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  • 251.
    Dalefalk Basiri, Nilofar
    University of Skövde, School of Life Sciences.
    Att vara förälder till ett barn med diagnosen leukemi: - en studie av självbiografier2010Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Akut lymfatisk leukemi (ALL) är den vanligaste typen av leukemi bland barn. I Sverige diagnostiseras cirka 80 barn med leukemi varje år. Cancer är en sjukdom som inte enbart drabbar barnet utan hela familjen påverkas. Tidigare forskning påvisar hur sjukdomen, behandlingarna samt sjukhusvistelsen påverkar föräldrarna. Syftet med denna studie är att, med hjälp av självbiografier, belysa föräldrars upplevelser av att ha ett barn med diagnosen leukemi. Metoden som använts är en kvalitativ metod där sex självbiografier analyserats. Genom analys framträdde tre huvudteman med tio tillhörande subteman. Huvudtemana är: förlora fotfästet i tillvaron, nya tillvaron och när hoppet sviker. Resultatet visade att väntan och ovisshet ökade stressen hos föräldrarna och ledde till en känsla av hjälplöshet. Under barnets sjukdomstid slets föräldrarna mellan hopp och känslan av maktlöshet. Föräldrarna upplevde personalkontinuiteten som en viktig del under sjukhusvistelsen. Att bryta upp från en välkänd miljö och lära känna ny personal var svårt. Resultatet i studien är värdefull för sjukvårdspersonal. Genom ökad förståelse kan ett optimalt samarbete främjas mellan sjuksköterska och föräldrar. Detta leder förhoppningsvis också till ett ökat välbefinnande hos barnen.

  • 252.
    Das Burman, Anindita
    University of Skövde, School of Life Sciences.
    TGF-β (BETA) AND PERIOSTIN MODULATE EACH OTHER’S EXPRESSION IN BOTH BREAST STROMA AND TUMOR CELLS2013Independent thesis Advanced level (degree of Master (One Year)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    Breast cancer is the most common cancer in female population worldwide. In addition to mutations, the breast tumor microenvironment especially the tumor cell - stroma interactions through extracellular matrix components and multiple growth factors have been shown to promote tumor progression. Among those, increases in both TGF-β (transforming growth factor beta) activities and periostin expression were associated with tumor cell survival, proliferation and metastasis. TGF-β role in breast cancer progression including its ability to promote periostin expression has been extensively studied. In contrast, the role of periostin in cancer progression remains to be fully understood. Thus, the present study aimed to determine whether TGF-β and periostin have effect on each other’s expressions in breast tumor and stroma cells using in vitro cell models. Through Western blot analyses and ELISAs, the periostin and TGF-β expressions of both stroma and tumor cells were analyzed following TGF-β and periostin treatments, respectively. The results indicate that TGF-β treatments led to significant increase in periostin expression in fibroblasts (p<0.05). In addition, periostin was differentially expressed by human breast cancer cells following TGF-β1 treatment. The TGF-β activities involved activation of pSMAD2 in both L929 fibroblasts and MCF10A mammary cells. Taken together, all experimental data indicate that within the breast tumor TGF-β and periostin likely participate in a regulation loop. Whether this putative regulation loop is critical to metastasis remains to be determined. Should periostin play a critical role in breast cancer progression, it could become a specific target in the preventive and/or therapeutic development of breast cancer patients.

  • 253.
    de Groot, Gudrun Cathrine Lindgren
    et al.
    Telemark Hospital, Norway / Buskerud University College, Norway.
    Fagerström, Lisbeth
    University of Skövde, School of Life Sciences. Buskerud University College, Norway / Lovisenberg Deaconale University College, Norway.
    Older adults' motivating factors and barriers to exercise to prevent falls2011In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 18, no 2, p. 153-160Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to describe motivating factors and barriers for older adults to adhere to group exercise in the local community aiming to prevent falls, and thereby gain knowledge about how health professionals can stimulate adherence. The motivation equation was used as a theoretical framework. Data were collected from individual semi-structured interviews (n = 10). The interviews were taped, transcribed, and thereafter analysed by using a descriptive content analysis consisting of four steps. The results showed that motivating factors to adhere to recommended exercise were perceived prospects of staying independent, maintaining current health status, and improving physical balance and the ability to walk. Barriers were reduced health status, lack of motivation, unpleasant experience during previous exercise group sessions, and environmental factors. All participants wanted information from health professionals on the benefit of exercise. Many considered individual variations in functional skills within each group as a disadvantage. The knowledge gained from this study suggests a greater involvement from all health professionals in motivating older adults to attend exercise groups. The results also suggest that physical therapists should be more aware of the importance of comparative levels of physical function when including participants in exercise groups.

  • 254.
    de la Rosée, Tommy
    University of Skövde, School of Life Sciences.
    Sjuksköterskans uppfattningar om vård av barn på sjukhus i samband med barnets diabetesdebut2008Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Approximately 600 young people in the ages 0-14 years get diagnosed with diabetes mellitus type 1 in Sweden each year. The numbers of young people that get diagnosed with diabetes mellitus type 1 increase continuously. In connection with the diabetes debut, the entire family is affected. Parents, relatives and children must learn to live with the disease and above all, try to adapt the everyday existence on the basis of the new conditions that comes with the disease. To make this adaptation possible, the healthcare contributes with important knowledge and care, especially during the diseases debut. The aim of this study was to describe the nurse's way of experiences about care of children on hospitals in connection with the child's diabetes debut. A qualitative method and a phenomenographic approach were used in order to describe variations and ways of experience at the nurses. Data collection occurred during interviews. The result describes the nurse's way of experience in three categories: information, questions and the way out of the hospital. The result shows that the nurses notice problems and scarcity in the information they handle. They saw that the adaption to the everyday is important and that the nurses have an important role in this guidance. The knowledge from this study shows that it’s important to see the child together with the family. It also shows the value of good follow-up.

  • 255.
    de Peppo, G.M.
    et al.
    Sahlgrenska Academy at University of Gothenburg.
    Svensson, S.
    Sahlgrenska Academy at University of Gothenburg.
    Lennerås, M.
    BIOMATCELL VINN Excellence Center of Biomaterials and Cell Therapy, Göteborg.
    Synnergren, Jane
    University of Skövde, The Systems Biology Research Centre. University of Skövde, School of Life Sciences.
    Stenberg, J.
    Sahlgrenska University Hospital, University of Gothenburg.
    Strehl, R.
    Cellartis AB, Göteborg.
    Hyllner, J.
    Cellartis AB, Göteborg.
    Thomsen, P.
    Sahlgrenska Academy at University of Gothenburg.
    Karlsson, C.
    Sahlgrenska Academy at University of Gothenburg.
    Human Embryonic Mesodermal Progenitors Highly Resemble Human Mesenchymal Stem Cells and Display High Potential for Tissue Engineering Applications2010In: Tissue Engineering. Part A, ISSN 1937-3341, E-ISSN 1937-335X, Vol. 16, no 7, p. 2161-2182Article in journal (Refereed)
    Abstract [en]

    Adult stem cells, such as human mesenchymal stem cells (hMSCs), show limited proliferative capacity and, after long-term culture, lose their differentiation capacity and are therefore not an optimal cell source for tissue engineering. Human embryonic stem cells (hESCs) constitute an important new resource in this field, but one major drawback is the risk of tumor formation in the recipients. One alternative is to use progenitor cells derived from hESCs which are more lineage restricted but do not form teratomas. We have recently derived a cell line from hESCs denoted human embryonic stem cell-derived mesodermal progenitors (hESMPs) and here, using genome wide microarray analysis, report that the process of hES-MPs derivation results in a significantly altered expression of hESCs characteristic genes to an expression level highly similar to that of hMSCs. However, hES-MPs displayed a significantly higher proliferative capacity and longer telomeres. Interestingly, the hES-MPs also demonstrated a lower expression of HLA class II proteins before and after interferon-γ treatment, indicating that these cells may somewhat be immunoprivileged and potentially used for HLA-incompatible transplantation. The hES-MPs are thus an appealing alternative to hMSCs in tissue engineering applications and stem cell-based therapies for mesodermal tissues.

  • 256.
    Deo, Ameya
    University of Skövde, School of Life Sciences.
    Normalization of microRNA expression levels in Quantitative RT-PCR arrays2010Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Real-time quantitative Reverse Transcriptase Polymerase Chain Reaction (qRT-PCR) is recently used for characterization and expression analysis of miRNAs. The data from such experiments need effective analysis methods to produce reliable and high-quality data. For the miRNA prostate cancer qRT-PCR data used in this study, standard housekeeping normalization method fails due to non-stability of endogenous controls used. Therefore, identifying appropriate normalization method(s) for data analysis based on other data driven principles is an important aspect of this study.

    Results: In this study, different normalization methods were tested, which are available in the R packages Affy and qpcrNorm for normalization of the raw data. These methods reduce the technical variation and represent robust alternatives to the standard housekeeping normalization method. The performance of different normalization methods was evaluated statistically and compared against each other as well as with the standard housekeeping normalization method. The results suggest that qpcrNorm Quantile normalization method performs best for all methods tested.

    Conclusions: The qpcrNorm Quantile normalization method outperforms the other normalization methods and standard housekeeping normalization method, thus proving the hypothesis of the study. The data driven methods used in this study can be applied as standard procedures in cases where endogenous controls are not stable.

  • 257.
    Deo, Ameya
    et al.
    University of Skövde, The Systems Biology Research Centre. University of Skövde, School of Life Sciences.
    Carlsson, Jessica
    University of Skövde, The Systems Biology Research Centre. University of Skövde, School of Life Sciences.
    Lindlof, Angelica
    University of Skövde, The Systems Biology Research Centre. University of Skövde, School of Life Sciences.
    HOW TO CHOOSE A NORMALIZATION STRATEGY FOR MIRNA QUANTITATIVE REAL-TIME (QPCR) ARRAYS2011In: Journal of Bioinformatics and Computational Biology, ISSN 0219-7200, E-ISSN 1757-6334, Vol. 9, no 6, p. 795-812Article in journal (Refereed)
    Abstract [en]

    Low-density arrays for quantitative real-time PCR (qPCR) are increasingly being used as an experimental technique for miRNA expression profiling. As with gene expression profiling using microarrays, data from such experiments needs effective analysis methods to produce reliable and high-quality results. In the pre-processing of the data, one crucial analysis step is normalization, which aims to reduce measurement errors and technical variability among arrays that might have arisen during the execution of the experiments. However, there are currently a number of different approaches to choose among and an unsuitable applied method may induce misleading effects, which could affect the subsequent analysis steps and thereby any conclusions drawn from the results. The choice of normalization method is hence an important issue to consider. In this study we present the comparison of a number of data-driven normalization methods for TaqMan low-density arrays for qPCR and different descriptive statistical techniques that can facilitate the choice of normalization method. The performance of the normalization methods was assessed and compared against each other as well as against standard normalization using endogenous controls. The results clearly show that the data-driven methods reduce variation and represent robust alternatives to using endogenous controls.

  • 258.
    Desale, Prithviraj
    et al.
    Dr. D. Y. Patil Biotechnology and Bioinformatics Institute, Mumbai-Pune Expressway, Survey No. 87/88, Tathawade, Pune 411033, India.
    Prakash, Divya
    Department of Microbiology, University of Pune, Pune 41107. India.
    Keyur, Patel
    Dr. D. Y. Patil Biotechnology and Bioinformatics Institute, Mumbai-Pune Expressway, Survey No. 87/88, Tathawade, Pune 411033, India.
    Rupali, Aursang
    Dr. D. Y. Patil Biotechnology and Bioinformatics Institute, Mumbai-Pune Expressway, Survey No. 87/88, Tathawade, Pune 411033, India.
    Nawani, Neelu
    Dr. D. Y. Patil Biotechnology and Bioinformatics Institute, Mumbai-Pune Expressway, Survey No. 87/88, Tathawade, Pune 411033, India.
    Kapadnis, Balasaheb
    Department of Microbiology, University of Pune, Pune 41107. India.
    Khetmalas, Madhukar
    Dr. D. Y. Patil Biotechnology and Bioinformatics Institute, Mumbai-Pune Expressway, Survey No. 87/88, Tathawade, Pune 411033, India.
    Mandal, Abul
    University of Skövde, School of Life Sciences. University of Skövde, The Systems Biology Research Centre.
    Biosorption of Heavy Metals by Actinomycetes for Treatment of Industrial Effluents2012In: / [ed] Buhri Arifin, Siti Nur`Afifah Jaafar, Sayed Mohamed Zain S. Hasan, Anuar Hassan, H. M. Edi Armanto, Chuah Tse Seng, Wan Zaliha Wan Sembok, Shahreza Md Sheriff, Suparjo Noordin Mokhtar, Fazlil Ilahi Abdul Wahab, Hayati Mohd Yusof, Adzemi Mat. Arshad, Universiti Malaysia Terengganu , 2012, p. 389-393Conference paper (Refereed)
    Abstract [en]

    Rapid industrialization usually is the cause of increase in pollutants in the natural river bodies. This pollution is attributed to lack of improper treatment and inadequate disposal mechanisms of the waste generated thereof. The aim of present investigation was to screen actinomycetes for their ability to adsorb heavy metals. Actinomycetes belong to most diverse group of filamentous prokaryotes with ubiquitous presence in different ecological niches. This ubiquity is due to their ability to degrade almost any type of polymer and to use several compounds as carbon sources. Nearly 200 actinomycetes from different niches like fresh water, soda lake, geothermal springs, acid soils, etc from different locations in India were screened for ability to grow in presence of 1 to 5 mM of heavy metals like Cd, Hg, Pb, Ni, Sr, Fe, Mo, Zn and Mn. Most of the strains tolerant to heavy metals belonged to the genus Streptomyces spp. Five strains could grow in presence of 5 mM Cd2+, 4 strains in presence of 0.1 mM Hg2+, 18 strains in presence of 5 mM Pb2+, 21 strains in presence of 5 mM Ni2+, whereas 34 strains grew in presence of 5 mM Fe2+. One of the most promising strain was studied for its ability to absorb cadmium where 2x1011 cells or spores could adsorb 0.32 mM to 0.33 mM of cadmium. Spores and vegetative cells showed nearly similar level of adsorbtion ability. This strain can be very useful in developing a bioreactor for the adsorption of heavy metals from industrial effluents containing cadmium.

  • 259.
    Di Marco, I.
    et al.
    Uppsala University, Sweden.
    Thunström, P.
    Uppsala University, Sweden / Institute for Solid State Physics, Vienna University of Technology, Austria.
    Katsnelson, M. I.
    Radboud University Nijmegen, The Netherlands.
    Sadowski, J.
    Polish Academy of Sciences, Poland / Lund University, Sweden.
    Karlsson, Krister
    University of Skövde, School of Life Sciences.
    Lebegue, S.
    Institut Jean Barriol, Université de Lorraine, France.
    Kanski, J.
    Chalmers University of Technology, Sweden.
    Eriksson, O.
    Uppsala University, Sweden.
    Electron correlations in MnxGa1-xAs as seen by resonant electron spectroscopy and dynamical mean field theory2013In: Nature Communications, ISSN 2041-1723, E-ISSN 2041-1723, Vol. 4, article id 2645Article in journal (Refereed)
    Abstract [en]

    After two decades since the discovery of ferromagnetism in manganese-doped gallium arsenide, its origin is still debated, and many doubts are related to the electronic structure. Here we report an experimental and theoretical study of the valence electron spectrum of manganese-doped gallium arsenide. The experimental data are obtained through the differences between off- and on-resonance photo emission data. The theoretical spectrum is calculated by means of a combination of density-functional theory in the local density approximation and dynamical mean field theory, using exact diagonalization as impurity solver. Theory is found to accurately reproduce measured data and illustrates the importance of correlation effects. Our results demonstrate that the manganese states extend over a broad range of energy, including the top of the valence band, and that no impurity band splits-off from the valence band edge, whereas the induced holes seem located primarily around the manganese impurity.

  • 260.
    Dinha, Carolin
    University of Skövde, School of Life Sciences.
    Regulation of Ski co-repressor stability by TGF-β signaling in normal and tumorigenic hepatocytes2011Independent thesis Basic level (degree of Bachelor), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    Transforming growth factor beta (TGF-β) is a multifunctional cytokine that regulates cell differentiation, proliferation and migration depending on cell context. TGF-β has a growth inhibitory effect on epithelial cells via activation of Smad proteins (R-Smad/Co-Smad complex). TGF-β signaling is negatively regulated by the proto-oncogene Ski (Sloan Kettering Institute). Ski in turn is degraded by TGF-β signaling (Smads) via ubiquitin proteasome system. TGF-β acts like a tumor suppressor in early stages of cancer due to its inhibitory growth effect, but in late stages it acts like a tumor promoter. The main aim of this thesis was to study the regulation of corepressor Ski stability in normal and transformed hepatic cells by TGF-β signaling and Smad proteins as well as determine Ski protein subcellular localization by using immunoprecipitation and Western blot assays for these studies. The obtained data showed that the TGF-β/Smad signaling pathway caused a downregulation of Ski protein through its degradation via proteasome in HepG2 cells. In addition, the Ski protein levels were restored when Smads were restored in C9 and hepatocytes even though the activated Smads were still present. In the subcellular fractionation studies it was observed that Ski protein was mainly localized in the nucleus of HepG2 cells, whereas it was localized in both nucleus and cytoplasm in hepatocytes.  The presence of Ski in the cell cytoplasm could be explained because of low sensitivity in TGF-β signaling or translocation of Ski from nucleus to cytoplasm. C184M is a protein that binds to Ski in the cytoplasm and Ski in turn binds to Smads and inhibits their translocation from cytoplasm to nucleus, which in turn means inhibition of gene transcription that instead results in growth stimulation.

  • 261.
    Djapo, Medisa
    et al.
    University of Skövde, School of Life Sciences.
    Gustafsson, Ellinor
    University of Skövde, School of Life Sciences.
    Åhl, Isabell
    University of Skövde, School of Life Sciences.
    Betydelsen av stöd för postmenopausala kvinnor med bröstcancer: En litteraturöversikt2010Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Breast cancer is the most common cancer among women in Sweden.  In 2008 there were about 7300 women diagnosed with breast cancer and of these 72 per cent were 55 years or older. Earlier research showed that postmenopausal women with breast cancer aged 55 years and older felt that they were not getting enough support from health professionals and relatives.

    Aim: The aim of this study is to describe how postmenopausal women with breast cancer experience different types of support and how these affect their health.

    Method: A literature review was used in which 16 qualitative and quantitative studies were examined and analyzed according to Friberg (2006).

    Results: The data analysis of the articles revealed five themes and these are: emotional support, health professionals` support, relatives´ support, religious support and information support. We found that these supports are important for postmenopausal women´s health and quality of life.

    Conclusions: Different types of support from relatives and health professionals are perceived as important for postmenopausal women with breast cancer. More research is needed to get a better understanding of which supports that are important for postmenopausal women with breast cancer and how it affects their health.

  • 262.
    Djup- Larsson, Lisbeth
    et al.
    University of Skövde, School of Life Sciences.
    Eriksson, Malin
    University of Skövde, School of Life Sciences.
    Samordningens betydelse för vård av patienter i hemmet: En kvalitativ studie av distriktssköterskors erfarenheter2010Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    With an increasing number of patients cared for at home, coordination between different health care actors requires to work in order to offer the patient a good and safe health care. Purpose of this study was to describe the district nurses experiences of coordinating health care for patients cared for at home. A qualitative method was used and as data collection method, interviews where used. Six district nurses from a township in western Sweden where interviewed. The study-results can be assigned to five categories: shifting and complex care to be coordinated; coordination based on the patients needs and situation; difficulties in coordinating health care when the holistic view breaks apart; coordination of a patient´s medical situation demands accessibility to a doctor which can be consulted and satisfaction for both patients and district nurses when coordination works. Results showed that in order to provide a good and safe nurse care, the coordination of health care between district nurses has to work. Depending on how the coordination between different care actors happens, the nursing of the district nurses around the patient is affected in both negative and positive directions. The study shows that there is a need of understanding between the different care services to insure the quality of the coordination between different care actors and their effect on district nurses care of patients at home. When the coordination fails it affects not only the care of the patients but also the districts nurses work situation.

  • 263.
    Djurberg, Annica Maria
    et al.
    University of Skövde, School of Life Sciences.
    Granberg, Anna Helena
    University of Skövde, School of Life Sciences.
    Sjuksköterskors attityder och förhållningssätt till patienter med fetma: en litteraturöversikt2008Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Fetma är en sjukdom som drabbar allt fler människor i världen, och problemet beräknas öka bland befolkningen. Många människor med fetma får hjälp av sjukvården för att få stöd i en livsstilsförändring. Alla patienter har rätt att bli behandlade med respekt och värdighet, utifrån den de är, oberoende av kroppsstorlek eller personlighet. Syfte: Syftet med studien var att belysa sjuksköterskors attityder och förhållningssätt till patienter med fetma utifrån tidigare forskning. Metod: Studien bestod i en litteraturöversikt över tidigare publicerad forskning. Datamaterialet som format resultatet inom ämnet begränsades till åtta vetenskapliga artiklar, av både kvalitativ och kvantitativ ansats. Resultat: Fem teman med subtema framstår: känsligheten runt patientens vikt och livssituation, -patientens eget ansvar för sin vikt och livsföring, -beteende och personlighet, -kunskap, utbildning och utrustning, -sjuksköterskans ansvar. Slutsats: Sjuksköterskors attityder till patienter med fetma, positiva och negativa, påverkar patientens möjlighet att uppleva tillfredsställelse och genomföra en livsstilsförändring. I studien framgår även att en god relation mellan patient och sjuksköterska är en förutsättning för att patienten ska få förtroende för sjuksköterskan och känna sig trygg i sin situation.

  • 264.
    Dnyansagar, Rohit
    University of Skövde, School of Life Sciences.
    Investigation of phylogenetic relationships using microRNA sequences and secondary structures2010Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    MicroRNAs are important biomolecules for regulating biological processes. Moreover, the secondary structure of microRNA is important for its activity and has been used previously as a mean for finding unknown microRNAs. A phylogenetic study of the microRNA secondary structure reveals more information than its primary sequence, because the primary sequence can undergo mutations that give rise to different phylogenetic relationships, whereas the secondary structure is more robust against mutations and therefore sometimes  more informative.

    Here we constructed a phylogenetic tree entirely based on microRNA secondary structures using tools PHYLIP (Felsenstein, 1995) and RNAforester (Matthias Höchsmann, 2003, Hochsmann et al., 2004), and compared the overall topology and clusters with the phylogenetic tree constructed using microRNA sequence. The purpose behind this comparison was to investigate the sequence and structure similarity in phylogenetic context and also to investigate if functionally similar microRNA genes are closer in their structure-derived phylogenetic tree.

    Our phylogenetic comparison shows that the sequence similarity has hardly any effect on the structure similarity in the phylogenetic tree. MicroRNAs that have similar function are closer in the phylogenetic tree based on secondary structure than its respective sequence phylogeny. Hence, this approach can be very useful in predicting the functions of the new microRNAs whose function is yet to be known, since the function of the miRNAs heavily relies on its secondary structure.

     

  • 265.
    Doktorova, Tatyana Y.
    et al.
    Department of Toxicology, Center for Pharmaceutical Research, Vrije Universiteit Brussel, Brussels, Belgium.
    Yildirimman, Reha
    Department of Vertebrate Genomics, Max Planck Institute for Molecular Genetics, Berlin, Germany.
    Vinken, Mathieu
    Department of Toxicology, Center for Pharmaceutical Research, Vrije Universiteit Brussel, Brussels, Belgium.
    Vilardell, Mireia
    Department of Vertebrate Genomics, Max Planck Institute for Molecular Genetics, Berlin, Germany.
    Vanhaecke, Tamara
    Department of Toxicology, Center for Pharmaceutical Research, Vrije Universiteit Brussel, Brussels, Belgium.
    Gmuender, Hans
    Genedata AG, Basel, Switzerland.
    Bort, Roque
    Unit of Experimental Hepathology, University Hospital La Fe Valencia, Spain / Faculty of Medicine, Department of Biochemistry and Molecular Biology, University of Valencia, Valencia, Spain.
    Brolen, Gabriella
    Cellectis, Göteborg, Sweden.
    Holmgren, Gustav
    University of Skövde, School of Life Sciences. University of Skövde, The Systems Biology Research Centre. Cellectis, Göteborg, Sweden.
    Li, Ruoya
    Biopredic International, Rennes, France.
    Chesne, Christophe
    Biopredic International, Rennes, France.
    van Delft, Joost
    Department of Toxicogenomics, Maastricht University, Maastricht, The Netherlands.
    Kleinjans, Jos
    Department of Toxicogenomics, Maastricht University, Maastricht, The Netherlands.
    Castell, Jose
    Unit of Experimental Hepathology, University Hospital La Fe Valencia, Spain / Faculty of Medicine, Department of Biochemistry and Molecular Biology, University of Valencia, Valencia, Spain.
    Björquist, Petter
    Cellectis, Göteborg, Sweden.
    Herwig, Ralf
    Department of Vertebrate Genomics, Max Planck Institute for Molecular Genetics, Berlin, Germany.
    Rogiers, Vera
    Department of Toxicology, Center for Pharmaceutical Research, Vrije Universiteit Brussel, Brussels, Belgium.
    Transcriptomic responses generated by hepatocarcinogens in a battery of liver-based in vitro models2013In: Carcinogenesis, ISSN 0143-3334, E-ISSN 1460-2180, Vol. 34, no 6, p. 1393-1402Article in journal (Refereed)
    Abstract [en]

    As the conventional approach to assess the potential of a chemical to cause cancer in humans still includes the 2-year rodent carcinogenicity bioassay, development of alternative methodologies is needed. In the present study, the transcriptomics responses following exposure to genotoxic (GTX) and non-genotoxic (NGTX) hepatocarcinogens and non-carcinogens (NC) in five liver-based in vitro models, namely conventional and epigenetically stabilized cultures of primary rat hepatocytes, the human hepatoma-derived cell lines HepaRG and HepG2 and human embryonic stem cell-derived hepatocyte-like cells, are examined. For full characterization of the systems, several bioinformatics approaches are employed including gene-based, ConsensusPathDB-based and classification analysis. They provide convincingly similar outcomes, namely that upon exposure to carcinogens, the HepaRG generates a gene classifier (a gene classifier is defined as a selected set of characteristic gene signatures capable of distinguishing GTX, NGTX carcinogens and NC) able to discriminate the GTX carcinogens from the NGTX carcinogens and NC. The other in vitro models also yield cancer-relevant characteristic gene groups for the GTX exposure, but some genes are also deregulated by the NGTX carcinogens and NC. Irrespective of the tested in vitro model, the most uniformly expressed pathways following GTX exposure are the p53 and those that are subsequently induced. The NGTX carcinogens triggered no characteristic cancer-relevant gene profiles in all liver-based in vitro systems. In conclusion, liver-based in vitro models coupled with transcriptomics techniques, especially in the case when the HepaRG cell line is used, represent valuable tools for obtaining insight into the mechanism of action and identification of GTX carcinogens.

  • 266.
    Dreimane, Baiba
    et al.
    University of Skövde, School of Life Sciences.
    Hagman, Wiebke
    University of Skövde, School of Life Sciences.
    Familjens upplevelser av sorg när en närstående vårdas i livets slutskede: en litteraturbaserad studie2011Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Being faced with the end of life of a loved one has an extensive impact on the whole family, altering their lives and causing grief and suffering. Aim: The aim of this study was to describe family experiences of grief, what impact bereavement had on their lives and also how nurses can support them in their situation. Method: A literature study was conducted and 14 scientific articles were reviewed and analyzed. Result: Three main themes emerged: family’s grief, impact on the family and encounters with health professionals and their support. Families were surprised by their intense grieving reactions.  An open communication between family and patient was often difficult to maintain. Families were affected by the situation with for example family conflicts, a tendency towards isolation and poor health caused by the workload of patient care. Support given by health care professionals was experienced as both positive and negative. Conclusion: Grief is a far more complicated phenomenon than expected. It has to be looked at individually and in its own context each time it occurs. Improved communication skills and an orientation toward family centered care are needed to improve family’s suffering and grief experience.

     

  • 267.
    Drevhage, Pernilla
    et al.
    University of Skövde, School of Life Sciences.
    Thorén, Erica
    University of Skövde, School of Life Sciences.
    Informationens betydelse för patienten med hjärtinfarkt i det akuta skedet2008Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Information should be seen as an integrated part in caring for patients´ that suffer from acute myocardial infarction. The nurse´s support and communication is an important part in caring for the patient. It is of significance that the nurse has an ability to provide knowledge and understanding under busy conditions in the emergency ward. In that way the patient can participate and have ability to take part in their own care and treatment.The aim with the study is to elucidate the information's importance for the patient at the acute phase of his myocardial infarction. The method that has been used is a literature study and the result comprizes in 12 articles, 10 qualitative and 2 quantitative. In the result, five categories has shown. These are: The patient´s experience of the information, the nurse´s roll when giving information, communication between the nurse and the patient, the nurses support to the patient and the patient´s anxiety and fear. The result in the literature study shows that good information in plain language reduces the patient´s worries and anxiety and increases the patient´s understanding of his/her condition. Patients who are given relevant and individual information feel satisfaction with the care and experience an increased well-being.

  • 268.
    Drungaite, Akvile
    University of Skövde, School of Life Sciences.
    Anorexia Nervosa: What Makes Patients Feel Better During the Illness and the Process of Recovery?2009Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

     

     

     

     

     

     

     

     

     

     

     

     

     

    Objective: When caring for a patient with Anorexia Nervosa (AN) it is difficult for the registered nurses to develop a good nurse-patient relationship due to a lack of understanding for the illness.  It is important for the nurse to understand the suffering that the AN patients experience, and what makes them feel better, to be able to improve the patient-nurse relationship. This study aims to explore what makes patients with AN feel better during the illness and the process of recovery.

    Method: A qualitative scientific approach was used. Eight autobiographies were selected as data for this study. Both English and Swedish books were used. The data was analyzed using a qualitative method of data analysis.

    Results: The ways patients with AN could feel better are presented in seven themes: being seen as a whole individual behind the illness, being able to trust and find security, taking responsibility for recovery, finding motivation to keep fighting towards recovery, when one's suffering is noticed, filling a void, and the strengthening of the relationship between care giver and patient. This study may help registered nurses understand the needs of the patient recovering from AN and help them meet these needs in a better way.

  • 269.
    du Rietz Söderström, Ann
    University of Skövde, School of Life Sciences.
    Barnsjuksköterskors erfarenheter i möten med små underviktiga barn och deras föräldrar2009Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    The aim of child health care is to promote health and development for all children, to early identify problems that concern children´s growth and development and to prevent ill-health among children. Today in our society the proportion of children who are underweight are few.

    The aim with this study was to describe paediatric nurses experience in meeting with underweight children and their parents. Interviews were implemented and analyzed according to qualitative content analysis. Focus was placed on looking at differences and interpretations in the text content. The analyse resulted in six main categories, such as a need of sensitivity and a holistic view from the nurse, difficulties in handling the meeting because lack of tools. A positive experience which facilitated the meeting was the emotional sensitivity from the parents. In their work the nurses used different facilities. It was also described how the nurse influenced the meeting with the family.

    It would be desirable to have guidelines for how to handle underweight children.

  • 270.
    Dujso, Denis
    et al.
    University of Skövde, School of Life Sciences.
    Fastesson, Peter
    University of Skövde, School of Life Sciences.
    Omvårdnad vid typ 2 diabetes: En litteraturöversikt om faktorer som påverkar patienters hälsa och välbefinnande2010Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: It’s important to understand the patients’ role in the diabetic care. The careprovider must be able to help the patient on issues like patient education and lifestylechange. The patients’ motivation and self management goes hand in hand and the patientplays an important part coping with his or hers diabetes type 2 disease.Purpose: To deepen our knowledge about the different factors in the caring of patients withdiabetes type 2 that affects their health and wellbeing. Method: The method in this study isa literature review. A model from Friberg (2006) was used to examine the scientific articles.Result: To get an optimal treatment result the relationship between the patient and the careprovider must be built on an equal ground and have a mutual understanding of the treatmentgoals. Patient education is helpful to patients and is seen as a helpful tool to get knowledgeabout diabetes and to get motivation to handle ones diabetes disease at the best waypossible. The patient are a central part in diabetic care and the inner motivation to changeones lifestyle and to handle ones self-management lies within the patient. Discussion: Sincethe inner motivation comes from the patient that’s what the care provider must lay the focuson, to understand how the patient feels and then get him or her motivated. If the careprovider does build a relation with the patient that creates a positive attitude and let’s thepatient come up with own ideas then the patient can be motivated on his or hers own terms,these patients are going to make lifestyle changes and do a lot better with their selfmanagement.This will also mean that the costs for the medical care system and the societyare going to be lower.

  • 271.
    Ebenman, Bo
    et al.
    Department of Biology, IFM, Linköping University, SE-58183 Linköping, Sweden.
    Jonsson, Tomas
    University of Skövde, School of Life Sciences.
    Using community viability analysis to identify fragile systems and keystone species2005In: Trends in Ecology & Evolution, ISSN 0169-5347, E-ISSN 1872-8383, Vol. 20, no 10, p. 568-575Article in journal (Refereed)
    Abstract [en]

    Owing to interdependences among species in ecological communities, the loss of one species can trigger a cascade of secondary extinctions with potentially dramatic effects on the functioning and stability of the community. It is, therefore, important to assess the risk and likely extent of secondary extinctions. Community viability analysis is a new technique that can be used to accomplish this goal. The analysis can also be used to identify fragile community structures and keystone species and, hence, to provide guidelines for conservation priorities. Here, we describe the principles underlying community viability analysis and review its contributions to our understanding of the response of ecological communities to species loss.

  • 272.
    Eckervall, Anneli
    University of Skövde, School of Life Sciences.
    Comparison of plot survey and distance sampling as pellet group counts for deer in Sweden2008Independent thesis Basic level (degree of Bachelor), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    Wildlife management deals with problems concerning sustainable harvest, conservation of threatened species and adjustment of wildlife populations to levels acceptable to for instance forestry, agriculture, traffic and conservation interests. A detailed knowledge of the population is then required. It is therefore important to develop reliable and cost-efficient survey methods.

    The purpose of this study was to test the distance sampling method where objects are observed while walking along a line, as a way of counting deer pellet groups and to compare the results with ordinary plot surveys.

    The inventory speed for distance sampling increases with increasing amount of droppings/km2. The amount of droppings seems to have little or no effect on the inventory speed of the plot survey method. Therefore the plot survey method could be a better alternative than the distance sampling method when the densities of droppings are high and vice versa.

    When comparing the two methods estimates of animal densities with data (orally) from game managers based on other surveys and flying observations and estimations in the different areas, both methods showed too low density for red deer in Valinge. This indicates that the supplementary feeding seem to have an effect on the results of red deer density for both methods.

  • 273.
    Edvardsson, Anton
    et al.
    University of Skövde, School of Life Sciences.
    Nilsson, Karin
    University of Skövde, School of Life Sciences.
    Omvårdnadsåtgärder vid andningssvårigheter hos patienter med sjukdomen KOL: En litteraturstudie2008Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    BACKGROUND: COPD is a disease that increasingly affects more patients around the world; by 2020 is it is projected to be the third most common cause of death. There is no cure against COPD. Moreover, difficulty breathing affects the patient’s quality of life physically and mentally. However, with extensive care patients and their relatives can experience wellbeing in spite of the illness. PURPOSE: The aim of this study is to illustrate how nurses can ease the suffering of patients with COPD with a starting point from the patient’s wishes and the nurse’s experience. METHOD: The study was a literature review based on existing researched data material based on nine scientific articles of qualitative and quantitative nature.

    RESULT: Three themes emerged: the continuously exchange of knowledge; saving the patients strength; and give security and support. The continuously exchange of knowledge refers to knowledge exchange between nurse and patient during the caring process. The second theme describes how the patient’s breathing is affected by the planning of everyday life. The last theme illustrates the mental aspects. CONCLUSION: This study shows a good relationship between patient and nurse is important to create security and support which are the most important things for patients suffering from COPD.

  • 274.
    Edvardsson, Kristina
    et al.
    University of Skövde, School of Life Sciences.
    Carlsson, Johanna
    University of Skövde, School of Life Sciences.
    Bolinder, Catarina
    University of Skövde, School of Life Sciences.
    Patientens delaktighet i vården: En litteraturöversikt2010Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: The patient’s role in health care has changed over the past decade. Today they are more aware of the rights they have in care. All people have the legal right to information and participation in decision making concerning their own care. To include the patient in their own healthcare the approach from the nurse is very important. Research has shown that there still remains a gap in the patients right to participation and because of that, it is important to know what the patients experience as participation and how the nurses could promote this. Aim: The aim of this study is to describe patients’ experience of participation and how nurses believe that they should approach to promote the patient’s participation. Method: The study is a literature review in which both qualitative and quantitative articles were used. Result: The result of the study has shown that patient’s experience participation when they get information and knowledge, which leads to patient feel control over the situation. Patients also experience participation when they have a good relationship with nurses. In order to promote patients participation nurse need to establish a good relationship, provide information, help to control and ensure the patients resources. Discussion: It is important that the nurse always reflect over the patient’s participation and to increase their knowledge in both education and professional activities

  • 275.
    Ehtesham, Ehtesham
    University of Skövde, School of Life Sciences.
    Embryonic Gene Alterations in rats Caused by Exposure to Diabetes and/or Obesity2012Independent thesis Advanced level (degree of Master (One Year)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    There is ample evidence that both diabetes as well as obesity leads to various metabolic disturbances that leads to oxidative stress. Oxidative stress has been shown  to  be  associated  with  congenital  malformations  of  which  neural  tube defects  and  cardiac  malformations  are  more  common.  The  cellular  and molecular  mechanisms  through  which  oxidative  stress  induces  these  defects during the developmental stage are not well known. Previous work in this field suggests   that   oxidative   stress   results   in   lipid   peroxidation   and   altered expression  of  genes  that  have  key  roles  in  the  developmental  processes.  The present study aimed to investigate gene alterations in embryos from pregnant diabetic  or  obese  rats.  Embryos  and  adipose  tissue  obtained  from  the  locally bred  diabetic  and  obese  Sprague-Dawley  inbred  rat  strain  were  subjected  to Total  RNA  extraction  and  were  quantified  using  Real  time  PCR  for  relative gene expressions analysis. The present study showed that maternal diabetes as well  as  obesity  diminishes  the  antioxidative  defense  mechanisms  by  down regulating the gene expressions of the key reactive oxygen species scavenging enzymes   copper   zinc   superoxide   dismutase   and   manganese   superoxide dismutase  in  day  10  rat  embryos.  There  was  also  altered  embryonic  gene expression  for  several  developmental  genes  due  to  maternal  diabetes  at gestational day 11 and 13 in rat embryos.

  • 276.
    Eilefors, Carola
    et al.
    University of Skövde, School of Life Sciences.
    Nordgren, Michaela
    University of Skövde, School of Life Sciences.
    Hur påverkas unga människors sexuella beteenden av olika typer av sexualundervisning?: En litteraturstudie2012Independent thesis Basic level (university diploma), 5 credits / 7,5 HE creditsStudent thesis
    Abstract [sv]

    Sexuellt beteende kan bidra till oönskade konsekvenser hos unga människor. Genom sexualundervisning kan sexuella risktaganden samt oönskade konsekvenser minska hos unga människor. Syftet med denna studie var att studera sexualundervisning och hur den påverkar beteendet hos unga människor mellan 12-24 år. Metoden som användes var en litteraturstudie där tio vetenskapliga artiklar granskades noga. Artiklarna inhämtades från vetenskapliga databaser. Resultatet från litteraturstudien påvisade att sexualundervisning i skolan var en betydelsefull kunskapskälla då den oftast är obligatorisk samt att en del ungdomar inhämtade kunskap från andra källor som till exempel föräldrar, media och kompisar där sexualundervisningen var otillräcklig. Unga människor visade sig ha en varierad kunskap om sexuell hälsa och skillnader mellan kön, etnicitet och sociala förhållanden konstaterades. Inom ämnet behövs fortsatt forskning, för att öka förståelsen för nödvändigheten av obligatorisk sexualundervisning i skolan och eventuellt på andra arenor.

  • 277.
    Einarsson, Sara
    et al.
    University of Skövde, School of Life Sciences.
    Lyppert, Linda
    University of Skövde, School of Life Sciences.
    Sjuksköterskans pedagogiska och preventiva funktion i diabetesvården för att förhindra fotsår2010Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    I denna systematiska litteraturstudie analyseras och beskrivs sjuksköterskans förebyggande(prevention), undervisande och rådgivande funktion i att stödja (promotion) patienter medsjukdomen diabetes typ 2 och i att förhindra (protection) att komplikationer uppstår. I Sverigefinns cirka 365 000 personer som har en diagnostiserad diabetes typ 2 och ungefär lika mångaberäknas ha sjukdomen oupptäckt och odiagnostiserad. Förekomsten av diabetes ökarlavinartat i hela världen just nu. Ökningen kommer att få stora hälsoekonomiska konsekvenserför olika länders sjukvård och samhällen. Då diabetes är en kronisk livslång sjukdom krävsdet i framtiden ökade kunskaper för att möta den utmaning som den pågående utbredningenav sjukdomen utgör.Syftet med denna studie var att söka kunskap utifrån aktuell forskning mellan åren 2005-2009om sjuksköterskans undervisande och rådgivande funktion angående egenvård i samband meddiabetes typ 2, hur uppkomst av fotsår förhindras samt undervisningens effekter.Datamaterialet (10 inkluderade studier) analyserades och sammanställdes.Studiens resultat visade att undervisning i egenvård inte är patient eller individbaserad, attfotkomplikationer inte förebyggs tillräckligt, att det föreligger starkt samband mellanutbildning och livskvalitet samt att sjuksköterskan behöver öka sin pedagogiska kompetens.

  • 278.
    Ekberg Rydén, Siri
    University of Skövde, School of Life Sciences.
    Unga människors upplevelse av övervikt. Vilken roll har skolsköterskan?: En litteraturöversikt2009Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Ungdomstiden är en kritisk period i livet med fysiska och psykiska förändringar. Övervikt och fetma ökar bland unga människor och påverkar deras hälsa. Syftet med denna studie var att beskriva unga människors egna upplevelser av övervikt och detta gjordes i en litteraturöversikt. Tre databaser användes för litteratursökningen, som genomfördes med hjälp av nyckelord som bedömdes relevanta för ämnet. Artiklarna bearbetades och resultatet sammanställdes i fyra olika områden: Kroppsuppfattning och utseende, Upplevd hälsa, Sociala relationer, Skolsituationen. Både uppmätt och upplevd övervikt påverkade självkänslan och vardagen för de unga människorna i varierande grad. Flickor uppfattade sig ofta som överviktiga även om deras BMI var normalt. BMI, Body Mass Index (kroppsmasseindex), är ett mätvärde där kroppsvikt bedöms i förhållande till kroppslängd. Skolsituationen kunde vara svår för unga människor med övervikt eller fetma. Skolsköterskan har en stor del i arbetet med att främja elevers hälsa eftersom lärande och hälsa har ett samband. I detta arbete bekräftades att skolsköterskan behöver kunskap om unga människors egna upplevelser av övervikt.

  • 279.
    Ekblom, Eva- Lena
    et al.
    University of Skövde, School of Life Sciences.
    Götesson, Elin
    University of Skövde, School of Life Sciences.
    Sjuksköterskans moraliska dilemman och förhållningssätt i mötet med abortpatienten: en litteraturstudie2008Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    En sjuksköterska ställs dagligen inför moraliska ställningstaganden. När en patients livsstil och val inte stämmer överens med sjuksköterskans egna värderingar vid exempelvis en abort kan det vara problematiskt att ge en objektiv vård och ett gott bemötande. Syftet med litteraturstudien är att beskriva hur sjuksköterskan handskas med egna moraliska dilemman som uppstår i mötet med abortpatienten och hur sjuksköterskan hanterar dessa dilemman för att skapa förutsättningar för god vård. Metoden som valdes var en litteraturstudie där tolv artiklar analyserades som svarade på studiens syfte och frågeställningar. Ur studiens resultat framkom tre huvudteman, vilka var Egna värderingar och etiska principer i konflikt, Att tvingas ta ställning och Behov av stöd för växt i yrkesprofessionen. Denna studies resultat visar att sjuksköterskor, beroende av anledning till aborten var positivt eller negativt inställda. Genom att sjuksköterskor tog ställning i abortfrågan hanterade de dessa dilemman på olika sätt. Moraliska konflikter och emotionell stress var hög hos sjuksköterskor som upplever att det behövs fler diskussionsforum och fler stödgrupper för att diskutera och reflektera över dessa dilemman. Det är viktigt att sjuksköterskor klargör sina egna värderingar eftersom oreflekterade värderingar oavsiktligt kan påverka vården. Genom klara riktlinjer, diskussionsforum och en yrkesutveckling genom kollegial handledning kan sjuksköterskan stödjas i sitt arbete och få tillfälle att reflektera och diskutera svåra situationer som uppstått med patienter.

  • 280.
    Ekeberg, Helena
    et al.
    University of Skövde, School of Life Sciences.
    Larsson, Kristina
    University of Skövde, School of Life Sciences.
    Distriktssköterskors erfarenhet av hälsofrämjande arbete: En kvalitativ intervjustudie2010Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    The Health Care Nurse plays an important role in motivating patients to implement lifestyle changes. Unhealthiness causes risks of developing long-lasting diseases and other complications. Living conditions and living habits are of great significance in terms of human health.  Lifestyle changes, in contrast to drugs, often have an impact on both risk markers and states of diseases. The purpose of this study was to describe district nurses’ experiences when motivating patients to take part in health-promoting lifestyle changes. The study is based on a qualitative method with an inductive approach. Through interviews, data was collected from six health care nurses and analyzed using a qualitative content analysis. The results are based on two categories, quality of the professional support together with evidence and experiences important to the changing process. These categories formed the theme: Health Care Nurses´, sensitivity and knowledge are the guiding principles in terms of motivating patients to pursue a healthier lifestyle. The results of our study show that it is important to listen and to acknowledge the patient to be able to support them emotionally.  Undergoing lifestyle changes require explanation and information. The changing process requires tools, the informants must have a reflective attitude to be able to work based on evidence. The patient needs to realize the importance of making a lifestyle change and also be prepared to take the losses. When doing so the patients will learn that they gain more than they lose.

  • 281.
    Ekenvärn, Malin
    et al.
    University of Skövde, School of Life Sciences.
    Grann, Alexandra
    University of Skövde, School of Life Sciences.
    Coping - att finna sig till rätta i vardagen efter stroke: En självbiografistudie2014Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Patients who suffered stroke can experience different obstacles for wellbeeing. The illness itself implicates symptoms such as tiredness, depression and various functional limitations. Surroundings can increase the feeling of discomfort when based on prejudices, insufficient care and problems in relations to significant others. Coping concerns finding ways to control different situations in order to reduce stress and discomfort. Aim: To through selfbiographies describe what prevents and promotes coping seen from a lifeworldperspective from individuals who suffered from stroke. Method: Qualitative content analysis of selfbiographies as described in Granheim and Lundman (2012).Result: The findings were sorted in two domains, labeled what prevents and promotes coping. Categories that prevents coping are “Lac of compliance and caring from personnel”, “To struggle against illness and surrounding”, “To feel shame about ones incapacities” and “Unwanted loneliness and isolation”. Categories that promotes coping are “Capacity to adaption”, “Capacity to handle feelings and identity” and “Proper rehabilitation”. These are further described in subcategories. Conclusion: The result indicates that healthcare concerning the patient can be more favorable if the lifeworld of the patient is given more focus and out of that perspective understand what promotes and prevents coping of this individual.

  • 282.
    Ekeroth, Anna
    University of Skövde, School of Life Sciences.
    Sjuksköterskors erfarenheter av kommunikation med patienter i palliativ vård: en litteraturbaserad studie2011Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Palliative care is an approach that affirms life and sees death as a normal process and as an important end point of life. The palliative care should include symptom control, cooperation of multi-professional team, good communication and support for families. Palliative nursing put high demands on the nurse, not least in terms of communication skills. The aim was to describe nurses' experiences of communication with patients in palliative care. The chosen method was a literature based study. The data material consisted of 12 qualitative research articles. Three categories and nine subcategories were identified. The categories were: conditions in the workplace, the nurse’s readiness to act and patient and relatives’ involvement. Conditions in the workplace, such as cooperation, care ideology and emotional support are important preconditions for communication. The nurse’s experience, ability to manage thoughts and feelings about death and the ability to see and understand the patient also affects the communication, as well as the patients’ and the relatives’ approach. Opportunity for reflection and clinical supervision, a clear ideology of care in the ward as well as education in communication and/or palliative care would, according to the results, contribute to better conditions for good communication between the nurse and patients in palliative care.

  • 283.
    Eklund, Malin B.
    et al.
    Department of Physiology and Pharmacology, Karolinska Institutet, SE-171 77 Stockholm, Sweden.
    Johansson, Linda
    University of Skövde, The Systems Biology Research Centre. University of Skövde, School of Life Sciences.
    Uvnäs-Moberg, Kerstin
    Department of Animal Environment and Health, Swedish University of Agriculture, P.O. Box 234, SE-532 23 Skara, Sweden.
    Arborelius, Lotta
    Department of Clinical Neuroscience, Division of Psychology, Karolinska Institutet, SE-171 76 Stockholm, Sweden.
    Differential effects of repeated long and brief maternal separation on behaviour and neuroendocrine parameters in Wistar dams2009In: Behavioural Brain Research, ISSN 0166-4328, E-ISSN 1872-7549, Vol. 203, no 1, p. 69-75Article in journal (Refereed)
    Abstract [en]

    Repeated, prolonged maternal separation has been suggested to model the development of a depression-like syndrome in rats. The long separations from the pups have been proposed to be stressful for the dams, which in turn could mediate the changes seen in adult offspring. In the present study we investigated whether prolonged maternal separation really is stressful for rat dams by studying parameters known to be affected by long-term stress such as spontaneous motor activity, anxiety-like behaviour, adrenal gland weight and plasma corticosterone levels. Dams were separated from their litter for either 4 h (MS240) or 15 min (MS15) on eight random days during postnatal day 1–14, or left undisturbed (animal facility reared, AFR). After weaning MS240 dams showed decreased peripheral activity and habituated slower in horizontal activity. On the contrary, MS15 dams showed more peripheral activity and less rearing activity compared to both AFR and MS240 dams when habituated to the testing apparatus, suggesting that MS15 dams are more anxious. The adrenal glands from MS15 dams weighed significantly less and plasma corticosterone levels were significantly higher compared to AFR and MS240 dams. These results suggest that repeated brief maternal separations from pups could be stressful for rat mothers, whereas prolonged separations are not. Since these results are in contrast to the current notion that the short separation procedure may be considered as a safe milieu, whereas the prolonged separations have been suggested to be stressful for both dams and pups, further studies in this field are warranted.

  • 284.
    Eklund, Maria
    et al.
    University of Skövde, School of Life Sciences.
    Furubrink, Viktoria
    University of Skövde, School of Life Sciences.
    Upplevelser av krav på ändrade levnadsvanor vid diabetes typ 22011Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    BACKGROUND: Diabetes type 2 is an increasing disease in the world. By changing diet and exercise habits diabetes type 2 can be postponed or even prevented. This change can be very demanding for the person. AIM: The aim of this study was to create an overview of studies that concern the demands of changed habits as a part of treatment of diabetes type 2. METHOD: A literature review based on analyses of 14 scientific articles. RESULTS: Results showed that support was important for people with diabetes type 2. It helped them to get the motivation that was necessary to change their habits. Also knowledge of the disease showed to be a good help to be able to handle diabetes type 2. Some of the people with diabetes type 2 experienced that they were limited by the disease but some could see opportunities despite the disease. CONCLUSION: Support and knowledge about the disease helped the person with diabetes type 2 to get the motivation that was necessary. It’s important for nurses to realize that every person with diabetes type 2 needs their own time to process the information they get about the disease.

  • 285.
    Eklund, Rebecca
    et al.
    University of Skövde, School of Life Sciences.
    Kaveh, Mona
    University of Skövde, School of Life Sciences.
    Vem är jag nu ?: Identitetsförändringar hos kvinnor som har en bröstcancerdiagnos2013Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Varje år ställs ca 7000 bröstcancer diagnoser i Sverige. 70 till 80 % överlever tio år efter sjukdomsdebuten. Behandlingar och biverkningar leder till förändringar i livet för de cancerdrabbade kvinnorna. Dessa förändringar kan vara både yttre och inre och kan leda till upplevelser av förändrad identitet. Studiens syfte är att beskriva identitetsförändringar hos kvinnor med en bröstcancerdiagnos. Datamaterial har samlats in från 8 biografier och självbiografier. Metoden som använts för att analysera litteraturen är ”att analysera berättelser”. Tre kategorier har använts i resultatet, dessa kategorier är: En ny opåverkbar identitet, Att bli en annan kvinna, En förvirrad identitet. Hos många kvinnor väcks rädslor för hur deras utseende kommer att förändras efter behandlingarna. De upplever att sjukdomen blir ett hot mot deras kvinnlighet. Detta leder till att de ifrågasätter sin identitet och vilka de har blivit efter sjukdomen. Det är därför viktigt att man som sjuksköterska förstår kvinnornas känslor och upplevelser av sin förändrade identitet. På så sätt kan en större förståelse för dessa kvinnors livsvärld fås och där av kan en bättre omvårdnad uppnås.

  • 286.
    Ekström, Anette
    University of Skövde, School of Life Sciences.
    Amning och vårdkvalitet2005Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The over all objectives of this thesis was to map factors of importance for breastfeeding such as maternal background factors, maternal perception of breastfeeding support, confidence, caring routines, breastfeeding attitudes of health care professionals, and to investigate whether a training intervention within the care team of

    the antenatal (ANC) and child health centres (CHC) would improve maternal perception of support and strengthen maternal feelings for the baby.

    Material and method: A questionnaire was sent to mothers when their babies were 9-12 months old (n=540). The questionnaire embraced questions regarding maternal background, caring routines, perception of support and duration of breastfeeding (I-II). Thereafter an attitudinal instrument was developed to measure breastfeeding attitudes in health care professionals (n=168). Four attitude dimensions were identified by factor analysis (III). Ten municipalities in a county of south west Sweden was paired and randomized to intervention or control (IV). Thus, all midwives and postnatal nurses working at the ANC or CHC in a randomised municipality were asked to participate in the study (n=81). Health professionals in the intervention group had a process-oriented training in breastfeeding counselling including planned continuity in family education and development of a common breastfeeding policy within the caring team. Changes in attitude were measured by the instrument developed in study III. For study V, mothers were recruited from the maternity and were allocated to intervention- or control group according to the randomization of municipalities in study IV (n=565). Questionnaires were sent out at three days, 3 and 9 months post partum to investigate how the care and counselling skills acquired by the health care professionals would be reflected in maternal perception of breastfeeding support and maternal feelings for and relation to the baby.

    Results: Early initiation of suckling, late discharge from hospital (more than 72 hours) and perceived good support contributed positively to the duration of exclusive breastfeeding. Supplementation the first days after birth for other than medical reasons shortened the duration of breastfeeding. For primiparas, the partner’s presence after childbirth contributed positively to the duration of exclusive breastfeeding. Multiparas who were aware of their mothers breastfeeding history had a longer breastfeeding period than those who did not know of their mother’s breastfeeding history. Mothers were more satisfied with the breastfeeding information they had received at maternity than the breastfeeding information they got from the ANC and CHC (I-II). This induced the idea to develop an attitude instrument and start a training intervention for the care team at ANC and CHC. The attitudinal dimensions identified by the factor analysis were: The regulating factor comprising statements scheduling breastfeeding; the facilitating factor comprising statements showing confidence in the ability of the mother-infant dyad to breastfeed on their own; the disempowering factor comprising statements that objectified the woman and ascribed her no ability to breastfeed without guidance of the health care professional and the breastfeeding antipathy factor comprising statements that showed unwillingness and failing knowledge about breastfeeding (III). After training the health care professionals became less regulating and more facilitating (IV). Family classes provided the intervention mothers with better breastfeeding information, more knowledge about their social rights, the needs of the baby and a stronger social network than the control mothers (V). The postnatal nurse gave a better over all support, was a better listener, showed more understanding and provided the mother with better information about breastfeeding and the needs of the baby. Mothers in the intervention group reported that they interacted more with their baby. They had also more positive views on their baby and felt more confident and close with the baby than mothers in the control groups (V).

    Conclusion: This study showed that it is important to adopt caring routines, which will facilitate breastfeeding. The health care professional needs to find out the background of the mother to be able to provide her with adequate breastfeeding counselling. Caring routines should include early suckling. Supplementation of the baby the first week after birth should only be given on medical grounds. This study showed that a processoriented training in breastfeeding counselling alters attitudes of health care professionals in a positive way. The trained health care professionals organized continuity of family classes and developed a common breastfeeding policy and were more supportive in their encounters with the mothers. These behaviors strengthen the mother’s feelings for her baby and brought about a richer interaction with her baby. A model to provide continuity of family classes, conducted by trained antenatal midwives and postnatal nurses should thus be practiced within the caring team around first time parents.

  • 287.
    Ekström, Anette
    et al.
    University of Skövde, School of Life Sciences.
    Arvidsson, Kristina
    Department of Obstetrics and Gynaecology, Karlskoga Hospital, Sweden.
    Falkenström, Malin
    Department of Obstetrics and Gynaecology, Karlskoga Hospital, Sweden.
    Thorstensson, Stina
    University of Skövde, School of Life Sciences.
    Fathers’ feelings and experiences during pregnancy and childbirth: A qualitative study2013In: Journal of Nursing & Care, ISSN 2167-1168, Vol. 2, no 2, article id 136Article in journal (Refereed)
    Abstract [en]

    Background: Fathers feel excluded and insecure during childbirth and professional support for fathers can be inadequate. Therefore it is important to further understand fathers experience in order to develop professional support and to create a positive childbirth experience for both fathers and their partners.

    Aim: The aim of this study was to explore fathers’ feelings and experiences during pregnancy and childbirth.

    Materials and Methods: A qualitative method was used, with written interviews which were analyzed using a qualitative content analysis. Participants were eight fathers who wrote answers to two open questions.

    Results: The theme “Fathers have strong, mixed feeling while striving to become prepared and to participate during pregnancy and childbirth” crossed over into all the four categories: Being prepared gave security, Feeling needed, Feeling strong, mixed feelings during pregnancy, and Feeling strong, mixed feelings during childbirth. Fathers’ previous experiences from childbirth facilitated being prepared and increased sense of security.

    Conclusion: It was important for fathers to be prepared and to feel needed and to witness the birth of their baby was fantastic. Overall, the fathers were faced with handling their strong but mixed feelings while striving to prepare for and participate in pregnancy and childbirth.

    Implications: Healthcare professionals need to acknowledge that fathers have needs of their own during pregnancy and childbirth. Fathers also worry about the woman and the baby so they need explanations about normal changes as well as possible complications.

  • 288.
    Ekström, Anette
    et al.
    University of Skövde, School of Life Sciences.
    Guttke, Kristin
    Lenz, Marika
    Hertfelt Wahn, Elisabeth
    University of Skövde, School of Life Sciences.
    Long term effects of professional breastfeeding support - An intervention2011In: International Journal of Nursing and Midwifery, ISSN 2141-2456, Vol. 3, no 8, p. 109-117Article in journal (Refereed)
    Abstract [en]

    Professional support is important for women during pregnancy, but more research is needed to provide a better understanding of how this support affects the mother's experience of support and breastfeeding behavior the first days after birth and its relation to the duration of breastfeeding. This study aims to evaluate the effects of a professional support during pregnancy in relation to mothers’ perceived support at delivery and maternity ward, and on the number of breastfeeding sessions during the first three days after birth. These factors would be subsequently considered in relation to the duration of breastfeeding. Mothers in the Intervention group (IG) and Control group B (CGB) (November 2000 to April 2002) perceived significant better overall support, breastfeeding information and preparation for parenting from the professionals in the delivery and maternity wards compared with the Control group A (CGA) (April to October 2000), (p<0.001), (n = 540). The IG showed a higher frequency of breastfeeding sessions in the first 24 h compared with the mothers in the CGB (p<0.008) and a positive correlation between preparation for the parental role and duration of exclusive breastfeeding (p = 0.006).

  • 289.
    Ekström, Anette
    et al.
    University of Skövde, School of Life Sciences.
    Kylberg, Elisabeth
    University of Skövde, School of Life Sciences.
    Nissen, Eva
    University of Skövde, School of Life Sciences. Department of Woman and Child Health, Division of Reproductive and Perinatal Health Care, Karolinska Institutet, Stockholm, Sweden.
    A Process-Oriented Breastfeeding Training Program for Healthcare Professionals to Promote Breastfeeding2010In: Proceedings of the Second Biannual Uppsala Symposium on lactation research in mammals and humans: The mammary gland in health and disease with particular focus on the mammary gland close post partum including indicators of inflammation and pathogens of the mammary gland / [ed] Sigrid Agenäs, Gunilla Hallberg, Elisabeth Kylberg, Karin Perss on Waller & Bodil Ström Holst, Uppsala: CRU , 2010, p. 9-Conference paper (Refereed)
    Abstract [en]

    Introduction: The impact of giving an infant food other than breast milk depends on several factors. Evidence to date supports the recommendation for exclusive breastfeeding for six months.

    The aim of the this study was to evaluate the effect of a process-oriented training in support during childbirth and breastfeeding for midwives and postnatal nurses in relation to  the time of initial breastfeeding session, introduction of breast milk substitute and solids effects on  the duration of breastfeeding.

    Materials and methods: Ten municipalities in Sweden were randomized to either intervention (IG) or control groups (CGA and CGB). The intervention included a process-oriented training program* for midwives and postnatal nurses in the intervention municipalities. Primiparas (n=540) who were living at either site were asked to respond to questionnaires at three days, three and nine months postpartum. Data collection for mothers in CGA (n=162) started before effects of the intervention could be studied, CGB (n=172) was collected simultaneously with the IG (n=206).

    Results: Preliminary results showed that fewer infants in the IG received breast milk substitute (the first week of life) without medical reasons (p=0.01) and were older (3.8 months) when breast milk substitute was introduced after discharge compared with the infants in the control groups (CGA 2.3 months p= 0.01 and CGB 2.5 months p= 0.03).

    Discussion and Conclusion: A process-oriented training program for midwives and postnatal nurses (by changed attitudes among health staff and changing mothers self imaging) reduced the number of infants who got breastmilk substitute during the first week without medical reasons and delayed the introduction of breast milk substitute after the first week.

     

  • 290.
    Ekström, Anette
    et al.
    University of Skövde, School of Life Sciences.
    Kylberg, Elisabeth
    University of Skövde, School of Life Sciences.
    Nissen, Eva
    University of Skövde, School of Life Sciences.
    A process-oriented breastfeeding training program for healthcare professionals to promote breastfeeding: an intervention study2012In: Breastfeeding medicine : the official journal of the Academy of Breastfeeding Medicine, ISSN 1556-8342, Vol. 7, no 2, p. 85-92Article in journal (Refereed)
    Abstract [en]

    Abstract Aim: The aim of the study was to evaluate the effects of process-oriented training in supportive breastfeeding counseling for midwives and postnatal nurses on the time lapse between the initial breastfeeding session, introduction of breastmilk substitutes and solids, and the duration of breastfeeding. Materials and Methods: Ten municipalities in Sweden were randomized to either the intervention or control groups. The intervention included a process-oriented training program for midwives and postnatal nurses in the intervention municipalities. Primiparas (n=540) living in either an intervention or control municipality were asked to participate in a longitudinal study to evaluate the care given. Data collection for control group A (CGA) (n=162) started before the intervention was initiated. Data for control group B (CGB) (n=172) were collected simultaneously with the intervention group (IG) (n=206). The mothers responded to questionnaires at 3 days, 3 months, and 9 months postpartum. Results: As a result of the process-oriented training program for midwives and postnatal nurses, the IG mothers had a significantly longer duration of exclusive breastfeeding, even if the initial breastfeeding session did not occur within 2 hours after birth, than the corresponding group of CGA mothers (p=0.01). Fewer infants in the IG received breastmilk substitutes (in the first week of life) without medical reasons compared with the control groups (p=0.01). The IG infants were significantly older (3.8 months) when breastmilk substitutes were introduced (after discharge from the hospital) compared with the infants in the control groups (CGA, 2.3 months, p=0.01; CGB, 2.5 months, p=0.03). Conclusion: A process-oriented training program for midwives and postnatal nurses was associated with a reduced number of infants being given breastmilk substitutes during the 1st week without medical reasons and delayed the introduction of breastmilk substitutes after discharge from the hospital.

  • 291.
    Ekström, Anette
    et al.
    University of Skövde, School of Life Sciences.
    Kylberg, Elisabeth
    University of Skövde, School of Life Sciences.
    Svensson, Kristin
    Karolinska institutet.
    Föräldrar vill ha amningsstöd baserat på fakta2012In: Jordemodern - Tema Amning, ISSN 0021-7468, no 3, p. 27-29Article in journal (Other (popular science, discussion, etc.))
  • 292.
    Ekström, Anette
    et al.
    University of Skövde, School of Life Sciences.
    Matthiesen, Ann-Sofi
    Department of Woman and Child Health, Division of Reproductive and Perinatal Health Care, Karolinska Institutet, Stockholm, Sweden / Department of Statistics, University of Stockholm, Stockholm, Sweden.
    Widström, Ann-Marie
    Department of Woman and Child Health, Division of Reproductive and Perinatal Health Care, Karolinska Institutet, Stockholm, Sweden.
    Nissen, Eva
    University of Skövde, School of Life Sciences.
    Breastfeeding attitudes among counselling health professionals: Development of an instrument to describe breastfeeding attitudes2005In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 33, no 5, p. 353-359Article in journal (Refereed)
    Abstract [en]

    Aim: The aim of the study was to develop an instrument that can be used for accurate assessment of nurses' and midwives' attitudes toward breastfeeding in a group of midwives, maternity-nursing staff and postnatal nurses experienced in breastfeeding counselling. Method: An instrument based on WHO standards was developed to measure breastfeeding attitudes. In all, 168 healthcare professionals filled in the instrument. A factor analysis using maximum likelihood and varimax rotation was performed. Spearman's correlation was used to correlate factorial dimensions and self-described interest in breastfeeding. Results: By means of factor analysis four factors were identified: the "regulating" factor focused on regulating the mothers' breastfeeding management, the "facilitating" factor focused on making it easy for mothers to manage their breastfeeding, the "disempowering" factor focused on giving advice, disregarding the needs of the mother being counselled, and the "breastfeeding antipathy" factor focused on insufficient, basic, breastfeeding knowledge and aversive reactions to breastfeeding. Midwives rated higher on the facilitating factor and breastfeeding antipathy factor and lower on the regulating factor than postnatal nurses. Breastfeeding interest was positively correlated with the facilitating factor, and negatively with the disempowering factor and the breastfeeding antipathy factor. Conclusion: This instrument provides a picture of health professionals' attitudes towards breastfeeding. Four factors were identified in order of importance: regulating, facilitating, disempowering, and breastfeeding antipathy factors. Harmful attitudes were identified and suggested a need for educational programmes to help health professionals to reconcile damaging values, in order to improve breastfeeding counselling

  • 293.
    Ekström, Anette
    et al.
    University of Skövde, School of Life Sciences.
    Nissen, Eva
    University of Skövde, School of Life Sciences.
    A Mother's feelings for Her Infant Are Strengthened by Excellent Breastfeeding Counseling and Continuity of Care2006In: Pediatrics, ISSN 0031-4005, E-ISSN 1098-4275, Vol. 118, no 2, p. e309-e314Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE. Continuous support during the childbirth process ultimately may strengthen the mother's self-esteem and her capacity to interact with and nurture her infant and also may improve paternal involvement in general. In the present study, we investigated whether mothers, who were attended by midwives and nurses who had had a process-oriented training program in breastfeeding counseling, perceived stronger maternal feelings for their infant than mothers who had received only routine care.

    METHODS. In a previous study, an intervention that included a process-oriented program on breastfeeding counseling for health professionals and continuity in family classes through childbirth was conducted. The 10 largest municipalities were classified in pairs that were similar in size and had similar figures of breastfeeding duration. The municipalities were randomized pairwise to either an intervention or a control group. The present study is a follow-up study on women's feelings for their infants in relation to the kind of care that they had had and was undertaken between April 2000 and January 2003. The sampling frame was based on women who were cared for at either the intervention clinic or control clinics. The mothers at the control clinics had received standard routine care and had attended family classes through the point of birth. Data collection for control group A started before effects of the intervention could be studied. Data for control group B were collected simultaneously with data collection for the intervention group (n = 540). The mothers responded to 3 questionnaires at 3 days and at 3 and 9 months postpartum. Background data of the mothers were collected. The perception of support that was provided by the health professionals and the perception of mother–infant relationship and feelings for the infant were rated on Likert scales.

    RESULTS. At 3 days postpartum, both the intervention group and control group B versus the control group A thought that their understanding of the infant was better, they perceived more strongly that the infant as their own, and they enjoyed more breastfeeding and resting with the infant. Although there was no significant difference between the intervention group and control group B at 3 days and 3 months observation, mothers in the intervention group talked more to their infant, perceived their infant to be more beautiful than other infants, and perceived more strongly that the infant was their own than did the mothers in control group B at 9 months observation. In addition, the mothers in the intervention group felt significantly more confident with the infant and felt the infant to be closer than did the mothers in control group B.

    CONCLUSION. A process-oriented breastfeeding training program for antenatal midwives and postnatal nurses that included an intervention that guaranteed continuity of care strengthened the maternal relationship with the infant and the feelings for the infant.

  • 294.
    Ekström, Anette
    et al.
    University of Skövde, School of Life Sciences.
    Nissen, Eva
    University of Skövde, School of Life Sciences.
    Process-oriented training in breastfeeding attitudes and continuity of care improve mothers perception of support2007In: Health Education Research Trends / [ed] Peter R. Hong, Nova Science Publishers, Inc., 2007, p. 211-225Chapter in book (Refereed)
  • 295.
    Ekström, Anette
    et al.
    University of Skövde, School of Life Sciences.
    Widström, Ann-Marie
    University of Skövde, School of Life Sciences.
    Nissen, Eva
    University of Skövde, School of Life Sciences.
    Breastfeeding support from partners and grandmothers: Perceptions of Swedish women2003In: Birth, ISSN 0730-7659, E-ISSN 1523-536X, Vol. 30, no 4, p. 261-266Article in journal (Refereed)
    Abstract [en]

    Background: Support from the mother’s network of relatives, friends, and professional caregivers during childbirth is likely to be important for breastfeeding success. Few studies have been conducted to examine mothers’ perceptions of breastfeeding support. The objective of this study was to describe breastfeeding support and feelings of confidence of primiparas and multiparas in relation to duration of breastfeeding. Methods: Mothers who

    delivered vaginally were eligible for inclusion. After receiving a questionnaire when their children were 9 to 12 months of age, 194 primiparas and 294 multiparas responded to questions on

    breastfeeding history and on perceived and overall breastfeeding support and feelings of confidence. Results: Feelings of overall breastfeeding support were correlated with duration of

    exclusive breastfeeding in both primiparas (p < 0.001) and multiparas (p < 0.001). Multiparas who knew how long they were breastfed as a child showed a longer duration of exclusive

    (p ¼ 0.006) and total (p ¼ 0.007) breastfeeding than multiparas who did not know. The time during which the partner was present after labor was correlated with the duration of exclusive

    (p < 0.001) and total breastfeeding (p ¼ 0.002) in primiparas. Feelings of confidence when the baby was 6 to12 months old, as retrospectively rated on a visual analog scale, was correlated

    with feelings of confidence in the partner during childbirth in both primiparas (p < 0.001) and multiparas (p < 0.001) and the experience of overall breastfeeding support (primiparas,

    p ¼ 0.002; multiparas, p < 0.001). Both groups were more content with breastfeeding information they received from midwives in the maternity wards, compared with that from antenatal midwives and postnatal nurses (p < 0.001). Conclusions: A helpful support strategy for mothers with respect to breastfeeding outcome is for health professionals to discuss the grandmother’s perception of breastfeeding with the mother. It is important for perinatal

    caregivers to provide an environment that enables the family to stay together after delivery. A helpful support strategy for health professionals might be to mobilize grandmothers with positive breastfeeding perception to provide support for their daughters’ breastfeeding. (BIRTH 30:4 December 2003)

  • 296.
    Ekström, Anette
    et al.
    University of Skövde, School of Life Sciences.
    Widström, Ann-Marie
    Department of Woman and Child Health, Division of Reproductive and Perinatal Health Care, Karolinska Institutet, Stockholm, Sweden.
    Nissen, Eva
    University of Skövde, School of Life Sciences.
    Does Continuity of Care by Well-Trained Breastfeeding Counselors Improve a Mother´s Perception of Support?2006In: Birth, ISSN 0730-7659, E-ISSN 1523-536X, Vol. 33, no 2, p. 123-130Article in journal (Refereed)
    Abstract [en]

    Background:Social support has been shown to be greatly important for breastfeeding success. The objective of this study was to investigate if mothers who were attended by midwives and nurses specially trained in breastfeeding counseling perceived better continuity of care and emotional and informative breastfeeding support than mothers who received only routine care. Method:Ten municipalities, each with an antenatal center and child health center, in southwest Sweden were randomized either to intervention or control municipalities. The intervention included a process-oriented training in breastfeeding counseling and continuity of care at the antenatal and child health centers. Primiparas were asked to evaluate the care given, and those living in the control municipalities were divided into control groups A and B. Data collection took place at different points in time for the two control groups. The 540 mothers responded to 3 questionnaires at 3 days and at 3 and 9 months postpartum. The perception of support provided by the health professionals and from the family classes was rated on Likert scales. Results:Intervention group mothers rated the breastfeeding information given during the family class as significantly better during pregnancy than both control groups, and better than control group B mothers at 3 months postpartum; compared with both control groups, intervention group mothers perceived that they received significantly better overall support and that postnatal nurses provided better information about breastfeeding and the baby's needs. At 9 months, intervention group mothers were more satisfied with knowledge about social rights, information about the baby's needs, and their social network than control group B mothers. Both intervention group and control group B mothers perceived better overall support than control group A during pregnancy. At 3 and 9 months, intervention group mothers perceived that postnatal nurses were more sensitive and understanding compared with both control groups. Conclusions:After implementation of a process-oriented breastfeeding training program for antenatal midwives and postnatal nurses that included an intervention guaranteeing continuity of care, the mothers were more satisfied with emotional and informative support during the first 9 months postpartum. The results lend support to family classes incorporating continuity of care. (BIRTH 33:2 June 2006)

  • 297.
    Ekström, Anette
    et al.
    University of Skövde, School of Life Sciences.
    Widström, Ann-Marie
    Department of Woman and Child Health, Division of Reproductive and Perinatal Health Care, Karolinska Institutet, Stockholm, Sweden.
    Nissen, Eva
    University of Skövde, School of Life Sciences.
    Duration of Breastfeeding in Swedish Primiparous and Multiparous Women2003In: Journal of Human Lactation, ISSN 0890-3344, E-ISSN 1552-5732, Vol. 19, no 2, p. 172-178Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to describe the effects of sociodemographicfactors and maternity ward practices on the duration of breastfeedingin Swedish primiparas (n = 194) and multiparas (n = 294), consecutivelyselected from hospital birth files for 3 months, who respondedto a questionnaire 9 to 12 months after childbirth. The impactof sociodemographic data and maternity ward practices on exclusiveand any breastfeeding were examined. Smoking and supplementationwithout medical reasons influenced the duration of both exclusiveand any breastfeeding negatively, whereas early first breastfeedinginfluenced the duration of both exclusive and any breastfeedingpositively, and parity had no significant influence. Late hospitaldischarge influenced the duration of exclusive breastfeedingpositively, and higher maternal age influenced the durationof any breastfeeding positively. These variables altogetherexplained 11.4% (P <.001) of the variance in the durationof exclusive breastfeeding and 8.2% (P <.001) of the durationof any breastfeeding

  • 298.
    Ekström, Anette
    et al.
    University of Skövde, School of Life Sciences.
    Widström, Ann-Marie
    Department of Woman and Child Health, Division of Reproductive and Perinatal Health Care, Karolinska Institutet, Stockholm, Sweden.
    Nissen, Eva
    University of Skövde, School of Life Sciences.
    Process-oriented training in breastfeeding alters attitudes to breastfeeding in health professionals2005In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 33, no 6, p. 424-431Article in journal (Refereed)
    Abstract [en]

    Aim: The purpose of the study was to measure the attitudes of antenatal midwives and postnatal nurses to breastfeeding before and after common, process-oriented breastfeeding training. Method: Antenatal centres and child-health centres in 10 municipalities were randomized to either an intervention or a control group. The antenatal midwives and postnatal nurses in the intervention group were together given process-oriented breastfeeding training and were, in addition, asked to develop a common breastfeeding policy. A previously developed instrument was used to measure the effects of a training programme on breastfeeding attitudes among midwives and postnatal nurses. It consisted of four scales measuring a person's attitudes toward breastfeeding in four dimensions: regulating, facilitating, disempowering, and breastfeeding-antipathy attitudes. A mean score was calculated for each individual on these four dimensional scales. The higher the score, the stronger the attitude. Results: After one year, the intervention group reduced their scores on the regulating scale when compared with the control group (p<0.001). The intervention group decreased their scores on the regulating scale and increased their scores on the facilitating scale over the first year after training. The control group also significantly increased their scores on the facilitating scale. When the results were analysed profession-wise, the postnatal nurses in the intervention group decreased their scores on the regulating and disempowering scales and increased their scores on the facilitating scale. In contrast, the midwives in the intervention group decreased their scores only on the breastfeeding antipathy scale. The control group midwives decreased their scores on the disempowering scale. No differences were found among the postnatal nurses in the control group. Conclusion: Process-oriented breastfeeding training made both antenatal midwives and postnatal nurses better disposed to breastfeeding; postnatal nurses in particular improved their attitudes. Attitudes to breastfeeding tended to be stable over time, but process-oriented training lowered the scores a little on the regulating scale, suggesting that after this kind of training counsellors would find it less necessary to schedule and control the mothers' breastfeeding behaviour.

  • 299.
    Ekström, Linnéa
    et al.
    Karolinska Institute, Stockholm, Sweden.
    Adolfsson, Annsofie
    Department of Obstetrics and Gynaecology, Skaraborg Hospital, Skövde, Sweden / School of Health and Medical Sciences, University of Örebro, Örebro, Sweden.
    Ericson, Henrik
    University of Skövde, School of Life Sciences. University of Skövde, The Systems Biology Research Centre.
    Poutakidis, Georgios
    Department of Obstetrics and Gynaecology, Skaraborg Hospital, Skövde, Sweden.
    Charonis, Georgios
    Department of Obstetrics and Gynaecology, University of Linköping, Linköping, Sweden / Mitera General and Maternity Hospital, Athens, Greece.
    Larsson, Per-Göran
    Department of Obstetrics and Gynaecology, Skaraborg Hospital, Skövde, Sweden.
    Vaginal flora and urinary and vaginal group B streptococci in early pregnancy2013In: Gynecology, ISSN 2052-6210, Vol. 1, article id 6Article in journal (Refereed)
    Abstract [en]

    Background: Bacterial vaginosis (BV) is a risk factor for premature birth and group B streptococci (GBS) colonizing the vagina are etiological agents of neonatal infections. Significant growth of GBS in the vagina has been assumed to be detectable through urinary culture. The aim was to investigate the correlation between BV and the presence of GBS in qualitative vaginal or quantitative urinary culture, since this could predict a higher risk for perinatal morbidity. Design and setting: A consecutive prospective study of women in early pregnancy included 3101 women between 2007 and 2010, in a region of south-western Sweden. Methods: Vaginal and urine samples were obtained from women in early pregnancy at maternity health care clinics. BV was diagnosed according to the Ison/Hay classification. GBS in urine were detected in amounts as low as 100 CFU/ml. Vaginal culturing for GBS was obtained from a selected group of 481 women. Results: There was no difference in the prevalence of GBS in the urine among women with BV compared with women with lactobacilli flora (OR 0.7; 95% CI 0.4-1.1). Vaginal presence of GBS was found among 17.3% of women with BV and among 23.5% of women with lactobacilli flora (OR 0.7; 95% CI 0.3-1.4). Among the 105 women who had vaginal GBS, the urine culture of GBS was positive in only 21.9% of cases. Conclusions: Even though women with BV. have much higher concentration of bacteria in the vagina, they do not necessarily have more GBS in the vagina or urine. The modest correlation between positive vaginal culture and positive urine culture of GBS question the value of urinary culture for detection of vaginal GBS.

  • 300.
    Elgbratt, Kristina
    et al.
    Univ Örebro, Sch Hlth & Med Sci, Orebro, Sweden.
    Jansson, Andreas
    University of Skövde, School of Life Sciences. University of Skövde, The Systems Biology Research Centre.
    Hultgren-Hornquist, Elisabeth
    Univ Örebro, Sch Hlth & Med Sci, Orebro, Sweden.
    A Quantitative Study of the Mechanisms behind Thymic Atrophy in G alpha i2-Deficient Mice during Colitis Development2012In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 7, no 5, p. e36726-Article in journal (Refereed)
    Abstract [en]

    Mice deficient for the G protein subunit G alpha i2 spontaneously develop colitis, a chronic inflammatory disease associated with dysregulated T cell responses. We and others have previously demonstrated a thymic involution in these mice and an aberrant thymocyte dynamics. The G alpha i2(-/-) mice have a dramatically reduced fraction of double positive thymocytes and an increased fraction of single positive (SP) thymocytes. In this study, we quantify a number of critical parameters in order to narrow down the underlying mechanisms that cause the dynamical changes of the thymocyte development in the G alpha i2(-/-) mice. Our data suggest that the increased fraction of SP thymocytes results only from a decreased number of DP thymocytes, since the number of SP thymocytes in the Gai2(-/-) mice is comparable to the control littermates. By measuring the frequency of T cell receptor excision circles (TRECs) in the thymocytes, we demonstrate that the number of cell divisions the G alpha i2(-/-) SP thymocytes undergo is comparable to SP thymocytes from control littermates. In addition, our data show that the mature SP CD4(+) and CD8(+) thymocytes divide to the same extent before they egress from the thymus. By estimating the number of peripheral TREC+ T lymphocytes and their death rate, we could calculate the daily egression of thymocytes. G alpha i2(-/-) mice with no/mild and moderate colitis were found to have a slower export rate in comparison to the control littermates. The quantitative measurements in this study suggest a number of dynamical changes in the thymocyte development during the progression of colitis.

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