)
  • Forfatter A-Ø
  • Forfatter Ø-A
  • Tittel A-Ø
  • Tittel Ø-A
  • Type publikasjon A-Ø
  • Type publikasjon Ø-A
  • Eldste først
  • Nyeste først
  • Skapad (Eldste først)
  • Skapad (Nyeste først)
  • Senast uppdaterad (Eldste først)
  • Senast uppdaterad (Nyeste først)
  • Disputationsdatum (tidligste først)
  • Disputationsdatum (siste først)
Merk
Maxantalet träffar du kan exportera från sökgränssnittet är 250. Vid större uttag använd dig av utsökningar.
  • 1151.
    Warrén Stomberg, Margareta
    Högskolan i Skövde, Institutionen för vård och natur. Institute of Health and Care Sciences, The Sahlgrenska Academy at Göteborg University, Göteborg, Sweden.
    Guest at Hospice: Time for Consideration2009Inngår i: The American Journal of Hospice and Palliative Medicine, ISSN 1049-9091, Vol. 26, nr 4, s. 277-280Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    This study focuses on daily life situation of terminally ill guests residing at a hospice. In the study, interviews were conducted with 9 such guests. Data were analyzed using a method similar to content analysis. Categories emerged that were related to aspects regarding as external and internal essentials for the well-being of the individual at the hospice. These essentials were as follows: encouragement from the staff, the alleviation of pain, a pleasant and calm atmosphere at the hospice, the significance of visits from relatives, the regret of not being able to take care of oneself, and time to reconcile to one's life. These results not only show the need for close community with both family and staff but also the need for privacy to reflect on life.

  • 1152.
    Warrén Stomberg, Margareta
    et al.
    Högskolan i Skövde, Institutionen för vård och natur. The Sahlgrenska Academy, University of Gothenburg, Sweden.
    Nilsson, Kerstin
    Högskolan i Skövde, Institutionen för vård och natur. The Sahlgrenska Academy, University of Gothenburg, Sweden.
    Nursing Students' Self-Graded Motivation to Complete their Programme of Study2010Inngår i: Open Nursing Journal, ISSN 1874-4346, E-ISSN 1874-4346, Vol. 4, s. 42-47Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The aim of this study was to explore variation in nursing students’ motivation to complete their programme of study,  as  well  as  factors  relating  to  low  versus  high  motivation  and  students’  opinions  of  what  would  increase  their motivation to complete their programme of study. A study was carried out between April 2006 and December 2007. A total of 872 students registered in a 3-year nursing programme  randomly  participated  in  self-rating  their  motivation  score  once  each  semester.  Descriptive  statistics, statistical calculations and content analysis regarding open-ended questions were performed. Most of the students, 73%, rated their motivation as ≥6 on a 0-10 Likert scale; and 16% gave a rating of ≤4. The desire to become  a registered nurse (RN)  and having  a positive  attitude towards the  studies were  the main factors influencing high motivation to complete the programme of study. Having a negative attitude towards the studies was an explanation of decreased motivation. There was a significant decrease (p=0.001) in the motivation score with respect to number of semesters, and motivation increased with the student’s age (p=0.0119). Suggestions for increasing motivation given by those who rated their motivation as ≤4 mainly focused on improvements in didactics and study organisation.

  • 1153.
    Warrén Stomberg, Margareta
    et al.
    Högskolan i Skövde, Institutionen för vård och natur.
    Tronstad, Svein - Erik
    Skaraborgs Hosp Skövde, Dept Obstet & Gynecol, SE-54185 Skövde, Sweden.
    Hedberg, Karin
    Department of Health Employment, Hälsan och arbetslivet, Skövde, Sweden.
    Bengtsson, Jan
    Högskolan i Skövde, Institutionen för vård och natur.
    Jonsson, Peter
    Högskolan i Skövde, Institutionen för vård och natur.
    Johansen, Lars
    Skaraborgs Hosp Skövde, Dept Surg, SE-54185 Skövde, Sweden.
    Lindvall, Birgitta
    Högskolan i Skövde, Institutionen för vård och natur.
    Work-related musculoskeletal disorders when performing laparoscopic surgery.2010Inngår i: Surgical laparoscopy, endoscopy & percutaneous techniques, ISSN 1530-4515, E-ISSN 1534-4908, Vol. 20, nr 1, s. 49-53Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aim: The aim of this study was to survey the occurrence of musculoskeletal disorders in the population of gynecologists and general surgeons performing laparoscopic surgery.

    Methods: A questionnaire was distributed to 558 general surgeons and gynecologists and 378 were answered (68%). Descriptive data analysis and statistical calculations were performed.

    Results: One or more disturbing symptoms were common among laparoscopists. More than 70% of the laparoscopists had one or more symptom. Pain was the most common symptom followed by fatigue and stiffness. Lower back, neck, and shoulders were most frequently affected. Headache and visual discomfort were also reported. Longer workload over time and ageing resulted in significantly more disorders (P<0.01). Female physicians had significantly more disorders (P<0.01).

    Conclusions: This study revealed musculoskeletal disorders in a majority of laparoscopists. The laparoscopic technique often requires static and tiring work positions, sometimes extreme, which can explain musculoskeletal disorders among general surgeons and gynecologist.

  • 1154.
    Warrén-Stomberg, Margareta
    Högskolan i Skövde, Institutionen för vård och natur.
    Observation vid anestesi ger viktig kunskap2006Inngår i: Vårdfacket, ISSN 0347-0911, Vol. 30, nr 3, s. 55-56Artikkel i tidsskrift (Annet (populærvitenskap, debatt, mm))
  • 1155.
    Warrén-Stomberg, Margareta
    Högskolan i Skövde, Institutionen för vård och natur.
    Postoperativ smärta2005Inngår i: Incitament, ISSN 1103-503X, Vol. 14, nr 2, s. 211-213Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Trots att det idag finns kraftfulla och skonfulla läkemedel, tekniker och kunskap som möjliggör smärtlindring, upplever omkring 50% av patienterna moderat till svår smärta efter operation. Akut smärta efter kirurgisk intervention kan utlösa ogynnsamma effekter. Det är med andra ord fortfarande angeläget att vidareutveckla den postoperativa smärthanteringen. Denna avhandling fokuserar på möjligheter att optimera smärthanteringen efter operation.

  • 1156.
    Warrén-Stomberg, Margareta
    Högskolan i Skövde, Institutionen för vård och natur.
    Postoperative pain management: Nurse perspectives on acute pain services2004Doktoravhandling, med artikler (Annet vitenskapelig)
    Abstract [en]

    Postoperative pain management (POPM) has remained an area of concern despite major efforts to improve pain assessment and management by the introduction of specified guidelines, advanced techniques for pain alleviation, and education of staff members. Different nurse specialists are involved in the perioperative care of surgical patients. It is still not known to what extent the specific information noted by the nurses about the individual surgical patient at the different steps of the perioperative management is taken into consideration so that a potentially more optimal, individualised POPM as part of acute pain services (APS) can be provided.

    The aims of the present study were to assess if information of potential value for the POPM is noted by nurse anaesthetists involved in the perioperative management of surgical patients and to what extent such information could be of value for an individualised POPM of surgical patients and if nurse involvement is of importance for the adequacy and efficacy of POPM routines in a nurse-based, anaesthesiologist-supervised acute pain service (APS) model on surgical wards.

    Semistructured interviews of nurse anaesthetists (n=40), questionnaire responses of staff members (n=375)/surgical patients (n=110) and assessment of medical records (n=135)/database data (n=222) were included for evaluation of factors of importance in the perioperative care and POPM of surgical patients. Descriptive statistics, non-parametric and parametric tests were used for the analysis of the data.

    It was found that nurse anaesthetists continuously monitor different stress evoked physiological signs induced by surgical interventions during general anaesthesia. Nurses considered the signs indicative of pain evoked stimuli and/or insufficient depth of anaesthesia. The intraoperative information of the response pattern and anaesthetic drug requirements of the individual patient noted by the nurse anaesthetist was considered at present not to be routinely taken into consideration but could be a successful strategy in an optimal multi-professional approach to postoperative pain management. The introduction of APS, using a nurse-based anaesthesiologist-supervised model, resulted in more adequate pain management routines, better patient satisfaction with information about POPM, and increased confidence in pain management among nurses on the surgical wards than was noted for the outcome data for the hospital not having introduced such an APS model. Database documentation of outcome measures of POPM for patients receiving postoperative epidural analgesia was found to provide valuable information about the adequacy of the POPM. The feedback of information from the anaesthesia services to the surgical ward nurses was found not to be efficient enough to make ward nurses properly aware of the importance of their own direct involvement in the documentation process of POPM and that such involvement could further optimise POPM outcome

  • 1157.
    Warrén-Stomberg, Margareta
    Högskolan i Skövde, Institutionen för vård och natur.
    Postoperative pain management: Nurse perspectives on acute pain services2005Inngår i: Smärta, ISSN 1402-1048, Vol. 10, nr 1, s. 5-6Artikkel i tidsskrift (Annet (populærvitenskap, debatt, mm))
  • 1158.
    Warrén-Stomberg, Margareta
    Högskolan i Skövde, Institutionen för vård och natur.
    Specialistsjuksköterskan viktig för nyopererades smärtlindring2005Inngår i: Perspektiv på högskolan i Skövde, ISSN 1653-8242, Vol. 1, nr 2, s. 16-17Artikkel i tidsskrift (Annet (populærvitenskap, debatt, mm))
    Abstract [en]

    Det är viktigt med kontinuerlig kommunikation mellan all personal som bedömer, behandlar och dokumenterar patientens smärta i samband med kirurgi. Här har specialistsjuksköterskan en viktig roll för att föra information om patienten vidare. Det visar en avhandling från Sahlgrenska akademin.

  • 1159.
    Warrén-Stomberg, Margareta
    et al.
    Högskolan i Skövde, Institutionen för vård och natur.
    Haljamäe, Hengo
    Department of Anaesthesiology and Intensive Care, Sahlgrenska University Hospital, Göteborg.
    Postoperative pain management: impact of quality assurance and audit documentation on clinical outcome2003Inngår i: Current Anaesthesia & Critical Care, ISSN 0953-7112, Vol. 14, nr 5-6, s. 217-221Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Progress in postoperative clinical pain assessment and management is not only dependent on optimal choice of analgesic drugs and techniques but also of quality assurance of the clinical routines, i.e. the overall organization of the acute pain services. Proper revision of present routines on the basis of accepted quality assurance standards and practice guidelines on pain management is an essential part of improved postoperative pain management. The present survey reflects the impact of organizational revision of pain management routines on the audit of pain management and on the attitudes of staff members involved in the acute pain service. Monitoring and documentation of relevant audit variables are essential and such outcome variables should continuously be analysed and constitute a feedback channel between all staff members involved in the APS so that remaining problems can be identified and properly managed

  • 1160.
    Warrén-Stomberg, Margareta
    et al.
    Högskolan i Skövde, Institutionen för vård och natur.
    Lorentzen, Per
    Skaraborgs Hospital, Skövde, Sweden.
    Joelsson, Håkan
    Skaraborgs Hospital, Skövde, Sweden.
    Lindquist, Helene
    Skaraborgs Hospital, Skövde, Sweden.
    Haljamäe, Hengo
    Sahlgrenska University Hospital, Göteborg, Sweden.
    Postoperative pain management on surgical wards: impact of database documentation of anesthesia organized services2003Inngår i: Pain Management Nursing, ISSN 1524-9042, E-ISSN 1532-8635, Vol. 4, nr 4, s. 155-164Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Postoperative pain management (POPM) should be based on an organization exploiting existing expertise and documenting the outcome of the POPM in each individual patient. The aims of the present study were to evaluate the adequacy of database documentation of POPM of an anesthesia organized, nurse-based, anesthesiologist-supervised acute pain service (APS) on surgical wards and to assess to what extent the information obtained was continuously used to improve practice. From 2890 registered cases in the database (patient controlled analgesia, n = 1975; epidural analgesia [EDA], n = 915), a homogeneous two-year sample of documentation charts from use of EDA for POPM in connection with major, open, abdominal surgical procedures (n = 381) was chosen for detailed analysis. The data charts contained information on patient data, drug dosage, total amount of infused drug, duration of EDA treatment, occurrence of side effects, and patient’s level of satisfaction. The database information was easily accessible making assessment of relevant aspects of the routines, including associations between analgesic technique, patient related factors, and satisfaction with the services, immediately available. Only 58% of the data charts were properly completed and fed into the database but the clinical safety of the missing nondatabase documented sample was not found jeopardized. Although the database documentation routines were considered to fulfill basic requirements of data collection and monitoring of the appropriateness of POPM, they were not found to function optimally. The reason seemed to be inadequate feedback of information between the parties involved in the POPM services. The present study stresses the importance of establishing routines for adequate, continuous feedback of recorded audit data from the APS team to the surgical wards for the maintenance of a high level of compliance with accepted guidelines.

  • 1161.
    Warrén-Stomberg, Margareta
    et al.
    Högskolan i Skövde, Institutionen för vård och natur.
    Segerdahl, M.
    Karolinska Institutet.
    Rawal, N.
    Örebro University Hospital.
    Jakobsson, J.
    Karolinska Institutet.
    Brattwall, M.
    Sahlgrenska University Hospital, Gothenburg.
    Clinical Practice and Routines for Day Surgery in Sweden: Implications for Improvement in Nursing Interventions2008Inngår i: Journal of Perianesthesia Nursing, ISSN 1089-9472, E-ISSN 1532-8473, Vol. 23, nr 5, s. 311-320Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The purpose of this study was to examine nursing practice in day surgery settings in Sweden. A questionnaire focusing on the routines of the day surgery process of patients in Sweden was administered. Based on these findings, appropriate nursing interventions are outlined and discussed. Day surgery routines were in accordance with general worldwide practice. The study revealed that nursing involvement was rare in the preoperative routine. In addition, the major part of the recovery process, including assessments of discharge eligibility and information about pain management, was managed by PACU nurses. The nurse follow-up revealed a number of subjective queries and symptoms that, in a seemingly easy way, could have been prevented by further perianesthesia/perioperative patient education. There is an obvious place for nursing interventions when the decision for day surgery is taken. These interventions should focus on providing the patient with information before surgery, preoperative patient health screening, and information/education at discharge. Furthermore, nursing interventions should include quality assurance, such as follow-up calls for the evaluation of care, as well as providing information and coaching for the patient at home.

  • 1162.
    Warrén-Stomberg, Margareta
    et al.
    Högskolan i Skövde, Institutionen för vård och natur.
    Sjöström, Björn
    Högskolan i Skövde, Institutionen för vård och natur.
    Haljamae, Hengo
    Routine intra-operative assessment of pain and/or depth of anaesthesia by nurse anaesthetists in clinical practice2001Inngår i: Journal of Clinical Nursing, ISSN 1365-2702, Vol. 19, nr 4, s. 429-436Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    • Patient safety and comfort during general anaesthesia and surgery are to a considerable extent dependent on the capability of anaesthesia personnel to interpret directly monitored as well as indirect clinical signs of pain and/or depth of anaesthesia.

    • The aim of the present study was to evaluate how nurse anaesthetists in their clinical routine work assess and interpret intra-operative responses evoked by pain stimuli and/or insufficient depth of anaesthesia.

    • A questionnaire was designed to assess the perceived relevance and validity of cardiovascular, respiratory, mucocutaneous, eye-associated, and muscular responses for routine assessment of intra-operative pain and/or insufficient depth of anaesthesia in patients undergoing surgery under general anaesthesia.

    • Data were obtained from 223 nurse anaesthetists working at nine different university anaesthesia departments in Sweden.

    • A number of significant indicators for pain and depth of anaesthesia could be identified for spontaneously breathing as well as for mechanically ventilated patients. No variable was considered entirely specific for either intra-operative pain or depth of anaesthesia. Changes in breathing rate/volume, central haemodynamics (BP, HR), lacrimation, and presence of moist and sticky skin were given higher score values as indicators of pain than as indicators of depth of anaesthesia. Occurrence of grimaces, attempted movements, and presence of non-centred pupils were variables considered more indicative of insufficient depth of anaesthesia than intra-operative pain.

    • In conclusion, it is obvious from the present data that indirect physiological signs of intra-operative pain and depth of anaesthesia are still considered of importance by Swedish anaesthesia nurses in the anaesthetic management of surgical patients.

  • 1163.
    Warrén-Stomberg, Margareta
    et al.
    Högskolan i Skövde, Institutionen för vård och natur. University of Göteborg.
    Sjöström, Björn
    Högskolan i Skövde, Institutionen för vård och natur.
    Haljamäe, Hengo
    Sahlgrenska University Hosptial, University of Göteborg.
    The role of the nurse anesthetist in the planning of postoperative pain management2003Inngår i: AANA Journal, ISSN 0094-6354, Vol. 71, nr 3, s. 197-202Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Adequate pain relief after surgery is essential for avoiding pain-associated stress and patient comfort in the postoperative period. The Swedish nurse anesthetist has an important role in the intraoperative management of the surgical patient by assessing and moderating individual physiological response evoked by surgical stimuli during general anesthesia. The extent to which knowledge of specific individual response patterns are used to plan postoperative pain management is unknown. The aim of the present study was to assess the role of the nurse anesthetist in planning early postoperative pain management for surgical patients. Nurse anesthetists (N = 101) at 4 academic hospitals in Sweden responded to a questionnaire focusing, in addition to demographic data, on intraoperative routines for postoperative pain management, perceived clinical relevance of used routines, personal involvement (in addition to existing routines) in postoperative pain management, factors influencing pain alleviation requirements, and the potential role of the nurse anesthetist for improved postoperative pain management. We found that type of anesthesia and type of surgical procedure were both factors considered important for postoperative pain management. A majority of the participants believed that pain management approaches were not appropriately individualized to the patient.

  • 1164.
    Warrén-Stomberg, Margareta
    et al.
    Högskolan i Skövde, Institutionen för vård och natur.
    Wickström, Kerstin
    Sahlgrenska University Hospital, Göteborg, Sweden.
    Joelsson, Håkan
    Högskolan i Skövde, Institutionen för vård och natur. Skaraborgs Hospital, Skövde, Sweden.
    Sjöström, Björn
    Högskolan i Skövde, Institutionen för vård och natur. Sahlgrenska University Hospital, Göteborg, Sweden.
    Haljamäe, Hengo
    Sahlgrenska University Hospital, Göteborg, Sweden.
    Postoperative pain management on surgical wards: do quality assurance strategies result in long-term effects on staff member attitudes and clinical outcomes?2003Inngår i: Pain Management Nursing, ISSN 1524-9042, E-ISSN 1532-8635, Vol. 4, nr 1, s. 11-22Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Postoperative pain management (POPM) remains suboptimal on surgical wards in many countries despite the availability of effective analgesics, new technologies for drug administration, and clinical practice guidelines for pain management. The aim of the present study was to assess remaining long-term effects on pain management routines, patient experiences, and staff member attitudes in surgical wards more than 3 years after introduction of a quality assurance program for POPM and compare the findings to those of an organization where a corresponding systematic, entire hospital, quality assurance program had not been completed. A descriptive and comparative design, based on survey data from both patients (N = 110) and staff members (N = 51) on urologic surgery wards, was used. Significant (p < .05 to p < .0002) overall relationships were observed for identified shortages in pain management routines (lack of preoperative information, inadequate preoperative discussions on pain management, wait for pain killer) and reported experience of pain, nausea, or vomiting in the postoperative period. The quality assurance program, anesthesia-based pain services using a nurse-based anesthesiologist-supervised model, resulted in more adequate pain management routines, better patient satisfaction with POPM, and increased confidence in pain management among nurses on the surgical wards. On the basis of the present study it may be concluded that more than 3 years after the introduction of a quality assurance program for POPM in surgical wards, the pain management routines, patient experiences, and staff member attitudes have remained markedly improved and in accordance with the aims of accepted clinical practice guidelines for surgical pain management.

  • 1165.
    Warrén-Stomberg, Margareta
    et al.
    Högskolan i Skövde, Institutionen för vård och natur.
    Öhman, Ulla-Britt
    Surgical Department, Hospital of Falköping, Sweden.
    Patients undergoing total hip arthroplasty: a perioperative pain experience2006Inngår i: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 15, nr 4, s. 451-458Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aim. The aim was to evaluate patient’s perioperative pain experience after total hip replacement and patients’ satisfaction with pain management.

    Background. Total hip arthroplasty is a common surgical procedure intended to reduce pain and return patients to better function. Realistic expectations about total hip arthroplasty is important for optimal postoperative recovery and the information must be adapted to fit the individual patient.

    Methods. A descriptive design was used comparing patients outcome data. Pitman’s test was used for statistical analyses. Adult patients (n ¼ 112) undergoing surgical hip replacement procedures answered a 17-item questionnaire on the fourth postoperative day. The questionnaire included given alternatives and visual analogue scales (0–100 mm) for the pain assessment.

    Result. The patients’ postoperative pain experience after hip replacement surgery was in average low, 33Æ1 mm on a 100 mm visual analogue scale. Patient’s pain experience was reported to be highest on the first postoperative day for most of the patients. The preoperative pain experience tends to be higher than the postoperative

    pain experience. Older patients reported less average pain level postoperatively. Satisfaction with pain management was high.

    Conclusion. The pain experience tends to be higher preoperatively than postoperatively. Patients who reported a higher pain experience postoperatively reported that their pain experience was significant higher than preoperative expected.

    Relevance to practice. It is important for the postoperative outcome measure that the patients have a realistic expectation of pain experiences after total hip arthroplasty. The nurse is one of the staff members responsible for information to the individual patient.

  • 1166.
    Warzecha, Tomasz
    et al.
    University of Agriculture, Kraków, Poland.
    Lundh, Dan
    Högskolan i Skövde, Institutionen för vård och natur. Högskolan i Skövde, Forskningscentrum för Systembiologi.
    Mandal, Abul
    Högskolan i Skövde, Institutionen för vård och natur. Högskolan i Skövde, Forskningscentrum för Systembiologi.
    Effect of Fusarium culmorum infection on survivability of a T-DNA tagged mutant of Arabidopsis thaliana harboring a mutation in the peptide transporter gene At5g460502011Inngår i: Biotechnologia: Journal of Biotechnology, Computational Biology and Bionanotechnology, ISSN 0860-7796, Vol. 92, nr 1, s. 77-84Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Previously, we have reported a T-DNA tagged mutant (TAG_009) of Arabidopsis thaliana exhibiting a significant sensitivity to biotic stresses. We have also cloned and analyzed the tagged gene At5g46050. Based on bioinformatic and molecular characterization, we proposed that At5g46050 is involved in the transport of peptides participating in plant defense against biotic stresses. To provide further evidence for supporting our proposal, this time we exposed this mutant to Fusarium culmorum, a potential fungal pathogen. Besides TAG_009 line, in our investigations we included two SALK insertion mutants (SALK_003119 and SALK_145209), two wild-type ecotypes (WT_C24 and WT_Col-0) and an additional T-DNA tagged mutant (TAG_197-6) of A. thaliana. We have found that the highest degree of leaf damage was exhibited by TAG_009 line (damage score 4.37), whereas the lowest was observed in WT_Col-0 ecotype (damage score 3.43). The highest rate of mortality after eight weeks of inoculation with F. culmorum was also observed in TAG_009 line (85.24%), while the lowest was in WT_Col-0 line (37.22%). We have also found that plants of SALK_145209 line, despite being infected with Fusarium, produced the highest number of leaves (average 14.17 leaves per plant), whereas the lowest number of leaves was produced by plants of TAG_197-6 line ( average 9.5 leaves per plant). Statistical analyses showed that the differences between the T-DNA tagged line TAG_009 and WT_Col-0 were significant, whereas in comparison with wild-type control plants WT_C24, they were insignificant. Based on these results, we can conclude that the gene we have tagged by using T-DNA-mediated in vivo gene fusion is indeed involved in the plant defense against Fusarium infection.

  • 1167.
    Wegman, Pia
    et al.
    Department of Clinical Medicine, School of Health and Medical Sciences, Örebro University, 701 85 Örebro, Sweden.
    Göthlin Eremo, Anna
    Department of Clinical Medicine, School of Health and Medical Sciences, Örebro University, 701 85 Örebro, Sweden.
    Lindlöf, Angelica
    Högskolan i Skövde, Institutionen för vård och natur. Högskolan i Skövde, Forskningscentrum för Systembiologi.
    Karlsson, Mats
    Department of Pathology, School of Health and Medical Sciences, Örebro University Hospital, 701 85 Örebro, Sweden.
    Stål, Olle
    Department of Clinical and Experimental Medicine/Oncology, Faculty of Health Sciences, Linköping University, 581 85 Linköping, Sweden.
    Wingren, Sten
    Department of Clinical Medicine, School of Health and Medical Sciences, Örebro University, 701 85 Örebro, Sweden.
    Expression of the forkhead transcription factor FOXL2 correlates with good prognosis in breast cancer patients treated with tamoxifen2011Inngår i: International Journal of Oncology, ISSN 1019-6439, Vol. 38, nr 4, s. 1145-1151Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aromatase is an important enzyme in the local synthesis of oestrogens and its expression has been shown to be increased in breast cancer through the activation of multiple promoters. However, the mechanisms behind this are not yet fully understood. A novel candidate in this context is the transcription factor forkhead box L2 (FOXL2), which has been recognised to be co-expressed with aromatase and transcriptionally active promoter II in developing goat and chicken ovaries. We propose that FOXL2 could be involved in the increased expression of aromatase in breast cancer. We examined FOXL2 and its relation to aromatase in 132 post-menopausal breast cancer patients by immunohistochemistry. Using in silico analysis, we further searched for FOXL2 binding-elements in the aromatase gene promoters. The results demonstrate that FOXL2 is expressed in breast cancer and influences clinical outcome with improved recurrence-free survival in cases with nuclear expression. In a multivariate Cox model, nuclear FOXL2 was a significant prognostic factor in ER-positive patients treated with tamoxifen (HR=0.18, 95% confidence interval (CI)=0.04-0.81, P=0.03). Tumours expressing nuclear FOXL2 were also more likely positive for stromal and/or cytoplasmic aromatase (P=0.03 and P=0.008, respectively). In silico analyses revealed binding elements of FOXL2 in promoters I.3, II and I.7 of the aromatase gene of which promoter I.7 was most significant. In conclusion, this is the first study to report that FOXL2 is expressed in breast cancer and correlates with aromatase as well as with clinical outcome. The results further strengthen a possible binding of FOXL2 to aromatase promoter I.7. Nevertheless, whether FOXL2 is a direct activator of aromatase requires further investigation.

  • 1168.
    Wendel, Carina
    et al.
    Högskolan i Skövde, Institutionen för vård och natur.
    Bodén, Emma
    Högskolan i Skövde, Institutionen för vård och natur.
    Endometrios hos unga kvinnor: - upplevelser av skolhälsovården2011Independent thesis Advanced level (degree of Master (One Year)), 10 poäng / 15 hpOppgave
    Abstract [sv]

    Endometrios,  en  sjukdom  med  symtom  som  smärtor  eller  blödningar  i  samband  med menstruation, börjar ofta i tonåren men diagnostiseras inte förrän flera år senare. Kvinnorna med denna diagnos beskriver ofta att de inte  fått förståelse för sina problem under tonåren. Sjukdomen kan innebära stora besvär  för den drabbade och följder på det fysiska, psykiska och sociala planet kan ses. Syftet var att studera hur unga kvinnor med endometriossymtom upplevde  skolsköterskans  stöd  under  högstadie-  och  gymnasietiden,  för  att  kunna  påverka deras livskvalitet. Via Svenska endometriosföreningens ungdomssektion i Sverige gjordes en kvantitativ   undersökning   med   kvalitativt   inslag.   Ett   frågeformulär   skickades   ut   till föreningens  59  medlemmar,  24  kvinnor  svarade.  Resultatet  visade  att  några  få  kvinnor  var nöjda med den hjälp de fått under skoltiden men de flesta kvinnorna uttryckte att de saknade kunskap,  stöd  och  förståelse  från  skolsköterskan  vilket  ibland  gav  ett  icke  tillfredsställande bemötande. Det framkom även i studien att förståelse och kunskaper saknades i vissa fall även hos  ungdomsmottagningar  och  läkare.  Tillgängligheten  av  skolsköterskan  på  de  olika skolorna  varierade.  Mer  resurser  bör  läggas  på  kunskaper  både  hos  skolsköterskor  och  de unga kvinnorna själva för att förbättra livskvaliteten hos de unga kvinnorna. 

    Fulltekst (pdf)
    Endometrios hos unga kvinnor - upplevelser av skolhälsovården
  • 1169.
    Wennerström, Berith
    et al.
    Skaraborg Hospital, Kärnsjukhuset.
    Warrén Stomberg, Margareta
    Högskolan i Skövde, Institutionen för vård och natur.
    Modin, Marina
    Skaraborg Hospital, Kärnsjukhuset.
    Skullman, Stefan
    Skaraborg Hospital, Kärnsjukhuset.
    Patient symptoms after colonic surgery in the era of enhanced recovery - a long-term follow-up2010Inngår i: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 19, nr 5-6, s. 666-672Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aims. The main purpose of this study was to analyse, prospectively, patient symptoms during the first four weeks following elective colon surgery. A secondary aim was to find areas to improve inpatient information and postoperative care.

    Background. Fast-track recovery following colon surgery has been proven beneficial to patients in the early postoperative phase. Less is known about the continuous recovery at home.

    Design. A prospective follow-up survey.

    Methods. Consecutive patients (n = 32) planned for elective colon surgery were evaluated. Both open and laparoscopic operations were included. All followed a fast-track protocol in hospital. Patient symptoms were recorded by validated quality of life questionnaires (EORTC QLQ-C 30, EORTC QLQ-CR 38 and Brief Pain Inventory). An interview was conducted five weeks and one year after surgery.

    Results. The hospital stay was six days, and 10% of patients were readmitted. The fast-track concept worked well. The main problems after discharge were fatigue, nausea and bowel disturbances. Pain was not a significant issue. Most symptoms had disappeared after four weeks.

    Conclusions. The first period at home is troublesome, and better information about common symptoms is needed. A direct telephone line has been set up to answer questions and to lower patient anxiety.

    Relevance to clinical practice. Clinical guidelines for patient’s discharge planning can be performed based on the results from this study. Further improvement regarding the epidural anaesthesia is needed to reduce minor side effects.

  • 1170.
    Wennström, Berith
    et al.
    Department of Anaesthesia, Skaraborg Hospital, Skövde, Sweden.
    Bergh, Ingrid
    Högskolan i Skövde, Institutionen för vård och natur. Faculty of Health Caring Sciences, Göteborg University, Sweden.
    Bodily and verbal expressions of postoperative symptoms in 3- to 6-year-old boys2008Inngår i: Journal of Pediatric Nursing: Nursing Care of Children and Families, ISSN 0882-5963, E-ISSN 1532-8449, Vol. 23, nr 1, s. 65-76Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The aim of this study was to investigate how small boys between 3 and 6 years of age describe bodily and verbal expressions of postoperative symptoms. The data collection was carried out at a large general hospital in Sweden and included both participant observations and semistructured interviews. The results provided a description of how 3- to 6-year-old boys bodily and verbally express postoperative symptoms. The results also showed that small children have difficulties in distinguishing pain, nausea, and anxiety and that postoperative discomfort was experienced in many different ways.

  • 1171.
    Wennström, Berith
    et al.
    Department of Anaesthesia, Skaraborg Hospital, Kärnsjukhuset, Skövde, Sweden / Institute of Health and Care Sciences, The Sahlgrenska Academy, University of Gothenburg, Sweden.
    Nasic, Salmir
    Centre for Research and Development Skaraborg Hospital, Kärnsjukhuset, Skövde, Sweden.
    Hedelin, Hans
    Centre for Research and Development Skaraborg Hospital, Kärnsjukhuset, Skövde, Sweden / Skaraborg Hospital, Kärnsjukhuset, Skövde, Sweden.
    Bergh, Ingrid
    Högskolan i Skövde, Institutionen för vård och natur.
    Evaluation of the Swedish version of the Child Drawing: Hospital Manual2011Inngår i: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 67, nr 5, s. 1118-1128Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aim. This paper is a report of psychometric testing of the Swedish version of the Child Drawing: Hospital Manual.Background. Drawings have shown to be useful in assessing emotional status and anxiety in children because they generally speak to us more clearly and openly through their drawings than they are willing or able to verbally.Method. The Child Drawing: Hospital Manual was translated into Swedish according to World Health Organization guidelines (a routine procedure for translation of English instruments) in order to assess anxiety by analysing the drawings of 59 children (5–11 years), of whom nine were girls and 50 boys undergoing day surgery during 2007–2009.Results. Inter-rater reliability (five independent scorers) was high and internal consistency reliability was good (coefficient alpha = 0.77). Parts A and C, as well as the total scale score of the Child Drawing: Hospital Manual, discriminated anxiety significantly between the group of children undergoing day surgery and a comparison group of school children, indicating adequate construct validity.Conclusion. For the Swedish version of the Child Drawing: Hospital Manual, our study demonstrates evidence for adequate construct validity in Parts A and C (and total scale score), high inter-rater reliability and acceptable internal consistency reliability. However, some improvements are needed before the instrument will be a clinically useful assessment of anxiety in children undergoing day surgery.

  • 1172.
    Wennström, Berith
    et al.
    Department of Anaesthesia, Skaraborg Hospital, Skövde, Sweden.
    Törnhage, Carl-Johan
    Department of Pediatrics, Skaraborg Hospital, Skövde, Sweden.
    Hedelin, Hans
    Centre for Research and Development, Skaraborg Hospital, Skövde, Sweden.
    Nasic, Salmir
    Centre for Research and Development, Skaraborg Hospital, Skövde, Sweden.
    Bergh, Ingrid
    Högskolan i Skövde, Institutionen för vård och natur.
    Child drawings and salivary cortisol in children undergoing preoperative procedures associated with day surgery2013Inngår i: Journal of Perianesthesia Nursing, ISSN 1089-9472, E-ISSN 1532-8473, Vol. 28, nr 6, s. 361-367Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background

    Perioperative procedures in children can impair their emotional status negatively with stress and/or anxiety. Cortisol concentrations and drawings could be helpful in gaining information about a child's levels of stress and/or anxiety when attending the hospital for surgery.

    Purpose

    The purpose of this study was to determine the degree of anxiety and stress as well as to explore the association between objective measures of stress (cortisol concentration in saliva) and subjective assessment of hospital anxiety (children's drawings) as interpreted by the Swedish version of the Child Drawing: Hospital manual.

    Methods

    A total of 93 children scheduled for day surgery were included. Salivary cortisol was sampled preoperatively on the day of surgery at which time the children were also requested to make a drawing of a person at the hospital.

    Results

    Results showed no association between salivary cortisol concentration and the CD:H score.

    Conclusion

    The drawings and salivary cortisol concentration preoperatively on the day of surgery reflect different components of the conditions of fear, anxiety, or stress emerging in the situation.

  • 1173.
    Wennström, Berith
    et al.
    Department of Anaesthesia, Skaraborg Hospital, Kärnsjukhuset, 541 85 Skövde, Sweden / Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Törnhage, Carl-Johan
    Department of Pediatrics, Skaraborg Hospital, Skövde, Sweden.
    Nasic, Salmir
    Centre for Research and Development, Skaraborg Hospital, Skövde, Sweden.
    Hedelin, Hans
    Centre for Research and Development, Skaraborg Hospital, Skövde, Sweden / Department of Urology, Skaraborg Hospital, Skövde, Sweden.
    Bergh, Ingrid
    Högskolan i Skövde, Institutionen för vård och natur.
    The perioperative dialogue reduces postoperative stress in children undergoing day surgery as confirmed by salivary cortisol2011Inngår i: Pediatric Anaesthesia, ISSN 1155-5645, E-ISSN 1460-9592, Vol. 21, nr 10, s. 1058-1065Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aim: To evaluate the efficacy of 'the perioperative dialogue (PD)' by analyzing salivary cortisol, in 5- to 11-year-old children undergoing day surgery. Background: To deal with anxiety prior to investigations and/or procedures, children need to be confident and informed about what is going to happen. Therefore, intervention strategies should be initiated before admission to hospital. Methods and materials: Children (n = 93), 79 boys and 14 girls, scheduled for elective day surgery requiring general anesthesia were randomly recruited into three groups: (i) standard perioperative care (n = 31), (ii) standard perioperative care including preoperative information (n = 31), and (iii) the PD (n = 31). Saliva was sampled for cortisol analysis at specific time points during the pre- and perioperative procedures. Results: The children who received the PD had significantly lower (P = 0.003) salivary cortisol concentrations postoperatively. Moreover, it continuously decreased during the day of surgery compared with the other two groups (P < 0.01). Among the children who received analgesics, the PD group received significantly less morphine (P = 0.014) related to body-weight: the mean dose was 0.1 mg.kg(-1) (n = 9) in the control group vs 0.04 mg.kg(-1) (n = 6) in the PD group. Irrespective of group, there was a positive correlation between the children's morphine consumption and salivary cortisol concentration (r = 0.56; P = 0.038). The W-B scale score was higher in the group that received morphine (median = 3 vs median = 1; P = 0.001). Conclusions: The PD's caring, continuity, and on-going dialogues were associated with low concentrations of salivary cortisol postoperatively and reduced morphine consumption and thus appears to be a valuable complement to standard perioperative care in children undergoing day surgery.

  • 1174.
    Westerberg, J.
    et al.
    Vrinnevi Hosp, Dept Otorhinolaryngol, S-60182 Norrköping, Sweden.
    Harder, H.
    Linköping Univ Hosp, Dept Otolaryngol, Linköping, Sweden.
    Magnuson, B.
    Linköping Univ Hosp, Dept Otolaryngol, Linköping, Sweden.
    Westerberg, Lars
    Högskolan i Skövde, Institutionen för vård och natur. Högskolan i Skövde, Forskningscentrum för Systembiologi.
    Hydén, D.
    Linköping Univ Hosp, Dept Otolaryngol, Linköping, Sweden.
    Ten-year myringoplasty series: does the cause of perforation affect the success rate?2011Inngår i: Journal of Laryngology and Otology, ISSN 0022-2151, E-ISSN 1748-5460, Vol. 125, nr 2, s. 126-132Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective:  To  present  the  results  of  primary  myringoplasty  procedures  together  with  the  perforation  cause, perforation size and site, surgeon’s experience, and surgical method, and to investigate how these factors relate to graft ‘take’ rates. Study design: Retrospective chart review of 243 consecutive patients undergoing primary myringoplasty with temporalis fascia underlay over a 10-year period from 1994 to 2004. Results: The overall graft take rate was 95 per cent. The retroauricular approach resulted in a 97 per cent graft take rate, whereas a significantly lower rate (77 per cent) was seen for surgery conducted via the endaural approach, or via an ear speculum. There was no relationship between other factors and tympanic membrane healing. Conclusion: No association was found between perforation cause and graft take rate. The underlay technique is safe and reliable, and the retroauricular approach is preferable as it enables good surgical access and has better results.

  • 1175.
    Westin, Lars
    Högskolan i Skövde, Institutionen för vård och natur.
    Encounters in nursing homes: Experiences from nurses, residents and relatives2008Doktoravhandling, med artikler (Annet vitenskapelig)
    Abstract [en]

    The care of residents in nursing homes (special housing) is a major challenge for the nursing profession, especially as the population of older people has increased in recent decades. One important aim of this care is to promote the wellbeing and security of the residents. Encounters between residents, nurses and relatives are one important and frequent activity in the daily care of the residents. Available knowledge shows that the outcome of these encounters can affect the quality of care both in positive and negative ways. The meaning of these encounters is still a fairly unknown topic. The reason for conducting research on the meaning of encounters in nursing homes is mainly due to the lack of research with this focus and a need to improve understanding and knowledge about nursing home care with an emphasis on the meaning of encounters.

    The aim of this thesis was to investigate the experiences of encounters between nurses, residents, their relatives and other significant persons in order to reach a deeper understanding of the meaning of these encounters in nursing homes. A hermeneutic method was used for all four studies in this thesis (I–IV). The hermeneutic method was inspired by Hans George Gadamer and his philosophical hermeneutics. The hermeneutic method provides opportunities to interpret the meaning of human language. All data from participants in this thesis were collected through open-ended interviews with nurses, residents and relatives in four nursing homes in a municipality in Western Sweden in 2004-2005. The interviews were tape-recorded and transcribed verbatim.

    The main results of the original papers showed that the meaning of was interpreted and illuminated as the good encounter (I–IV) and the bad encounter (I–IV). In this thesis, encounters between people in nursing homes have been shown to be important for residents’ everyday life in terms of being visible and confirmed but also for nurses’ and relatives’ need to be visible and confirmed as significant persons in the care for the resident. Nurses play an important role in encounters with residents and their relatives in order to make the residents visible and to maintain his/her respect and dignity as a human being in the nursing home. It is therefore important for nurses to establish intentions for being able to contribute to the good encounter. Being present, attentive and open in the encounter with residents and their relatives and listening to their thoughts is the start of a caring action that will result in making the residents visible and confirmed.

     

    It is of great importance to realize that there are both good and bad encounters in a nursing home context, which makes certain demands on the nurses’ competence to be able to meet the resident with an open mind as an effort to achieve the good encounter, which means to see the resident as someone belonging somewhere. Accordingly, it is an urgent matter to implement knowledge about the meaning of encounters in this caring context, knowledge that can probably be transferred to nurses working in other forms of long-term care. This thesis can be seen as a contribution to generating knowledge and providing new understanding that can facilitate the development of such nursing competence; knowledge in the art of caring that gives a deeper understanding of how fundamental each encounter can be for making residents and relatives visible and confirmed as an effort to maintain good quality in the care of residents in nursing homes.

  • 1176.
    Westin, Lars
    et al.
    Högskolan i Skövde, Institutionen för vård och natur.
    Danielson, Ella
    Sahlgrens Acad, Inst Hlth & Care Sci, Gothenburg, Sweden / Mid Sweden Univ, Dept Hlth Serv, Östersund, Sweden.
    Encounters in Swedish nursing homes: a hermeneutic study of residents' experiences2007Inngår i: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 60, nr 2, s. 172-180Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aim. This paper is a report of a study to illuminate and interpret the meaning of residents' experiences of encounters with nurses in nursing homes.

    Background. A large number of older people suffer from illness and become dependent on other people in their daily living. These people are often in need of care in nursing homes. It is assumed that encounters between nurses and residents are of importance in how residents experience care in nursing homes.

    Method. Twelve residents from three nursing homes in Sweden were interviewed in 2004–2005 about their experiences in encounters with nurses. The interviews were tape-recorded and transcribed verbatim. A hermeneutic method was used to describe and interpret the meaning of residents' experiences.

    Findings. Three themes emerged: 'being somebody', 'being nobody' and 'being in a community'. The encounters had both positive and negative influences on residents, expressed as being somebody and belonging somewhere or being nobody and not being seen as a person or simply being left out of things. Encounters between residents and nurses have a mutual dependency where residents certainly have some influence on the relationship. The nurses have both an influence on the relationship and a professional responsibility for the outcome of encounters with residents.

    Conclusion. The insights gained from the study can guide nurses in their encounters with residents in nursing homes so that they feel respected as unique human beings and part of a community.

  • 1177.
    Westin, Lars
    et al.
    Högskolan i Skövde, Institutionen för vård och natur.
    Danielson, Ella
    Nurses’ experiences of caring encounters with older people living in Swedish nursing homes2006Inngår i: International Journal of Older People Nursing, ISSN 1748-3735, E-ISSN 1748-3743, Vol. 1, nr 1, s. 3-10Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aim. The aim of the study was to describe and interpret the meaning of nurses' experiences of caring encounters with residents in nursing homes.

    Background. Life for residents in nursing homes can be characterized as a process of decreased physical and psychological resources. Therefore, encounters with nurses are important activities for providing meaning and security for the residents. Research in this field has previously focused on communication, attitudes and job satisfaction, but gives limited knowledge about what the human encounters in this context mean for the nurses.

    Method. A hermeneutic method was used in this study. Interviews were conducted with 14 nurses from two nursing homes about their experiences of caring encounters. The transcribed interview texts were interpreted as a whole.

    Results. In the interpretation of the text concerning the meaning of nurses' experiences of encounters with resident's four themes and 11 subthemes emerged. The comprehensive interpretation mainly showed possible ways available being present, being significant and being aware of opportunities for the nurse to find meaning in the encounter with the resident, but impossible ways as being inadequately were also revealed.

    Conclusion. This study shows the importance of caring encounters between nurses and residents in nursing homes. The good encounters provide various possible ways for nurses to find meaning and a sense of communion with residents. However, bad encounters, described as being inadequate, were found to inhibit nurses from finding meaning in their encounters with residents.

    Relevance to clinical practice. Meeting the needs of older people in nursing homes requires special knowledge about the importance of the caring encounter. Therefore, nurses in this care context need supervision and continuous education in order to gain relevant knowledge about the meaning of caring encounters for themselves and residents.

  • 1178.
    Westin, Lars
    et al.
    Högskolan i Skövde, Institutionen för vård och natur.
    Öhrn, Ingbritt
    University of Gothenburg, The Sahlgrenska Academy, Sweden.
    Danielson, Ella
    Mid Sweden University.
    Residents' experiences of encounters with relatives and significant persons: A hermeneutic study2012Inngår i: Nursing and Health Sciences, ISSN 1441-0745, E-ISSN 1442-2018, Vol. 14, nr 4, s. 495-500Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The aim of this study was to explore and interpret the meaning of residents’ experiences of encounters with their relatives and other significant persons in nursing homes. Twelve residents in three different nursing homes in a western Sweden municipality were interviewed. The method used was hermeneutical text analysis. Three themes emerged in the interpretation of the text: being pleased, being someone, and being inconvenient. These themes were also described through seven subthemes: to be happy to have someone, to make someone else happy, going back in life, to be together in a community, not being alone, to be disconnected, and to be a burden.The study concludes that it is important for nurses in nursing homes to develop a deeper insight into what various social contacts can mean for residents. To develop this knowledge, it is important that nurses in nursing homes can be educated, and supported by clinical supervision, in relation to residents’ experiences of encounters with relatives and other significant persons.

  • 1179.
    Westin, Lars
    et al.
    Högskolan i Skövde, Institutionen för vård och natur.
    Öhrn, Ingbritt
    University of Gothenburg, Gothenburg, Sweden.
    Danielson, Ella
    Mid Sweden University, Östersund, Sweden.
    Visiting a nursing home: Relatives' experiences of encounters with nurses2009Inngår i: Nursing Inquiry, ISSN 1320-7881, E-ISSN 1440-1800, Vol. 16, nr 4, s. 318-325Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The purpose of this study was to explore and interpret the meaning of relatives' experiences of encounters with nurses when visiting residents in nursing homes. Thirteen relatives of residents in three nursing homes in Sweden were interviewed. The interviews were tape-recorded and transcribed verbatim. The method used was hermeneutical text analysis. Four themes emerged in the analysis and interpretation of the whole text: 'being paid attention to', 'being ignored', 'being involved' and 'being safe and secure'. A further interpretation of the findings shows a deeper understanding of the meaning of relatives. This meaning was revealed as being invited into an encounter with nurses and gave a sense of community but the opposite was being ignored and left outside. This study gives a deeper understanding of the meaning of encounters between relatives and nurses in nursing homes; it also illuminates how these encounters also can affect the care of the residents. This new understanding can hopefully offer support for nurses during their encounters with relatives and optimise the ability to provide a positive outcome for residents in nursing homes.

  • 1180.
    Westroth, Kria
    et al.
    Högskolan i Skövde, Institutionen för vård och natur.
    Khessib, Merja
    Högskolan i Skövde, Institutionen för vård och natur.
    Skolsköterskors erfarenheter av att stödja elever som upplever skoltrötthet inom grund- och gymnasieskola2012Independent thesis Advanced level (degree of Master (One Year)), 10 poäng / 15 hpOppgave
    Abstract [sv]

    Bakgrund: Skoltrötthet är ett symtom på att någonting inte står rätt till. Det finns orsaker som påverkar  och  ger  konsekvenser  vid  skoltrötthet.  Elever  själva  anger  att  hög  studietakt  och otillräckligt stöd kan vara anledning till skoltrötthet. Skolhälsovården har en viktig stödjande funktion. Syfte: Syftet var att beskriva skolsköterskors erfarenheter av att stödja elever som upplever skoltrötthet inom grund- och gymnasieskola. Metod:  Data  analyserades  med  kvalitativ  innehållsanalys  med  induktiv  ansats  beskriven  av Graneheim och Lundman. Åtta intervjuer genomfördes med skolsköterskor. Resultat: Ur analysen av datamaterialet framträdde fem kategorier såsom; kartlägger elevens svårigheter, engagerar föräldrarna, följer upp studiemiljön, har en respektfull  inställning och reflekterar över egna insatser, med 13 underkategorier. Konklusion:   Resultaten   av   denna   studie   kan   bidra   till   att   utveckla   och   förbättra skolsköterskor  möjlighet  att  ge  stöd  till  skoltrötta  elever.  De  kan  även  utgöra  grund  för riktlinjer vid hantering av skoltrötthet så att elever inte utelämnas från stödinsatser.

    Fulltekst (pdf)
    Skolsköterskors erfarenheter av att stödja elever som upplever skoltrötthet inom grund- och gymnasieskola
  • 1181.
    Wickerts, L.
    et al.
    Danderyds Univ Hosp, Dept Anaesthesia & Intens Care, Stockholm, Sweden .
    Warrén Stomberg, Margareta
    Högskolan i Skövde, Institutionen för vård och natur.
    Brattwall, Metha
    Mölndals Univ Hosp, Dept Anaesthesia, Sahlgrenska Acad, Gothenburg, Sweden .
    Jakobsson, Jan
    Karolinska Inst, Inst Physiol & Pharmacol, Sect Anaesthesia & Intens Care, Stockholm, Sweden.
    Coxibs: is there a benefit when compared to traditional non-selective NSAIDs in postoperative pain management?2011Inngår i: Minerva Anestesiologica, ISSN 0375-9393, E-ISSN 1827-1596, Vol. 77, nr 11, s. 1084-1098Artikkel, forskningsoversikt (Fagfellevurdert)
    Abstract [en]

    A multi-modal approach for the management of postoperative pain has become increasingly popular. Strategies to avoid the use of opioids and thus any opioid analgesic related side-effect is an important part of the expansion of ambulatory surgery Combining long acting local anesthesia in the wound area and non-opioid analgesics are today a basic concept in management of day care, short stay patients. Paracetamol and non-steroidal anti-inflammatory drugs (NSAIDs) is often sufficient to provide satisfactory pain relief after minor and intermediate procedures. The use of multimodal or balanced analgesia has since long been shown to facilitate resumption of activities of daily living. The opioid sparing effects of the addition of NSAIDs to morphine patient-controlled analgesic (PCA) after major surgery has also shown repeatedly. The development and introduction of the most selective cyclo-oxygenase-2-inhibitors (Coxibs) was primarily indicated to reduce the risk and severity of gastrointestinal bleeding. The Coxibs have become an interesting option in postoperative pain management. The less pronounced effect on platelet function and subsequent lower risk for impaired hemeostasis makes them, in theory, a preferred option to the nonselective traditional NSAIDs. The benefit versus risk for a more generalized use of Coxibs must, however, be based on a thorough evaluation of the overall benefits and risks for the use of NSAIDs and a further evaluation on whether the specific therapeutic features of the Coxibs provide benefits outweighing their increased cost. This review aims at providing a background and an overview of the benefits versus risks for the use of Coxibs as part of a multimodal postoperative pain management. (Minerva Anestesiol 2011;77:1084-98)

  • 1182.
    Wickström Ene, Kerstin
    et al.
    The Sahlgrenska Academy at Gothenburg University, Institute of Health and Care Sciences, Gothenburg, Sweden / Departments of Anesthesiology and Intensive Care, Sahlgrenska University Hospital, Gothenburg, Sweden.
    Nordberg, Gunnar
    Departments of Anesthesiology and Intensive Care, Sahlgrenska University Hospital, Gothenburg, Sweden.
    Bergh, Ingrid
    The Sahlgrenska Academy at Gothenburg University, Institute of Health and Care Sciences, Gothenburg, Sweden.
    Gaston Johansson, Fannie
    Johns Hopkins University School of Nursing, Baltimore, MD, USA.
    Sjöström, Björn
    Högskolan i Skövde, Institutionen för vård och natur.
    Postoperative pain management - the influence of surgical ward nurses2008Inngår i: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 17, nr 15, s. 2042-2050Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aim. To compare pain levels reported by patients with those documented by ward nurses and to find out to what extent the amount of opioids given correlated with the pain level. Secondly, to study if pain management and nurses' approaches to this task had improved during a two-year period, including an educational pain treatment program for ward staff. Background. The management of postoperative pain continues to remain problematic and unsatisfactory and ward nurses play an important role for this task. Design. The study was a cross-sectional, descriptive, two-part study based on survey data from both patients and nurses on two urology surgical wards. Methods. Part I of the study included 77 patients and 19 nurses. Part II took place approximately two years later and included 141 patients and 22 nurses. Data were collected the day after surgery by asking patients about 'worst pain' experienced. The pain scores given by the patients were compared with those documented in the patients' records and with the doses of opioids administered. Nurses' approaches to pain management were sought after, by using a categorical questionnaire. Results. The nurses' ability to assess pain in accordance with the patients' reports had increased slightly after two years even if and the number of documented pain scores had decreased. Forty per cent of the nurses reported that they did not use visual analogue scale and that they did not assess pain at both rest and activity, neither did one fourth evaluate the effect of given analgesics. Conclusion. The study showed a discrepancy in pain scoring between nurses and patients, where active treatment was related to nurses' documentation rather than to patients' scoring. Relevance to clinical practice. The study shows a need for more accurate pain assessment, since the patient experiences and suffers pain and the nurse determines upon treatment.

  • 1183.
    Wickström Ene, Kerstin
    et al.
    The Sahlgrenska Acedemy at Göteborg University, Institute of Health and Care Sciences, Gothenburg, Sweden / Departments of Anesthesiology and Intensive Care, Sahlgrenska University, Sweden.
    Nordberg, Gunnar
    Departments of Anesthesiology and Intensive Care, Sahlgrenska University, Sweden.
    Sjöström, Björn
    Högskolan i Skövde, Institutionen för vård och natur.
    Bergh, Ingrid
    The Sahlgrenska Acedemy at Göteborg University, Institute of Health and Care Sciences, Gothenburg, Sweden.
    Prediction of postoperative pain after radical prostatectomy2008Inngår i: BMC Nursing, ISSN 1472-6955, E-ISSN 1472-6955, Vol. 7, nr 14Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: There is a belief that the amount of pain perceived is merely directly proportional to the extent of injury. The intensity of postoperative pain is however influenced by multiple factors aside from the extent of trauma.The purpose of the study was to evaluate the relationship between preoperative factors that have been shown to predict postoperative pain and the self- reports of pain intensity in a population of 155 men undergoing radical prostatectomy (RP), and also to investigate if previous pain score could predict the subsequent pain score.Methods: The correlation between potential pain predictors and the postoperative pain experiences during three postoperative days was tested (Pitmans´ test). By use of a logistic regression analysis the probability that a Visual Analogue Scale (VAS) score at one occasion would exceed 30mm or 70mm was studied, depending on previous VAS score, age, depression and pain treatment method.Results: Age was found to be a predictor of VAS >30mm, with younger patients at higher risk for pain, and preoperative depression predicted VAS >70mm. The probability that VAS would exceed 30mm and 70mm was predicted only by previous VAS value. Day two however, patients with epidural analgesia were at higher risk for experiencing pain than patients with intrathecal or systemic opioid analgesia.Conclusion: The results show that it would be meaningful to identify RP patients at high risk for severe postoperative pain; i.e. younger and/or depressive patients who might benefit from a more aggressive therapy instituted in the very early postoperative period.

     

     

     

     

     

  • 1184.
    Wickström-Ene, Kerstin
    et al.
    Sahlgrenska Academy, Gothenburg University, Institution of Health and Care Sciences, Gothenburg, Sweden / Departments of Anaesthesiology and Intensive Care, Sahlgrenska University Hospital, Gothenburg, Sweden.
    Nordberg, Gunnar
    Departments of Anaesthesiology and Intensive Care, Sahlgrenska University Hospital, Gothenburg, Sweden.
    Gaston-johansson, Fannie
    Johns Hopkins University, School of Nursing, Baltimore, MD, United States.
    Sjöström, Björn
    Högskolan i Skövde, Institutionen för vård och natur.
    Pain, psychological distress and health-related quality of life at baseline and 3 months after radical prostatectomy2006Inngår i: BMC Nursing, ISSN 1472-6955, E-ISSN 1472-6955, Vol. 5, s. Article number 8-Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background

    Inadequate management of postoperative pain is common, and postoperative pain is a risk factor for prolonged pain. In addition to medical and technical factors, psychological factors may also influence the experience of postoperative pain.

    Methods

    Pain was measured postoperatively at 24, 48, and 72 hr in hospital and after 3 months at home in 140 patients undergoing radical prostatectomy (RP). Patients answered questionnaires about anxiety and depression (HAD scale) and health-related quality of life (SF-36) at baseline and 3 months after surgery.

    Results

    In the first 3 postoperative days, mild pain was reported by 45 patients (32%), moderate pain by 64 (45%), and severe pain by 31 (22%) on one or more days. High postoperative pain scores were correlated with length of hospital stay and with high pain scores at home. Forty patients (29%) reported moderate (n = 35) or severe (n = 5) pain after discharge from hospital. Patients who experienced anxiety and depression preoperatively had higher postoperative pain scores and remained anxious and depressed 3 months after surgery. The scores for the physical domains in the SF-36 were decreased, while the mental health scores were increased at 3 months. Anxiety and depression were negatively correlated with all domains of the SF-36.

    Conclusion

    There is a need for nurses to be aware of the psychological status of RP patients and its impact upon patients' experience of postoperative pain and recovery. The ability to identify patients with psychological distress and to target interventions is an important goal for future research.

  • 1185.
    Widegren, Emma
    et al.
    Linkoping Univ, Dept Oncol, Inst Clin & Expt Med, SE-58185 Linkoping, Sweden .
    Onnesjo, Sofia
    Linkoping Univ, Dept Oncol, Inst Clin & Expt Med, SE-58185 Linkoping, Sweden .
    Arbman, Gunnar
    Vrinnevi Univ Hosp, Dept Surg, Norrkoping, Sweden .
    Kayed, Hany
    Univ Heidelberg, Inst Clin Radiol & Nucl Med, Univ Hosp Mannheim, Heidelberg, Germany .
    Zentgraf, Hanswalter
    German Canc Res Ctr, D-6900 Heidelberg, Germany .
    Kleeff, Joerg
    Tech Univ Munich, Dept Surg, Munich, Germany.
    Zhang, Hong
    Högskolan i Skövde, Institutionen för vård och natur.
    Sun, Xiao-Feng
    Linkoping Univ, Dept Oncol, Inst Clin & Expt Med, SE-58185 Linkoping, Sweden .
    Expression of FXYD3 Protein in Relation to Biological and Clinicopathological Variables in Colorectal Cancers2009Inngår i: Chemotherapy, ISSN 0009-3157, E-ISSN 1421-9794, Vol. 55, nr 6, s. 407-413Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: FXYD3 is up-/down-regulated in different types of cancers. We examined FXYD3 expression in colorectal cancers and its relationship to biological and clinicopathological variables. Patients and Methods: Expression of FXYD3 protein was immunohistochemically examined in distant normal mucosa (n = 34), adjacent normal mucosa (n = 72), primary tumour (n = 150) and lymph node metastasis (n = 35) from colorectal cancer patients. Results: FXYD3 was highly expressed in primary tumour compared to adjacent normal mucosa (p = 0.02). FXYD3 was or tended to be positively related to the expression of ras (p = 0.02), p53 (p = 0.06), legumain (p = 0.02) and proliferating cell nuclear antigen (p = 0.03). Moreover, there was a higher frequency of strong FXYD3 expression in Dukes A-C tumours than in D tumours (p = 0.04). The strong FXYD3 expression tended to predict worse survival in the patients with Dukes A + B tumour (p = 0.07), while there was no such tendency in the patients with Dukes C + D tumour (p = 0.94). The tumours located in the colon had a higher degree of FXYD3 expression than the tumours located in the rectum (p = 0.05). Conclusion: The FXYD3 was associated with certain biological variables and may be involved in the development of the relative earlier stages of colorectal cancers. Copyright (C) 2009 S. Karger AG, Basel

  • 1186.
    Widström, Ann-Marie
    et al.
    Division of Reproductive and Perinatal Health Care, Department of Woman's and Children's Health, Karolinska Institutet, Retzius väg 13 A, 171 77 Stockholm, Sweden.
    Lilja, Gunilla
    Division Nursing, Department of Neurobiology, Care Science and Society, Karolinska Institutet, S-17177 Stockholm, Sweden.
    Aaltomaa-Michalias, P.
    Södersjukhuset, Stockholm, Sweden.
    Dahllöf, A.
    Södersjukhuset, Stockholm, Sweden.
    Lintula, M.
    Karolinska University Hospital, Stockholm, Sweden.
    Nissen, Eva
    Högskolan i Skövde, Institutionen för vård och natur.
    Newborn behaviour to locate the breast when skin-to-skin: a possible method for enabling early self-regulation2011Inngår i: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 100, nr 1, s. 79-85Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aim: The aim of this study was to provide a more detailed analysis of the infant’s behavioural sequence that begins immediately after birth and terminates with grasping the nipple, suckling and then falling asleep. Method:Twenty-eight full-term infants were videotaped immediately after birth. A video protocol was developed to examine infant behaviours identified from five random videotapes. Results:When birth crying had stopped, the babies showed a short period of relaxation and then successively became alert. They went through an ‘awakening phase’, an ‘active phase’ with movements of limbs, rooting activity and looking at the mother’s face, a ‘crawling phase’ with soliciting sounds, a ‘familiarization phase’ with licking of the areola, and a ‘suckling phase’ and last a ‘sleeping phase’. Five factors related to the time spent to locate the breast: more number of looks at the breast 10–20 min after birth (p < 0.0001); and exposure to meperidine (p = 0.0006) related to increased time. Early start of crawling (p = 0,0040); increased number of ‘soliciting sounds’ (p = 0.0022); and performing hand–breast–mouth movements (p = 0.0105) related to shorter time. Conclusion:  Inborn breastfeeding reflexes were depressed at birth, possibly because of a depressed sensory system. It is hypothesized that when the infant is given the option to peacefully go through the nine behavioural phases birth cry, relaxation, awakening, activity, crawling, resting, familiarization, suckling and sleeping when skin-to-skin with its mother this results in early optimalself-regulation.

  • 1187.
    Wilhelmsson, Emilie
    et al.
    Högskolan i Skövde, Institutionen för vård och natur.
    Wååg, Maria
    Högskolan i Skövde, Institutionen för vård och natur.
    Sjuksköterskors bedömning och hantering av undernutrition hos äldre patienter som vårdas på sjukhus: Enkätstudie2008Independent thesis Basic level (degree of Bachelor), 10 poäng / 15 hpOppgave
    Abstract [sv]

    Mer än 25 % av äldre patienter lider av undernäring under sin sjukhusvistelse. Detta problem har varit känt i ett flertal år. Syftet med studien var att beskriva sjuksköterskors bedömning och hantering av undernutrition hos äldre patienter som vårdas på sjukhus. Metoden som valdes till studien var en kvalitativ enkätstudie och dess svar bearbetades genom en kvalitativ innehållsanalys. Resultaten presenterades i sju olika teman: Den kliniska blicken, Samlad bedömning, Bedömningshjälpmedel, Registrering av kostintag, Psykisk hälsa, Undersköterskans roll och Tidsbrist. Konklusionen är att sjuksköterskor har tillräcklig kunskap och hjälpmedel för att kunna bedöma ett adekvat nutritionsstatus på sina patienter. Det som dock hindrar dem är den ständiga tidsbristen som gör att nutritionsfrågor prioriteras lägre. Undersköterskorna tar ofta på sig ansvaret för nutritionsbedömningen.

    Fulltekst (pdf)
    FULLTEXT01
  • 1188.
    Wilsson, Margareta
    et al.
    Högskolan i Skövde, Institutionen för vård och natur. Primary Health, Mariestad, Sweden.
    Adolfsson, Annsofie
    Högskolan i Skövde, Institutionen för vård och natur. Department of Obstetrics and Gynecology, Skaraborg Hospital, Skövde, Sweden.
    Mother’s need of support and their expectations of the BVC nurse at the first home visit: an interview study2011Inngår i: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 1, nr 3, s. 1-8Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    One of the main priorities of the child healthcare services in Sweden is a home visit by the Child Health Care (BVC) nurse to newborn babies and their parents. It is essential that the BVC nurses have a comprehensive knowledge of the parent’s need of support and their expectations as new parents in order to be able to fulfill their needs. The aim of this study was to describe what type of support the mothers of infant children are in need of and what their expectations are of the BVC nurse when it is time for the home visit from the nurse. In this qualitative study twelve women were interviewed within one to two weeks after delivering a baby. The transcripts were analyzed using qualitative content analysis. The study shows that mothers who have previously given birth to children feel more secure in their parental role compared to what they experienced as first time mothers. The findings include that first time mother’s experienced uncertainty in their new role as a mother and caring for a baby. Parents seek support from the BVC nurse and they expect her behavior and attitude towards them to be friendly and professional. The fact that she is privy to personal knowledge of the family gives the parents a feeling of security when they contact the child healthcare center for various reasons. The mother’s need for support to develop as a parent and to feel secure in the parental role was a reoccurring theme in the interviews and became the theme of the study.

  • 1189.
    Wirheim, Elin
    et al.
    Högskolan i Skövde, Institutionen för vård och natur.
    Menze, Therese
    Högskolan i Skövde, Institutionen för vård och natur.
    PATIENTERS UPPLEVELSER AV ATT VÅRDAS FÖR BIPOLÄR SJUKDOM: En studie gjord på självbiografiska böcker2013Independent thesis Basic level (degree of Bachelor), 10 poäng / 15 hpOppgave
    Abstract [sv]

    Bakgrunden till studien är att bipolär sjukdom är en av de tjugo vanligaste orsaker till funktionsnedsättning i världen. Det finns få studier gjorda på hur patienter upplever att vårdas för sjukdomen. Vårdpersonal kommer möta patienter med diagnosen inom all form av sjukvård. Syftet är att belysa behov av vård och stöd såsom det upplevs av patienter med bipolär sjukdom. Metoden som användes var en litteraturstudie där sju självbiografiska böcker analyserades med hjälp av en kvalitativ metod. Resultatet sammanfattas i fem teman: livsrytm och balans, hinder för att söka vård när behovet finns, olika behov av stöd, behov av trygga punkter och olika sätt att bli värdigt bemött och lyssnad till. I diskussionen påvisas det utmärkande i resultatet, att patienter upplevde det svårt att ta in information när de var både i maniska- och depressiva episoder. Det är viktigt att sjuksköterskor har en förståelse för hur människor med bipolär sjukdom upplever sina liv för att kunna ge individuellt anpassad information och stöd.

    Fulltekst (pdf)
    Patienters upplevelser av att vårdas för bipolär sjukdom
  • 1190.
    Wixtröm, Marie-Christin
    et al.
    Högskolan i Skövde, Institutionen för vård och natur.
    Svensson, Magnus
    Högskolan i Skövde, Institutionen för vård och natur.
    "Anhörigas behov när en närstående vårdas på hospice": en litteraturstudie2009Independent thesis Basic level (degree of Bachelor), 10 poäng / 15 hpOppgave
    Abstract [sv]

    Hospiceverksamheten startade i slutet av 1960-talet. Denna vårdform går ut på att försöka skapa en så god livskvalitet som möjligt i livets slutskede. En av grundpelarna i denna vårdform är att låta familjen vara med i omvårdnaden runt den sjuke. Studiens syfte är att belysa de anhörigas behov när en närstående vårdas på hospice. Studien som gjorts är en litteraturöversikt som grundar sig på texter från forskningsartiklar. Analysen resulterade i fyra teman, vilka är information och kommunikation, de anhörigas delaktighet i omvårdnaden, anhörigas upplevelser i omvårdnaden och sjuksköterskans stöd till anhöriga. I resultatet så kom det fram att information och kommunikation är av stor vikt. Både patienterna och deras anhöriga önskade lite kortare information och många informationstillfällen. De anhörigas delaktighet i omvårdnaden kan ge de anhöriga en chans att påbörja det sorgearbetet. Anhöriga kan känna trygghet med att ha sjuksköterskan som ett stöd i den uppkomna situationen. Det är allmänt vedertaget att patienter som vårdas på hospice blir väl omhändertagna, men hur är upplevelsen för de anhöriga som deltar i omvårdnaden av sina nära och kära? Är det bara positivt att vara nära den sjukes hela tiden, eller finns det även negativa sidor?

    Fulltekst (pdf)
    FULLTEXT01
  • 1191.
    Wojnar, Danuta M.
    et al.
    Seattle Univ, Coll Nursing, Seattle, WA 98122 USA.
    Swanson, Kristen M.
    Univ N Carolina, Sch Nursing, Chapel Hill, NC USA.
    Adolfsson, Ann-Sofie
    Högskolan i Skövde, Institutionen för vård och natur.
    Confronting the inevitable: A conceptual model of miscarriage for use in clinical practice and research2011Inngår i: Death Studies, ISSN 0748-1187, E-ISSN 1091-7683, Vol. 35, nr 6, s. 536-558Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    In spite of scientific evidence that miscarriage has negative psychological consequences for many individuals and couples, silence and dismissal continue to surround this invisible loss in North American culture and beyond. The grief and sorrow of miscarriage has important implications for clinical practice. It indicates a need for therapeutic interventions delivered in a caring, compassionate, and culturally sensitive manner. This research, based on data from 3 phenomenological investigations conducted with 42 women from diverse geographical locations, sexual orientations, and cultural backgrounds offers a theoretical framework for addressing miscarriage in clinical practice and research.

  • 1192.
    Wu, Jie
    et al.
    IMS Health Shanghai.
    Dalal, Koustuv
    Högskolan i Skövde, Institutionen för vård och natur.
    Tuberculosis in Asia and the Pacific: The role of socioeconomic status and health system development2012Inngår i: International Journal of Preventive Medicine, ISSN 2008-7802, E-ISSN 2008-8213, Vol. 3, nr 1, s. 8-16Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: To identify the relationship between socioeconomic status, health system development and the incidence, prevalence and mortality of tuberculosis in Asia and the Pacific. Methods: Incidence, prevalence and mortality rates of tuberculosis and 20 variables of  socioeconomic, health system and biological behavioral issues were included in the study involving all 46 countries of  the Asian Development Bank region (2007 data). Both univariate and multivariate linear regressions were used. Results: The worst three tuberculosis affected countries were Cambodia, India and Indonesia, while the least affected was Australia. Tuberculosis incidence, prevalence and mortality rate were higher in countries with lower human development index, corruption perception index, gross domestic product (GDP) per capita and countries with more people under minimum food supplements. Among the health system variables, total health expenditure per capita, governmental health expenditure per capita, hospital beds, and access to improved water and sanitation were strongly associated with tuberculosis. Conclusions: Socioeconomic determinants and health system development have significant effect on the control of tuberculosis in Asia and the Pacific region. The study has some policy implications by means of  lowering the corruption and improving the sanitation.

  • 1193.
    Yan, Bao-Yong
    et al.
    Hebei Medical University, Shijiazhuang.
    Wang, Da-Wei
    Hebei Medical University, Shijiazhuang.
    Zhu, Zhen-Long
    Hebei Medical University, Shijiazhuang.
    Yang, Yan-Hong
    Hebei Medical University, Shijiazhuang.
    Wang, Ming-Wei
    Hebei Medical University, Shijiazhuang.
    Cui, Dong-Sheng
    Hebei Medical University, Shijiazhuang.
    Zhang, Hong
    Högskolan i Skövde, Forskningscentrum för Systembiologi. Högskolan i Skövde, Institutionen för vård och natur.
    Sun, Xiao-Feng
    University of Linköping.
    Overexpression of MAC30 in the Cytoplasm of Oral Squamous Cell Carcinoma Predicts Nodal Metastasis and Poor Differentiation2010Inngår i: Chemotherapy, ISSN 0009-3157, E-ISSN 1421-9794, Vol. 56, nr 6, s. 424-428Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Expression of the meningioma-associated protein (MAC30) was increased in several types of tumors, including esophageal, gastric and colon tumors, compared to normal tissue. MAC30 expression levels gradually increased from normal colorectal mucosa to primary colorectal cancer and colorectal cancer spreading to the lymph nodes. MAC30 expression was related to survival in patients with colorectal cancer. However, there is no study on MAC30 in oral squamous cell carcinoma (OSCC). Methods: Therefore, MAC30 expression in OSCC was investigated and possible associations of MAC30 expression with clinicopathological variables in OSCC have been analyzed. MAC30 expression was immunohistochemically examined in 20 normal oral mucosa and 43 OSCC specimens. Results: Expression levels of MAC30 in the cytoplasm markedly increased from normal oral epithelial cells to primary OSCC. Strong cytoplasmic staining was significantly higher in primary OSCC compared to normal oral mucosa samples (51 vs. 20%, p = 0.019). Furthermore, MAC30 expression levels in primary tumors of patients with lymph node metastasis exceeded levels in those without metastasis (65 vs. 35%, p = 0.048), and MAC30 expression in poorly differentiated tumors was higher than in well-differentiated ones (90 vs. 39%, p = 0.005). Conclusion: Overexpression of MAC30 in the cytoplasm of OSCC may predict nodal metastasis and poor differentiation.

  • 1194.
    Yang, L.
    et al.
    Linköping University.
    Olsson, B.
    Linköping University.
    Pfeifer, D.
    Linköping University.
    Jönsson, J.-I.
    Linköping University.
    Zhou, Z.-G.
    Sichuan University.
    Jiang, X.
    Sichuan University.
    Fredriksson, B.-A.
    Linköping University.
    Zhang, Hong
    Högskolan i Skövde, Institutionen för vård och natur. Högskolan i Skövde, Forskningscentrum för Systembiologi.
    Sun, X.-F.
    Linköping University.
    Knockdown of peroxisome proliferator-activated receptor-β induces less differentiation and enhances cell-fibronectinadhesion of colon cancer cells2010Inngår i: Oncogene, ISSN 0950-9232, E-ISSN 1476-5594, Vol. 29, nr 4, s. 516-526Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The role of peroxisome proliferator-activated receptor-/ (PPAR-/) in the pathogenesis of colon cancer remains highly controversial. This study specifically silenced the PPAR- expression in three colon cancer cell lines with different metastatic potentials. Although PPAR-knockdown resulted in more malignant morphological changes, bigger colony sizes and lower carcinoembryonic antigen (CEA) secretion, and enhanced the cell-fibronectin adhesion, cell invasion and migration were unaffected. These effects were stronger in poorly metastatic cell lines compared with highly metastatic ones. Simultaneously, PPAR-knockdown decreased the mRNAs encoding adipocyte differentiation-related protein and liver fatty acid binding protein, and increased the mRNA of ILK, whereas the mRNAs encoding integrin-1 and angiopoietin-like 4 were unchanged. Using immunohistochemistry, we determined that the intensity of PPAR- expression was stronger in rectal cancers with better differentiation than in those with poor differentiation, and was stronger in early-stage tumors than in advanced ones. Together, these findings consistently indicate that PPAR- may facilitate differentiation and inhibit the cell-fibronectin adhesion of colon cancer, having a role as an inhibitor in the carcinogenesis and progression of colorectal cancer. Interestingly PPAR- seems to have a more important role in poorly metastatic cells than in highly metastatic ones.

  • 1195.
    Yang, Lie
    et al.
    Sichuan Univ, W China Hosp, Inst Digest Surg, Chengdu 610064, Sichuan Prov, Peoples R China / Sichuan Univ, W China Hosp, State Key Lab Biotherapy, Chengdu 610064, Sichuan Prov, Peoples R China / Linkoping Univ, Dept Oncol & Clin & Expt Med, SE-58185 Linkoping, Sweden .
    Zhang, Hong
    Högskolan i Skövde, Forskningscentrum för Systembiologi. Högskolan i Skövde, Institutionen för vård och natur.
    Zhou, Zong-Guang
    Sichuan Univ, W China Hosp, Inst Digest Surg, Chengdu 610064, Sichuan Prov, Peoples R China / Sichuan Univ, W China Hosp, State Key Lab Biotherapy, Chengdu 610064, Sichuan Prov, Peoples R China .
    Yan, Hui
    Sichuan Univ, W China Hosp, Inst Digest Surg, Chengdu 610064, Sichuan Prov, Peoples R China / Sichuan Univ, W China Hosp, State Key Lab Biotherapy, Chengdu 610064, Sichuan Prov, Peoples R China .
    Adell, Gunnar
    Karolinska Univ Hosp, Dept Oncol, Stockholm, Sweden.
    Sun, Xiao-Feng
    Sichuan Univ, W China Hosp, Inst Digest Surg, Chengdu 610064, Sichuan Prov, Peoples R China / Sichuan Univ, W China Hosp, State Key Lab Biotherapy, Chengdu 610064, Sichuan Prov, Peoples R China / Linkoping Univ, Dept Oncol & Clin & Expt Med, SE-58185 Linkoping, Sweden .
    Biological Function and Prognostic Significance of Peroxisome Proliferator-Activated Receptor delta in Rectal Cancer2011Inngår i: Clinical Cancer Research, ISSN 1078-0432, E-ISSN 1557-3265, Vol. 17, nr 11, s. 3760-3770Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Purpose: To investigate the expression significance of PPAR beta/delta in relation to radiotherapy (RT), clinicopathologic, and prognostic variables of rectal cancer patients. Experimental Design: We included 141 primary rectal cancer patients who participated in a Swedish clinical trial of preoperative RT. Tissue microarray samples from the excised rectal cancers and the adjacent or distant normal mucosa and lymph node metastases were stained with PPAR delta antibody. Survival probability was computed by the Kaplan-Meier method and Cox regression model. The proliferation of colon cancer cell lines KM12C, KM12SM, and KM12L4a was assayed after PPAR delta knockdown. Results: PPAR delta was increased from adjacent or distant normal mucosa to primary cancers, whereas it decreased from primary cancers to lymph node metastases. After RT, PPAR delta was increased in normal mucosa, whereas it decreased in primary cancers and lymph node metastases. In primary cancers, the high expression of PPAR delta was related to higher frequency of stage I cases, lower lymph node metastasis rate, and low expression of Ki-67 in the unirradiated cases, and related to favorable survival in the cases either with or without RT. The proliferation of the KM12C, KM12SM, or KM12L4a cells was significantly accelerated after PPAR delta knockdown. Conclusions: RT decreases the PPAR delta expression in primary rectal cancers and lymph node metastases. PPAR delta is related to the early development of rectal cancer and inhibits the proliferation of colorectal cancer cells. Increase of PPAR delta predicts favorable survival in the rectal cancer patients either with or without preoperative RT. Clin Cancer Res; 17(11); 3760-70. (C)2011 AACR.

  • 1196.
    Ydreborg, Berit
    et al.
    Örebro Cty Council, Dept Community Med & Publ Hlth, Örebro, Sweden / Linköping Univ, Dept Hlth & Soc, Natl Ctr Work & Rehabil, S-58183 Linköping, Sweden.
    Ekberg, Kerstin
    Linköping Univ, Dept Hlth & Soc, Natl Ctr Work & Rehabil, S-58183 Linköping, Sweden.
    Nilsson, Kerstin
    Högskolan i Skövde, Institutionen för vård och natur.
    Swedish social insurance officers' experience of their working conditions when dealing with applications for disability pension2008Inngår i: Work: A journal of Prevention, Assesment and rehabilitation, ISSN 1051-9815, E-ISSN 1875-9270, Vol. 31, nr 4, s. 451-459Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The aim of this study was to describe how Swedish social insurance officers experienced their working conditions, when dealing with applications for disability pensions (DPs). A qualitative research design was selected to describe their experiences. Open-ended interviews with ten social insurance officers were analyzed with inductive content analysis. This analysis showed that the working conditions were influenced by rules and regulations and the social insurance officers' competence. The social insurance officers' powerful positions and how their discretion was implemented made them feel responsible for performing their work well. They felt that the large number of clients hampered them from being able to offer the clients the activities they were entitled to, and from paying each client sufficient attention. There was a need for time to reflect and to improve management, in order to better develop the way in which DPs were handled. There was a difference in culture between the older social insurance officers, who had experience-based training, and the younger social insurance officers, who had academic qualifications. The results from this study could be used to better develop the organisation of work in the social insurance agency, and in further educational activities.

  • 1197.
    Ydreborg, Berit
    et al.
    Department of Community Medicine and Public Health, Örebro County Council, Örebro, Sweden / National Centre for Work and Rehabilitation, Department of Health and Society, Linköping University, Linköping, Sweden.
    Ekberg, Kerstin
    National Centre for Work and Rehabilitation, Department of Health and Society, Linköping University, Linköping, Sweden.
    Nilsson, Kerstin
    Högskolan i Skövde, Institutionen för vård och natur.
    Swedish social insurance officers' experiences of difficulties in assessing applications for disability pensions: an interview study2007Inngår i: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 7, s. 128-Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background

    In this study the focus is on social insurance officers judging applications for disability pensions. The number of applications for disability pension increased during the late 1990s, which has resulted in an increasing number of disability pensions in Sweden. A more restrictive attitude towards the clients has however evolved, as societal costs have increased and governmental guidelines now focus on reducing costs. As a consequence, the quantitative and qualitative demands on social insurance officers when handling applications for disability pensions may have increased. The aim of this study was therefore to describe the social insurance officers' experiences of assessing applications for disability pensions after the government's introduction of stricter regulations.

    Methods

    Qualitative methodology was employed and a total of ten social insurance officers representing different experiences and ages were chosen. Open-ended interviews were performed with the ten social insurance officers. Data was analysed with inductive content analysis.

    Results

    Three themes could be identified as problematic in the social insurance officers' descriptions of dealing with the applications in order to reach a decision on whether the issue qualified applicants for a disability pension or not: 1. Clients are heterogeneous. 2. Ineffective and time consuming waiting for medical certificates impede the decision process. 3. Perspectives on the issue of work capacity differed among different stakeholders. The backgrounds of the clients differ considerably, leading to variation in the quality and content of applications. Social insurance officers had to make rapid decisions within a limited time frame, based on limited information, mainly on the basis of medical certificates that were often insufficient to judge work capacity. The role as coordinating actor with other stakeholders in the welfare system was perceived as frustrating, since different stakeholders have different goals and demands. The social insurance officers experience lack of control over the decision process, as regulations and other stakeholders restrict their work.

    Conclusion

    A picture emerges of difficulties due to disharmonized systems, stakeholder-bound goals causing some clients to fall between two stools, or leading to unnecessary waiting times, which may limit the clients' ability to take an active part in a constructive process. Increased communication with physicians about how to elaborate the medical certificates might improve the quality of certificates and thereby reduce the clients waiting time.

  • 1198.
    Yildirimman, Reha
    et al.
    Max Planck Inst Mol Genet, Dept Vertebrate Genom, D-14195 Berlin, Germany .
    Brolén, Gabriella
    Cellartis AB, SE-41346 Gothenburg, Sweden .
    Vilardell, Mireia
    Max Planck Inst Mol Genet, Dept Vertebrate Genom, D-14195 Berlin, Germany .
    Eriksson, Gustav
    Cellartis AB, SE-41346 Gothenburg, Sweden .
    Synnergren, Jane
    Högskolan i Skövde, Institutionen för vård och natur.
    Gmuender, Hans
    Genedata AG, CH-4053 Basel, Switzerland .
    Kamburov, Atanas
    Max Planck Inst Mol Genet, Dept Vertebrate Genom, D-14195 Berlin, Germany .
    Ingelman-Sundberg, Magnus
    Karolinska Inst, Dept Physiol & Pharmacol, Pharmacogenet Sect, S-17177 Stockholm, Sweden .
    Castell, Jose
    Univ Valencia, Fac Med, Dept Biochem & Mol Biol, E-46009 Valencia, Spain / Univ Hosp La Fe Valencia, Unit Expt Hepatol, E-46009 Valencia, Spain .
    Lahoz, Agustin
    Univ Hosp La Fe Valencia, Unit Expt Hepatol, E-46009 Valencia, Spain .
    Kleinjans, Jos
    Maastricht Univ, Dept Toxicogen, NL-6229 ER Maastricht, Netherlands.
    van Delft, Joost
    Maastricht Univ, Dept Toxicogen, NL-6229 ER Maastricht, Netherlands.
    Bjorquist, Petter
    Cellartis AB, SE-41346 Gothenburg, Sweden .
    Herwig, Ralf
    Max Planck Inst Mol Genet, Dept Vertebrate Genom, D-14195 Berlin, Germany .
    Human Embryonic Stem Cell Derived Hepatocyte-Like Cells as a Tool for In Vitro Hazard Assessment of Chemical Carcinogenicity2011Inngår i: Toxicological Sciences, ISSN 1096-6080, E-ISSN 1096-0929, Vol. 124, nr 2, s. 278-290Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Hepatocyte-like cells derived from the differentiation of human embryonic stem cells (hES-Hep) have potential to provide a human relevant in vitro test system in which to evaluate the carcinogenic hazard of chemicals. In this study, we have investigated this potential using a panel of 15 chemicals classified as noncarcinogens, genotoxic carcinogens, and nongenotoxic carcinogens and measured whole-genome transcriptome responses with gene expression microarrays. We applied an ANOVA model that identified 592 genes highly discriminative for the panel of chemicals. Supervised classification with these genes achieved a cross-validation accuracy of > 95%. Moreover, the expression of the response genes in hES-Hep was strongly correlated with that in human primary hepatocytes cultured in vitro. In order to infer mechanistic information on the consequences of chemical exposure in hES-Hep, we developed a computational method that measures the responses of biochemical pathways to the panel of treatments and showed that these responses were discriminative for the three toxicity classes and linked to carcinogenesis through p53, mitogen-activated protein kinases, and apoptosis pathway modules. It could further be shown that the discrimination of toxicity classes was improved when analyzing the microarray data at the pathway level. In summary, our results demonstrate, for the first time, the potential of human embryonic stem cell--derived hepatic cells as an in vitro model for hazard assessment of chemical carcinogenesis, although it should be noted that more compounds are needed to test the robustness of the assay.

  • 1199.
    Zeijlon, Jessika
    et al.
    Högskolan i Skövde, Institutionen för vård och natur.
    Lidestam, Magdalena
    Högskolan i Skövde, Institutionen för vård och natur.
    Vad förebygger depression bland äldre: en litteraturstudie2012Independent thesis Basic level (degree of Bachelor), 10 poäng / 15 hpOppgave
    Abstract [sv]

    Depression bland äldre är ett utbrett folkhälsoproblem, samtidigt ett eftersatt område. Depression innebär lidande för individen och dennes anhöriga samt medför stora sjukvårdskostnader. Cirka 12-15 procent av befolkningen över 65 år beräknas vara drabbade av depression. Syftet med litteraturstudien var att sammanställa och analysera forskningsresultat avseende vilka faktorer som kan ha betydelse för att förebygga depression bland äldre. Litteratursökningar gjordes i databaserna LibHub, PubMed och Cinahl med sökorden: prevention, depression, depressive symptoms, elderly, old och old people. Tolv artiklar analyserades och delades in i fem teman: aktivitet, kosttillskott, socialt stöd, kognitiva strategier och utbildning av omsorgspersonal. Tema aktivitet visade motstridiga resultat, kosttillskott var effektivt i en av två studier, socialt stöd var en betydelsefull faktor för att förebygga depression och motverka negativa effekter av stressfulla livshändelser och ekonomisk stress. Kognitiva strategier såsom copingstrategin ”positiv omstrukturering” samt KBT-behandling visade sig ha effekt på depressionssymtom. Ett interventionsprogram innehållande utbildning av omsorgspersonal hade signifikant effekt, speciellt på äldreboenden med hög prevalens av depression. Slutsats: Vidare litteraturstudier och ytterligare fördjupning i de olika temana behövs för att kunna dra riktiga slutsatser. Det finns behov av mer forskning på området, större studier och längre uppföljning behövs.

  • 1200.
    Zhang, Hong
    et al.
    Högskolan i Skövde, Institutionen för vård och natur.
    Sun, Xiao-Feng
    Department of Biomedicine and Surgery, Faculty of Health Sciences, Linköping University, Linköping, Sweden.
    Synnerstad, Ingrid
    Division of Dermatology, Department of Clinical and Experimental Medicine, Linköping University, Sweden.
    Rosdahl, Inger
    Division of Dermatology, Department of Clinical and Experimental Medicine, Linköping University, Sweden.
    Importance of FAS-1377, FAS-670 and FASL-844 Polymorphisms in Tumor Onset, Progression and Pigment Phenotypes of Swedish Patients With Melanoma: A Case-Control Analysis2007Inngår i: The Cancer Journal, ISSN 1528-9117, E-ISSN 1540-336X, Vol. 13, nr 4, s. 233-237Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    PURPOSE: Human skin melanoma at later stages usually has an extremely poor prognosis. It is of importance to search for biologic markers to identify and monitor individuals at risk for melanoma for early diagnosis and to avoid tumor progression. The FAS gene and its natural ligand (FASL) gene initiate the death signal cascade, playing a central role in the apoptotic signaling pathway and tumor growth and metastasis. PATIENTS AND METHODS: In this study, we analyzed polymorphisms in 229 patients with melanoma and 351 age- and gender-matched tumor-free individuals. Genomic DNAs were isolated from mononuclear cells in peripheral vein blood, and the polymorphisms were examined with polymerase chain reaction-restriction fragment length polymorphism techniques. Frequency in distribution of the polymorphisms was compared between the patients with melanoma and the healthy control subjects, and associations with patients' pigment phenotypes, age at diagnosis, and melanoma characteristics were analyzed. RESULTS AND CONCLUSIONS: The FAS-1377, FAS-670, and FASL-844 polymorphisms were not found to be markers of melanoma risk (P > 0.05). In patients with melanoma, frequencies of the FAS-1377, FAS-670, and FASL-844 polymorphisms were different between the patients aged <50 and > or =50 years (P < or = 0.025, P < or = 0.025, and P < or = 0.01). Moreover, the FAS-670 polymorphism correlated with tumor Breslow thickness (P < or = 0.01) and Clark level (P < or = 0.001) and was associated with tumors developing in sun-exposed locations (P < or = 0.001). FAS and FASL were not markers for melanoma risk but might be important in the development and progression of sun-induced melanoma independently of skin type.

2122232425 1151 - 1200 of 1212
RefereraExporteraLink til resultatlisten
Permanent link
Referera
Referensformat
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Annet format
Fler format
Språk
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Annet språk
Fler språk
Utmatningsformat
  • html
  • text
  • asciidoc
  • rtf