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  • 1.
    Abelsson, Anna
    et al.
    Department of Nursing Science, Jönköping University, Jönköping, Sweden.
    Appelgren, Jari
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Karlstad Business School (from 2013).
    Axelsson, Christer
    Prehospen – Centre for Prehospital Research, University of Borås, Borås, Sweden.
    Low-dose, high-frequency CPR training with feedback for firefighters2019In: International Journal of Emergency Services, ISSN 2047-0894, E-ISSN 2047-0908, Vol. 8, no 1, p. 64-72Article in journal (Refereed)
    Abstract [en]

    Purpose: The purpose of this paper is to investigate the effects of the intervention of low-dose, high-frequency cardiopulmonary resuscitation (CPR) training with feedback for firefighters for one month. Design/methodology/approach: The study had a quantitative approach. Data were collected through an intervention by means of simulation. The data collection consisted of a pre- and post-assessment of 38 firefighter’s CPR performance. Findings: There was a statistically significant improvement from pre- to post-assessment regarding participants’ compression rates. Compression depth increased statistically significantly to average 2 mm too deep in the group. Recoil decreased in the group with an average of 1 mm for the better. There was a statistically significant improvement in participants’ ventilation volume from pre- to post-assessment. Originality/value: Prehospital staff such as firefighters, police, and ambulance perform CPR under less than optimal circumstances. It is therefore of the utmost importance that these professionals are trained in the best possible way. The result of this study shows that low-dose, high-frequency CPR training with an average of six training sessions per month improves ventilation volume, compression depth, rate, and recoil. This study concludes that objective feedback during training enhances the firefighters’ CPR skills which in turn also could be applied to police and ambulance CPR training.

  • 2.
    Abrahamsen Grøndahl, Vigdis
    et al.
    Karlstad University, Faculty of Social and Life Sciences, Department of Nursing.
    Hall-Lord, Marie-Louise
    Karlstad University, Faculty of Social and Life Sciences, Department of Nursing.
    Karlsson, Ingela
    Karlstad University, Faculty of Social and Life Sciences, Department of Nursing.
    Appelgren, Jari
    Karlstad University, Faculty of Economic Sciences, Communication and IT, Department of Economics and Statistics.
    Wilde Larsson, Bodil
    Karlstad University, Faculty of Social and Life Sciences, Department of Nursing.
    Exploring patient satisfaction predictors in relation to a theoretical model2013In: International Journal of Health Care Quality Assurance, ISSN 0952-6862, E-ISSN 1758-6542, Vol. 26, no 1, p. 37-54Article in journal (Refereed)
  • 3.
    Abrahamsen Grøndahl, Vigdis
    et al.
    Karlstad University, Faculty of Social and Life Sciences, Department of Nursing.
    Karlsson, Ingela
    Karlstad University, Faculty of Social and Life Sciences, Department of Nursing.
    Hall-Lord, Marie-Louise
    Karlstad University, Faculty of Social and Life Sciences, Department of Nursing.
    Appelgren, Jari
    Karlstad University, Faculty of Economic Sciences, Communication and IT, Department of Economics and Statistics.
    Wilde-Larsson, Bodil
    Karlstad University, Faculty of Social and Life Sciences, Department of Nursing.
    Quality of care from patients' perspective: impact of the combination of person-related and external objective care conditions2011In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 20, no 17/18, p. 2540-2551Article in journal (Refereed)
    Abstract [en]

    Aims and objectives. To describe patients' perceptions of quality of care and to explore combinations of person-related and external objective care conditions as potential predictors of these perceptions. Background. Several studies have examined various single factors of person-related and external objective care conditions in relation to quality of care. None of these has included the effect of over-occupancy on patients' perception of quality of care. Furthermore, little is known about how combinations of different factors are related to each other and to the perception of quality of care using multivariate analysis. Design. A cross-sectional design. Method. A total of 528 patients (83·7%) from 12 medical, surgical or medical-surgical wards in five hospitals in Norway participated. Perceptions of quality of care and person-related conditions were measured with the 'Quality from Patient's Perspective' instrument. Data on external objective care conditions was collected from ward statistics provided by head nurses. Multivariate general linear modelling was used ( p < 0·05). Results. The combination of person-related and external objective care conditions revealed five factors that predict patients' perception of quality of care. Three of these are person-related conditions: sex, age and self-reported psychological well-being and two of them are external objective care conditions: RNs (headcount) on the wards and frequency of over-occupancy. These five factors explained 55% of the model. Patients rated the quality of care high. Conclusions. Sex, age, psychological well-being, frequency of over-occupancy and the number of RNs are important factors that must be emphasised if patients are to perceive the quality of care as high. Relevance to clinical practice. Head nurses and healthcare authorities must continually prepare the wards for over-occupancy and they must consider the number of RNs working on the wards.

  • 4.
    Appelgren, Jari
    Umeå universitet.
    Locally D-optimal Designs for Bivariate Logistic Regression2004Licentiate thesis, monograph (Other academic)
  • 5.
    Karlsson, E.
    et al.
    Karolinska Inst, Canc Ctr Karolinska, Radiumhemmet, Dept Oncol Pathol, Stockholm, Sweden.;St Gorans Univ Hosp, S-11281 Stockholm, Sweden.;Cent Hosp Karlstad, Dept Oncol, S-65230 Karlstad, Sweden..
    Appelgren, Jari
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Karlstad Business School. Karlstad Univ, Dept Econ & Stat, Karlstad, Sweden..
    Solterbeck, A.
    Cent Hosp Karlstad, Dept Pathol, S-65230 Karlstad, Sweden..
    Bergenheim, M.
    Cent Hosp Karlstad, Dept Surg, S-65230 Karlstad, Sweden..
    Alvariza, V.
    Cent Hosp Karlstad, Dept Oncol, S-65230 Karlstad, Sweden..
    Bergh, J.
    Karolinska Inst, Canc Ctr Karolinska, Radiumhemmet, Dept Oncol Pathol, Stockholm, Sweden.;St Gorans Univ Hosp, S-11281 Stockholm, Sweden..
    Breast cancer during follow-up and progression - A population based cohort on new cancers and changed biology2014In: European Journal of Cancer, ISSN 0959-8049, E-ISSN 1879-0852, Vol. 50, no 17, p. 2916-2924Article in journal (Refereed)
    Abstract [en]

    Background: Emerging data indicate an important role for biopsies of clinically/radiologically defined breast cancer 'recurrences'. The present study investigates tumour related events (relapses, other malignancies, benign conditions) after a primary breast cancer diagnosis. Patients and methods: The cohort includes 2102 women, representing all patients, with primary invasive breast cancer during 2000-2011 in the county of Varmland, Sweden. A comparative analysis of oestrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER2) and proliferation (Ki67) between the primary tumour and the relapse was performed and related to outcome. Results: With a mean follow-up time of 4.8 years, 1060 out of 2102 patients have had a biopsy taken after the initial breast cancer diagnosis demonstrating 177 recurrences, 93 other malignancies (colorectal, lung, skin), 40 cancer in situ (skin, breast) and 857 benign lesions. Approximately 70% (177 out of 245) of all cases of relapsed breast cancer underwent a biopsy during this time period. For patients with recurrences, ER (n = 127), PR (n = 101), HER2 (n = 73) and Ki67 (n = 55) status in both primary tumour and the corresponding relapse were determined. The discordance of receptor status was 14.2%, 39.6%, 9.6% and 36.3%, respectively. Loss of ER or PR in the relapse resulted in a significant increased risk of death (hazard ratio (HR) 3.62; 95% confidence interval (CI), 1.65-7.94) and (HR 2.34; 95% CI, 1.01-5.47) compared with patients with stable ER or PR positive tumours. The proportion of patients losing ER was bigger in the group treated with endocrine therapy alone or in combination with chemotherapy, 16.7% and 13.3%, respectively, compared with the group treated with chemotherapy alone or that which received no treatment 4.3% and 7.7%, respectively. Conclusion: Discordance of biomarkers between the primary tumour and the corresponding relapse was seen in 10-40% of the patients, adjuvant therapies seem to drive clonal selections. Patients with tumours losing ER or PR during progression have worse survival compared with patients with retained receptor expression. (C) 2014 Elsevier Ltd. All rights reserved.

  • 6.
    Karlsson, E.
    et al.
    Karolinska Institute, Sweden.
    Appelgren, Jari
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Karlstad Business School.
    Solterbeck, A.
    Central Hospital Karlstad, Sweden.
    Bergenheim, M.
    Central Hospital Karlstad, Sweden.
    Alvariza, V.
    Central Hospital Karlstad, Sweden.
    Bergh, J.
    Karolinska Institutet, Sweden..
    Population based study investigating biopsy verifications of "breast cancer recurrences" and biomarker changes2013In: European Journal of Cancer, ISSN 0959-8049, E-ISSN 1879-0852, Vol. 49, p. S399-S400Article in journal (Other academic)
  • 7.
    Karlsson, E.
    et al.
    Karolinska Inst, Dept Oncol & Pathol, Cent Hosp Karlstad, Dept Oncol Karlstad, Stockholm, Sweden..
    Sandelin, K.
    Karolinska University Hospital, Sweden.
    Appelgren, Jari
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Karlstad Business School.
    Wenjing, Z.
    Uppsala Univ, Dept Surg, Uppsala, Sweden.
    Jirstrom, K.
    Lund University, Sweden.
    Bergh, J.
    Karolinska Institute, Sweden.
    Warnberg, F.
    University Uppsala Hospital, Sweden.
    Receptor conversion between primary ductal carcinoma in situ (DCIS) and corresponding local relapse2013In: European Journal of Cancer, ISSN 0959-8049, E-ISSN 1879-0852, Vol. 49, p. S403-S403Article in journal (Other academic)
  • 8.
    Karlsson, Eva
    et al.
    Department of Oncology-Pathology, Radiumhemmet, Cancer Center Karolinska, Karolinska Institutet and University Hospital, Stockholm, Sweden.
    Sandelin, Kerstin
    Department of Surgery, Karolinska University Hospital, Stockholm, Sweden.
    Appelgren, Jari
    Karlstad University, Faculty of Economic Sciences, Communication and IT, Department of Economics and Statistics.
    Zhou, Wenjing
    Department of Surgery, Uppsala University, Uppsala, Sweden.
    Jirström, Karin
    Division of Pathology, Department of Clinical Sciences, Lund University, Lund, Sweden.
    Bergh, Jonas
    Department of Oncology-Pathology, Radiumhemmet, Cancer Center Karolinska, Karolinska Institutet and University Hospital, Stockholm, Sweden.
    Wärnberg, Fredrik
    Department of Surgery, Uppsala University Hospital, Uppsala, Sweden.
    Clonal alteration of breast cancer receptors between primary ductal carcinoma in situ (DCIS) and corresponding local events2014In: European Journal of Cancer, ISSN 0959-8049, E-ISSN 1879-0852, Vol. 50, no 3, p. 517-524Article in journal (Refereed)
    Abstract [en]

    BACKGROUND:Emerging data propose biomarker alteration due to clonal selection between the primary invasive breast cancer and corresponding metastases. In addition, impact on survival has been demonstrated. The present study investigates the relationship between the oestrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER2) between primary ductal carcinoma in situ (DCIS) and intra-individually matched ipsilateral event.

    MATERIALS AND METHODS:The cohort includes 1504 patients, diagnosed with a primary DCIS between 1986 and 2004. Of the 274 patients who developed a local relapse, 135 developed a new in situ carcinoma and 139 an invasive cancer up to 31st December 2011. ER and PR were identified by immunohistochemistry (IHC) and HER2 by silver-enhanced in situ hybridisation (SISH) as well as IHC.

    RESULTS:ER (n=112), PR (n=113) and HER2 (n=114) status from both the primary DCIS and the corresponding relapse were assessed and were demonstrated to be discordant in 15.1%, 29.2% and 10.5% respectively. The receptor conversion was both from negative to positive and from positive to negative with no general pattern being seen in spite of sub-dividing into in situ relapse and invasive relapse. However, primary DCIS was HER2 positive in 40.3% whereas in situ and invasive relapses were HER2 positive in 42.9% and 34.5% respectively.

    CONCLUSIONS:Receptor conversion for ER, PR and HER2 status occurred between primary DCIS and corresponding local relapse in 10-30%. This study could not confirm that HER2 overexpression in primary DCIS had any impact on tumour progression to invasive cancer which has been proposed.

1 - 8 of 8
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