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  • 151.
    Blomberg, Ann-Catrin
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper (from 2013).
    Operationssjuksköterskans vårdande och kompetens inom perioperativ vård2019Doktoravhandling, med artikler (Annet vitenskapelig)
    Abstract [en]

    The overall aim was to describe and deepen the understanding of what operating theatre nurses experience as caring and responsibility as well as ethical problems in perioperative practice. The aim was also to investigate how operating theatre nurses perceive clinical competence in perioperative nursing.

    Methods: This research has a hermeneutic design. Qualitative, quantitative and mixed method was used. In the study (I), data were collected through interviews and analysed with phenomenographic method. In studies (II-III) the interview texts from the study (I) was reused. Secondary analysis were performed with hermeneutic text interpretation. In the study (IV), data were collected through a modified questionnaire PROFFSNurse SAS I, which was supplemented with an open question. These data were analysed using statistics and qualitative conventional content analysis.

    Results: Operating theatre nurses have the will to meet the patient, be involved and created continuity in the perioperative nursing process (I). Operating theatre nurses experience that they have a formal responsibility to ensure that patients are not at risk and maintain patient integrity and dignity based on personal ethical values (II). Ethical problems and value conflicts can occur if routines and habits prevent operating theatre nurses from caring and when their clinical competence are not utilized in perioperative practice (III). The operating theatre nurses’ self-assessment of clinical competence showed that academic degree, professional experience and interprofessional learning were important for the development of clinical competence. On the other hand, existing routines and habits, as well as inadequate resources, were an obstacle (IV).

    Conclusion: Perioperative nursing care includes a nursing process and the operating theatre nurses have responsibility based on ethical values. When the operating theatre nurses are prevented from being a caregiver or that their clinical competence is not utilized, stress of conscience can be caused. Important for the development of clinical competence is an academic degree, professional experience and interprofessional learning.

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  • 152.
    Blomberg, Ann-Catrin
    et al.
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper (from 2013).
    Bisholt, Birgitta
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper (from 2013).
    Lindwall, Lillemor
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper (from 2013).
    Responsibility for patient care in perioperative practice2018Inngår i: Nursing Open, E-ISSN 2054-1058, Vol. 5, nr 3, s. 414-421Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aim: To obtain an understanding of operating theatre nurses' experiences of responsibility for patient care and safety in perioperative practice. Design: A hermeneutic design were used. Method: Data were collected during 2012 from 15 operating theatre nurses who participated in individual interviews. The text was analyzed by hermeneutical text interpretation. Findings: The texts revealed two main themes: A formal external responsibility and personal ethical value. Responsibility that the patient was not exposed to risks, protecting the patient's body, systematically planning and organizing work in the surgical team. The personal ethical value meant confirming the patient as a person, caring for the patient and preserving the patient's dignity. A new understanding emerged that the operating theatre nurse always have the patient in mind.

    Fulltekst (pdf)
    Blomberg_et_al_2018
  • 153.
    Blomberg, Ann-Catrin
    et al.
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper (from 2013).
    Bisholt, Birgitta
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper (from 2013).
    Lindwall, Lillemor
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper (from 2013).
    Value conflicts in perioperative practice2019Inngår i: Nursing Ethics, ISSN 0969-7330, E-ISSN 1477-0989, Vol. 26, nr 7-8, s. 2213-2224, artikkel-id 969733018798169Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND:: The foundation of all nursing practice is respect for human rights, ethical value and human dignity. In perioperative practice, challenging situations appear quickly and operating theatre nurses must be able to make different ethical judgements. Sometimes they must choose against their own professional principles, and this creates ethical conflicts in themselves.

    OBJECTIVES:: This study describes operating theatre nurses' experiences of ethical value conflicts in perioperative practice.

    RESEARCH DESIGN:: Qualitative design, narratives from 15 operating theatre nurses and hermeneutic text interpretation.

    ETHICAL CONSIDERATION:: The study followed ethical principles in accordance with the Helsinki Declaration and approval was granted by the local university ethics committee.

    FINDINGS:: The result showed that value conflicts arose in perioperative practice when operating theatre nurses were prevented from being present in the perioperative nursing process, because of current habits in perioperative practice. The patient's care became uncaring when health professionals did not see and listen to each other and when collaboration in the surgical team was not available for the patient's best. This occurred when operating theatre nurses' competence was not taken seriously and was ignored in patient care.

    CONCLUSION:: Value conflicts arose when operating theatre nurses experienced that continuity of patient care was lacking. They experienced compassion with the patient but still had the will and ability to be there and take responsibility for the patient. This led to feelings of despair, powerlessness and of having a bad conscience which could lead to dissatisfaction, and even resignations.

  • 154.
    Blomberg, Ann-Catrin
    et al.
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper (from 2013).
    Bisholt, Birgitta
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper (from 2013).
    Nilsson, Jan
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper (from 2013).
    Lindwall, Lillemor
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper (from 2013).
    Making the invisible visible: Operating theatre nurses’ perceptions of caring in perioperative practice2015Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 29, nr 2, s. 361-368Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The aim of this study was to describe operating theatre nurses' (OTNs') perceptions of caring in perioperative practice. A qualitative descriptive design was performed. Data were collected with interviews were carried out with fifteen strategically selected operating theatre nurses from different operating theatres in the middle of Sweden. A phenomenographic analysis was used to analyse the interviews. The findings show that operating theatre nurses' perceptions of caring in perioperative practice can be summarised in one main category: To follow the patient all the way. Two descriptive categories emerged: To ensure continuity of patient care and keeping a watchful eye. The operating theatre nurses got to know the patient and as a result became responsible for the patient. They protected the patient's body and preserved patient dignity in perioperative practice. The findings show different aspects of caring in perioperative practice. OTNs wanted to be more involved in patient care and follow the patient throughout the perioperative nursing process. Although OTNs have the ambition to make the care in perioperative practice visible, there is today a medical technical approach which promotes OTNs continuing to offer care in secret.

  • 155.
    Blomberg, Ann-Catrin
    et al.
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper (from 2013).
    Lindwall, Lillemor
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper (from 2013).
    Bisholt, Birgitta
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper (from 2013).
    Operating theatre nurses' self-reported clinical competence in perioperative practice: A mixed method study2019Inngår i: Nursing Open, E-ISSN 2054-1058, Vol. 6, nr 4, s. 1510-1516Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: During many years the operating theatre nurse's clinical competence has been describing in relation to patient safety, but the nursing care of the patient remains unclear. Therefore, we want in this study to investigate the relationship between background factors of operating theatre nurses self-rated clinical competence and describe factors of importance for development of clinical competence in perioperative nursing.Methods: A cross-sectional study with a mixed method approach was chosen. The instrument Professional Nurse Self-Assessment Scale of Clinical Core Competence was used for self-rating operating theatre nurses' clinical competence in perioperative nursing, and an open-ended question was added to describe factors of importance for development of clinical competence. In total, 1057 operating theatre nurses in Sweden were asked to participate, and 303 responded (28 %). They had different educational backgrounds and professional experiences, and were employed in universities or central/regional and district hospitals.Results: Academic degree, professional experience and place of employment were significant for the development of the operating theatre nurses' clinical competence. Academic degree appeared to affect operating theatre nurse leadership and cooperation, as well as how consultations took place with other professions about patient care. Being employed at a university hospital had a positive effect on professional development and critical thinking.Conclusions:  An academic degree influenced the operating theatre nurses' ability to act in complex situations, and along with professional experience strengthened the nurses' ability to use different problem-solving strategies and face the consequences of decisions made. Scientific knowledge and interprofessional learning and competence development in medical technologies should supplement nursing care for the development of clinical competence.

    Fulltekst (pdf)
    Blomeberg_et_al_2019
  • 156.
    Blomberg, Ann-Catrin
    et al.
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper.
    Willasen, E
    Akershus University Norge.
    von Post, Irene
    Åbo Akademi.
    Lindwall, Lillemor
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper.
    Student nurses' experiences of preserved dignity in perioperative practice: Part 12015Inngår i: Nursing Ethics, ISSN 0969-7330, E-ISSN 1477-0989, Vol. 22, nr 6, s. 676-687Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND:In recent years, operating theatre nurse students' education focussed on ethical value issues and how the patient's dignity is respected in the perioperative practice. Health professionals are frequently confronted with ethical issues that can impact on patient's care during surgery.

    OBJECTIVE:The objective of this study was to present what operating theatre nurse students experienced and interpreted as preserved dignity in perioperative practice.

    RESEARCH DESIGN:The study has a descriptive design with a hermeneutic approach. Data were collected using Flanagan's critical incident technique.

    PARTICIPANTS AND RESEARCH CONTEXT:Operating theatre nurse students from Sweden and Norway participated and collected data in 2011, after education in ethics and dignity. Data consisting of 47 written stories and the text were analysed with hermeneutical text interpretation.

    ETHICAL CONSIDERATIONS:The study was conducted accordance with the Declaration of Helsinki and approved by a local University Ethics Research Committee. FINDINGS:The findings revealed that students experienced that operating theatre nurses perserved patient's dignity in perioperative practice by being present for each other and making themselves known to the patient. Operating theatre nurses caring for the patient by being compassionate and preserved the patient privacy. The new understanding that emerged was that the operating theatre nurse students understood that the operating theatre nurse wanted to care for the patient like a human being. DISCUSSION:In the discussion, we have illuminated how professional ethics may be threatened by more pragmatic and utilitarian arguments contained in regulations and transplant act. CONCLUSION:Preserved dignity is an ethical and caring act. Ethical questions and how to preserve dignity in perioperative practice should be discussed more both in educations of healthcare professionals and in clinical practice.

  • 157.
    Blomberg, Karin
    et al.
    Örebro universitet.
    Anderzen-Carlsson, Agneta
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper (from 2013).
    Hagberg, Lars
    Örebro universitet.
    Jonsson, Osten
    Örebro universitet.
    Leissner, Lena
    Örebro universitet.
    Eriksson, Mats H.
    Quality of life and trust among young people with narcolepsy and their families, after the Pandemrix (R) vaccination: protocol for a case-control study2017Inngår i: BMC Pediatrics, ISSN 1471-2431, E-ISSN 1471-2431, Vol. 17, artikkel-id 183Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: The extensive vaccination programme against swine flu resulted in an increased incidence of narcolepsy among children and adolescents. There is a need to explore if these young persons' experiences have affected their trust in healthcare, their willingness to participate in future prevention programmes, and their contacts with the healthcare system. The overall aim is to identify factors important for the life-situation of children and adolescents with narcolepsy and their families, and factors that correlate with trust in healthcare. Methods/design: Data will be collected via questionnaires from all available children with narcolepsy following the vaccination and their families, as well as a control group of children with diabetes and their families. Longitudinal descriptive interviews will also be conducted with a selection of 20-25 children and their families. Techniques from media research will be used for Internet-based data collection and analysis of information relating to narcolepsy from social media. Discussion: This project will use the situation of young persons with narcolepsy after the swine flu vaccination as a case to build a model that can be used in situations where trust in healthcare is essential. This model will be based on findings from the included studies on how trust is influenced by support, quality of life, burden of disease, impact on family, and use of social media. The model developed in this project will be beneficial in future situations where trust in healthcare is essential, such as new pandemic outbreaks but also for " everyday" adherence to health advice.

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  • 158.
    Blomberg, karin
    et al.
    Örebro universitet.
    Bisholt, Birgitta
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper (from 2013). Swedish Red Cross Univ Coll, Sweden.
    Clinical group supervision for integrating ethical reasoning: view from students and supervisors2016Inngår i: Nursing Ethics, ISSN 0969-7330, E-ISSN 1477-0989, Vol. 23, nr 7, s. 761-769Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Clinical group supervision has existed for over 20 years in nursing. However, there is a lack of studies about the role of supervision in nursing students' education and especially the focus on ethical reasoning. Aim: The aim of this study was to explore and describe nursing students' ethical reasoning and their supervisors' experiences related to participation in clinical group supervision. Research design: The study is a qualitative interview study with interpretative description as an analysis approach. Participants and research context: A total of 17 interviews were conducted with nursing students (n = 12) who had participated in clinical group supervision in their first year of nursing education, and with their supervisors (n = 5). Ethical considerations: The study was based on the ethical principles outlined in the Declaration of Helsinki, and permission was obtained from the Regional Ethical Review Board in Sweden. Findings: The analysis revealed that both the form and content of clinical group supervision stimulated reflection and discussion of handling of situations with ethical aspects. Unethical situations were identified, and the process uncovered underlying caring actions. Discussion and conclusion: Clinical group supervision is a model that can be used in nursing education to train ethical reflection and to develop an ethical competence among nursing students. Outcomes from the model could also improve nursing education itself, as well as healthcare organizations, in terms of reducing moral blindness and unethical nursing practice.

  • 159.
    Blomberg, Karin
    et al.
    School of Health and Medical Sciences, Örebro University.
    Bisholt, Birgitta
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper.
    Kullén Engström, Agneta
    School of Health, University of Borås.
    Ohlsson, Ulla
    School of Health and Medical Sciences, Örebro University.
    Sundler Johansson, Annelie
    School of Life Sciences, University of Skövde.
    Gustafsson, Margareta
    School of Health and Medical Sciences, Örebro University.
    Swedish nursing students’ experience of stress during clinical practice in relation to clinical setting characteristics and the organisation of the clinical education2014Inngår i: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 23, nr 15/16, s. 2264-2271Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aims and objectives

    To describe nursing students' experience of stress during clinical practice and evaluate the risk of stress in relation to the clinical setting characteristics and the organisation of the clinical education.

    Background

    Stress during clinical practice is well documented, but there is a lack of knowledge concerning whether the clinical setting characteristics and the organisation of the education make a difference.

    Design

    A cross-sectional study with evaluative design.

    Methods

    Data were collected by means of a numerical rating scale for the assessment of stress and questions about the clinical setting characteristics and the organisation of the education. One hundred and eighty-four students who had completed their final year on the nursing programme at three universities in Sweden were included.

    Results

    Nearly half of the students (43%) experienced high level of stress during clinical practice. Measured by decision in the tree analysis, the absolute risk of stress was 57% in students with placements in hospital departments, as compared to 13% in students with placements in other clinical settings. The risk of stress increased to 71% if the students with placement in a hospital took the national clinical final examination. Performance of practice in a hospital department overcrowded with patients was also associated with increased risk of stress. The organisation of supervision and number of students at the clinical placement had an effect on the experience of stress, but did not prove to be risk factors in the analysis.

    Conclusions

    The risk of stress in nursing students during their clinical practice differs depending on clinical setting characteristics. The taking of the national clinical final examination could be a source of stress, but this requires further investigation.

    Relevance to clinical practice

    It is important that supervisors are aware that students in hospital departments overcrowded with patients are at risk of stress and may have increased need of support.

  • 160.
    Blomberg, Karin
    et al.
    Univ Orebro, Sch Hlth & Med Sci, S-70182 Orebro, Sweden..
    Isaksson, Ann-Kristin
    Univ Orebro, Sch Hlth & Med Sci, S-70182 Orebro, Sweden..
    Allvin, Renee
    Univ Orebro, Sch Hlth & Med Sci, S-70182 Orebro, Sweden.;Orebro Univ Hosp, Clin Skills Ctr, Orebro, Sweden..
    Bisholt, Birgitta
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper.
    Ewertsson, Mona
    Univ Orebro, Sch Hlth & Med Sci, S-70182 Orebro, Sweden..
    Engstrom, Agneta Kullen
    Univ Boras, Sch Hlth, Boras, Sweden..
    Ohlsson, Ulla
    Univ Orebro, Sch Hlth & Med Sci, S-70182 Orebro, Sweden..
    Johansson, Annelie Sundler
    Univ Skovde, Sch Life Sci, Skovde, Sweden..
    Gustafsson, Margareta
    Univ Orebro, Sch Hlth & Med Sci, S-70182 Orebro, Sweden..
    Work stress among newly graduated nurses in relation to workplace and clinical group supervision2016Inngår i: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 24, nr 1, s. 80-87Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aim The aim was to investigate occupational stress among newly graduated nurses in relation to the workplace and clinical group supervision. Background Being a newly graduated nurse is particularly stressful. What remains unclear is whether the workplace and clinical group supervision affect the stress. Method A cross-sectional comparative study was performed in 2012. Data were collected by means of a numerical scale measuring occupational stress, questions about workplace and clinical group supervision. One hundred and thirteen nurses who had recently graduated from three Swedish universities were included in the study. Results The stress was high among the newly graduated nurses but it differed significantly between workplaces, surgical departments generating the most stress. Nurses who had received clinical group supervision reported significantly less stress. The stress between workplaces remained significant also when participation in clinical group supervision was taken into account. Conclusions Newly graduated nurses experience great stress and need support, especially those in surgical departments. Nurses participating in clinical group supervision reported significantly less stress. Implications for nursing management It is important to develop strategies that help to adapt the work situation so as to give nurses the necessary support. Clinical group supervision should be considered as an option for reducing stress.

  • 161.
    Blommaberg, Manal
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper (from 2013).
    En litteraturstudie om elektroniska cigaretter - Innehåll och dess negativa effekter på cellnivå2018Independent thesis Basic level (degree of Bachelor), 10 poäng / 15 hpOppgave
  • 162.
    Blomster, Else
    et al.
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper (from 2013).
    Sääf Westin, Maria
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper (from 2013).
    Distriktssköterskors erfarenhet av svåra situationer i hemsjukvården.2014Independent thesis Advanced level (degree of Master (One Year)), 10 poäng / 15 hpOppgave
    Abstract [sv]

    Bakgrund: Distriktssköterskor i hemsjukvården arbetar självständigt i ett växande arbetsfält med allt sjukare patienter och mer avancerad vård. Teamarbete, samverkan och arbetsledning ställer höga krav på distriktssköterskans arbete vilket har väckt uppmärksamhet och forskning kring arbetssituationer som ställer så pass höga krav på distriktssköterskan att det inverkar negativt på distriktssköterskans hälsa och riskerar patientsäkerheten. Syfte: Att undersöka distriktssköterskors erfarenhet av svåra situationer i hemsjukvården. Metod: Studien har en kvalitativ ansats. Tolv distriktssköterskor verksamma inom kommunal hemsjukvård har deltagit i studien och med hjälp av semistrukturerade intervjuer har data insamlats. Därefter har data analyserats genom induktiv innehållsanalys. Resultat: Distriktssköterskor i hemsjukvården erfar svåra situationer i en bristande arbetsmiljö, i svårigheter i rollen som omvårdnadsledare, i bristande samsyn inom vårdorganisationen samt svårigheter i relationen med anhöriga och patient. För varje kategori finns underkategorier såsom hot och våld, ensamarbetets baksida, tidsbrist, svårt att leda arbetet när personalen brister i sin yrkesutövning, baspersonal som bedömer patienten ur ett annat perspektiv, stöttande av personal i svåra situationer, samverkan med andra professioner, svårt att få kontakt med läkare, anhörigas behov av bekräftelse och försummande av egenvårdsansvaret. Konklusion: Distriktssköterskorna erfor flera svåra situationer inom den kommunala hemsjukvården. För att säkerställa distriktssköterskors hälsa och trygga patientsäkerheten behöver dessa situationer synliggöras och åtgärdas.

    Fulltekst (pdf)
    fulltext
  • 163.
    Blüme, Sofia
    et al.
    Karlstads universitet.
    Liviken, Louise
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper.
    Att leva med pacemaker - patienters upplevelser och livskvalitet2017Independent thesis Basic level (degree of Bachelor), 10 poäng / 15 hpOppgave
    Fulltekst (pdf)
    fulltext
  • 164. Bohman, Doris M
    et al.
    Borglin, Gunilla
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper.
    Student exchange for nursing students: Does it raise cultural awareness'? A descriptive, qualitative study.2014Inngår i: Nurse Education in Practice, ISSN 1471-5953, E-ISSN 1873-5223, Vol. 14, nr 3, s. 259-264Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    With free movement for citizens within the European Union and with distant parts of our globe becoming more accessible, cultural awareness and cultural competence are becoming important skills for nurses. Internationalisation and raising awareness of other cultural contexts are essential elements in Swedish higher education, thus explaining the variety of student exchange programmes that are available. The aim of this study was to explore Swedish nursing students' perceptions of student exchange and their experiences. Data were collected through group interviews and then analysed following the principles of content analysis. Our analysis resulted in three categories: Preparing to go abroad, Reasons for going abroad and From expectation to experience. Cultural aspects and cultural awareness were emphasised as strong motivational factors, both personal and professional, behind participation in student exchange programmes. Information was also highlighted as a crucial means of reaching potential students as well as the power of knowledge through personal experience. This study highlights the importance of student exchange in expanding the individual student's personal and professional horizons. It also stresses the importance of including a transcultural nursing element in nursing curricula.

  • 165.
    Boman Lindström, Cecilia
    et al.
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper (from 2013).
    von Kobyletzki, Laura
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper (from 2013).
    Hallerbäck, M.U.
    Central Hospital Karlstad.
    Lindh, C.H.
    Lund University.
    Jönsson, B.A.
    Lund University.
    Knutz, Malin
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper (from 2013).
    Shu, Huan
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper (from 2013).
    Bornehag, Carl-Gustaf
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper (from 2013).
    Perfluorinated compounds in serum from 2, 373 pregnant women in Sweden2014Inngår i: Indoor Air, ISSN 0905-6947, E-ISSN 1600-0668, s. 927-929Artikkel i tidsskrift (Fagfellevurdert)
  • 166.
    Bonander, Carl
    et al.
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för miljö- och livsvetenskaper (from 2013).
    Beckman, Linda
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper (from 2013).
    Janson, Staffan
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper (from 2013).
    Jernbro, Carolina
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper (from 2013).
    Injury risks in schoolchildren with attention-deficit/hyperactivity or autismspectrumdisorder: Results from two school-based health surveys of 6- to 17-year-old children in Sweden2016Inngår i: Journal of Safety Research, ISSN 0022-4375, E-ISSN 1879-1247, Vol. 58, s. 49-56Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Introduction: Injuries are one of the leading causes of death and disability among children in Sweden and attention-deficit/hyperactivity disorder (ADHD) has previously been associated with an increased risk of injury in pediatric populations elsewhere in the world. Current evidence regarding the possible link between autism spectrum disorder (ASD) and injury risk appears limited, even though some potentially risk-increasing symptoms overlap. The purpose of this study was thus to study the association between both ADHD and ASD concerning the risk of injury among Swedish schoolchildren. Methods: Two samples were used: a population based register study containing data from 18,416 children ranging from the ages of 6-17 years collected by school nurses during 2012/2014 (Survey A), and a national cross-sectional study of 3202 ninth-grade children (similar to 15 years old) collected from 92 schools in 2011 (Survey B). The data were analyzed using chi(2)-tests and log binomial generalized linear models to obtain risk ratios (RR), comparing cases reportedly affected by ADHD or ASD to unaffected controls. Results: After adjusting for confounders, ADHD was associated with a 65% increased risk of injury (RR 1.65 [95% CI: 132-2.05] in Survey A, and a 57% increased risk of injury (RR 1.57 [95% CI: 1.27-1.95]) in Survey B. ASD was not significantly associated with any differences in injury risk (RR 0.81 [95% CI: 0.57-1.14]). Conclusions: The results indicate that there is an elevated injury risk among Swedish schoolchildren with ADHD but not for children with ASD. Future studies should focus on causal mechanisms mediating the association between ADHD and injuries in order to facilitate injury prevention strategies. Practical applications: Parents and teachers of schoolchildren with ADHD should be made aware of the elevated injury risks associated with the diagnosis. Safety experts and injury control professionals should consider the development of specialized prevention strategies in order to reduce these risks.

  • 167.
    Borglin, Gunilla
    et al.
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper (from 2013). Malmö University, Malmö, Sweden.
    Hentzel, Johanna
    Blekinge Cty Council, Primary Hlth Care RN, Nursing, Blekinge, Sweden..
    Bohman, Doris M.
    Blekinge Inst Technol, Dept Hlth, Fac Hlth Sci, Blekinge, Sweden..
    Public health care nurses' views of mothers' mental health in paediatric healthcare services: A qualitative study2015Inngår i: Primary Health Care Research and Development, ISSN 1463-4236, E-ISSN 1477-1128, Vol. 16, nr 5, s. 470-480Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aim: To investigate public health nurses' perceptions and experiences of mental health and of the prevention of mental ill health among women postpartum, within paediatric healthcare services. Background: Although maternal health following childbirth should be a priority within primary care, it is known that women postpartum do not always receive the support they need to adapt to and cope with motherhood. Research implies that postnatal problems lack recognition and are not always acknowledged in routine practice. Few studies have been presented on this topic or from the perspective of nurses. Methods: For this study, eight semi-structured interviews were conducted with public health nurses, and the transcribed texts were analysed through a process inspired by Burnard's description of the four-step qualitative content analysis. Findings: Three categories - external influences on postpartum mental health, screening for and preventing postpartum mental ill health and paediatric healthcare services as a platform for support - were interpreted to reflect the nurses' perceptions and experiences of mental health among women postpartum and of the prevention of mental ill health among women postpartum. Conclusion: We found that public health nurses can have an important role in supporting mothers' mental health postpartum. Although caution is warranted in interpreting our results, the findings concur with those of other studies, highlighting that an equal care emphasis on both the mother and child can be an important aspect of successful support. Implementing person-centred care might be one strategy to create such an emphasis, while also promoting the mental health of new mothers. Public health nurses have a unique opportunity to support mothers' transition into healthy motherhood, especially because they are likely to meet both mothers and children on a regular basis during the first year after birth.

  • 168.
    Borglin, Gunilla
    et al.
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper (from 2013). Högskolan i Blekinge.
    Richards, David A.
    Exter University.
    Bias in experimental nursing research: Strategies to improve the quality and explanatory power of nursing science2010Inngår i: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 47, nr 1, s. 123-128Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    In a guest editorial in this journal, Rahm Hallberg [Rahm Hallberg, I., 2006. Challenges for future nursing research: providing evidence for health-care practice. international Journal of Nursing Studies 43, 923-927] called for research which has greater explanatory power to determine the effectiveness of nursing interventions. in this paper we critique the suggestion made by the evidence-based nursing movement that randomisation per se is the principal route to better quality nursing research. In contrast, we evaluate the new CONSORT criteria for pragmatic RCTs, which assess the quality of strategies to reduce selection, performance, attrition and detection biases, allowing many different types of comparative studies to be covered by application of the checklist. We propose that randomisation alone is a necessary but insufficient strategy and that nursing researchers rise to Rahm Hallberg's challenge by adopting the extended criteria to assist in the critical appraisal, design and reporting of all experimental research in nursing.

  • 169.
    Borglund, Elin
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper.
    Patogenreducering av trombocytkoncentrat från aferes: Verifiering av INTERCEPT Blood Systems för införande på Transfusionsmedicin i Falun.2016Independent thesis Basic level (degree of Bachelor), 10 poäng / 15 hpOppgave
  • 170.
    Borjesson, Marcus
    et al.
    Karlstads universitet, Fakulteten för humaniora och samhällsvetenskap (from 2013), Institutionen för sociala och psykologiska studier (from 2013). Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för miljö- och livsvetenskaper (from 2013). Strategy and Leadership, Swedish Defence University, Karlstad, Sweden.
    Lundqvist, Carolina
    Behavioural Sciences and Learning, Linköping University, Linköping Sweden.
    Gustafsson, Henrik
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper (from 2013). Norwegian School of Sport Sciences, Oslo, Norway.
    Davis, Paul
    Faculty of Social Sciences, Umeå University, Umeå, Sweden..
    Flotation REST as a Stress Reduction Method: The Effects on Anxiety, Muscle Tension, and Performance2018Inngår i: JOURNAL OF CLINICAL SPORT PSYCHOLOGY, ISSN 1932-9261, Vol. 12, nr 3, s. 333-346Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The purpose of the study was to investigate the influence of flotation REST upon skilled and less skilled golfers' anxiety in terms of physiological indicators of stress, self-rated anxiety scores, muscle tension, and the effect on golf putting. Prior to performing the putting task participants underwent a treatment of flotation REST or a period of resting in an armchair. Participants completed both treatments in a randomized order with a two-week interval. The results showed that both flotation REST and the armchair treatment reduced systolic blood pressure and heart rate, with no differences between treatments or athlete skill levels. No significant differences between treatments were revealed regarding self-ratings, level of muscle tension or putting precision. The results indicate that flotation REST may be useful for reducing negative symptoms related to stress and anxiety in general; however, no support for direct positive effects on golf performance were found.

  • 171.
    Bornehag, Carl-Gustaf
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper.
    Phthalate exposure heralds birth defects2015Inngår i: TrAC. Trends in analytical chemistry, ISSN 0165-9936, E-ISSN 1879-3142, Vol. 64, s. VI-VIArtikkel i tidsskrift (Annet vitenskapelig)
  • 172.
    Bornehag, Carl-Gustaf
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper (from 2013).
    The shift in human health from infection-related diseases to chronic illnesses and the importance of indoor chemical exposure2018Inngår i: Indoor Air Pollution / [ed] Peter Pluschke, Hans Schleibinger, Berlin, Germany: Springer, 2018, 2, s. 109-123Kapittel i bok, del av antologi (Fagfellevurdert)
    Abstract [en]

    It has been recently estimated that the pattern of the global burden of diseases – expressed as disability-adjusted life years (DALY) – has changed over the last 20 years and a shift from communicable disorders to noncommunicable disorders has been observed. This shift is more pronounced in high-incomecountries. Even though there is lack of knowledge regarding the cause(s) behind the increase in chronic diseases/disorders, there are scientifically based suspicions that environmental factors do play an important role in interaction with genetic predisposition. Especially diffuse emissions of endocrine-disrupting compounds (EDCs) from consumer products are a matter of concern. The four reasons for concern with human EDC exposure are: The low-dose effect and a non-monotonic dose-response relationshipEarly life sensitivity and the persistency of effectsThe large number of EDC sources in our daily lifeThe wide range of health effects A full chain model is proposed which is following chemicals from their sources over environmental exposures in food, air, and dust over to human uptake and finally to human health effects. The model also includes modifying factors for environmental exposures, different pathways for human uptake, and biological mechanisms involved in health effects. With scientific information in this model risk management should be possible and result in preventive actions in order to reduce children’s exposure to health relevant factors. © Springer-Verlag Berlin Heidelberg 2014.

  • 173.
    Bornehag, Carl-Gustaf
    et al.
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper.
    Carlstedt, Fredrik
    Cty Council Varmland, Karlstad, Sweden..
    Jonsson, Bo A. G.
    Lund Univ, Div Occupat & Environm Med, Lund, Sweden..
    Lindh, Christian H.
    Lund Univ, Div Occupat & Environm Med, Lund, Sweden..
    Jensen, Tina K.
    Univ Southern Denmark, Dept Environm Med, Odense, Denmark..
    Bodin, Anna
    Cty Council Varmland, Karlstad, Sweden..
    Jonsson, Carin
    Cty Council Varmland, Karlstad, Sweden..
    Janson, Staffan
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper.
    Swan, Shanna H.
    Icahn Sch Med Mt Sinai, New York, NY 10029 USA..
    Prenatal Phthalate Exposures and Anogenital Distance in Swedish Boys2015Inngår i: Journal of Environmental Health Perspectives, ISSN 0091-6765, E-ISSN 1552-9924, Vol. 123, nr 1, s. 101-107Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND: Phthalates are used as plasticizers in soft polyvinyl chloride (PVC) and in a large number of consumer products. Because of reported health risks, diisononyl phthalate (DiNP) has been introduced as a replacement for di(2-ethylhexyl) phthalate (DEHP) in soft PVC. This raises concerns because animal data suggest that DiNP may have antiandrogenic properties similar to those of DEHP. The anogenital distance (AGD)-the distance from the anus to the genitals-has been used to assess reproductive toxicity. OBJECTIVE: The objective of this study was to examine the associations between prenatal phthalate exposure and AGD in Swedish infants. METHODS: AGD was measured in 196 boys at 21 months of age, and first-trimester urine was analyzed for 10 phthalate metabolites of DEP (diethyl phthalate), DBP (dibutyl phthalate), DEHP, BBzP (benzylbutyl phthalate), as well as DiNP and creatinine. Data on covariates were collected by questionnaires. RESULTS: The most significant associations were found between the shorter of two AGD measures (anoscrotal distance; AGDas) and DiNP metabolites and strongest for oh-MMeOP [mono(4-methyl-7-hydroxyloctyl) phthalate] and oxo-MMeOP [mono-(2-ethyl-5-oxohexyl) phthalate]. However, the AGDas reduction was small (4%) in relation to more than an interquartile range increase in DiNP exposure. CONCLUSIONS: These findings call into question the safety of substituting DiNP for DEHP in soft PVC, particularly because a shorter male AGD has been shown to relate to male genital birth defects in children and impaired reproductive function in adult males and the fact that human levels of DiNP are increasing globally.

  • 174.
    Bornehag, Carl-Gustaf
    et al.
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper (from 2013). Icahn Sch Med Mt Sinai, MSSM, New York.
    Gennings, C.
    Icahn Sch Med Mt Sinai, MSSM, New York.
    A novel approach to chemical mixture risk assessment: Linking data from population based epidemiology and experimental animal tests2018Inngår i: Toxicology Letters, ISSN 0378-4274, E-ISSN 1879-3169, Vol. 295, s. S52-S52Artikkel i tidsskrift (Fagfellevurdert)
  • 175.
    Bornehag, Carl-Gustaf
    et al.
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper (from 2013). Icahn School of Medicine at Mount Sinai, United States.
    Kitraki, Efthymia
    National and Kapodistrian University of Athens, Greece.
    Stamatakis, Antonios
    National and Kapodistrian University of Athens, Greece.
    Panagiotidou, Emily
    National and Kapodistrian University of Athens, Greece.
    Rudén, Christina
    Stockholm University, Sweden.
    Shu, Huan
    Stockholm University, Sweden.
    Lindh, Christian
    Lund University, Sweden.
    Ruegg, Joelle
    Karolinska Institutet, Sweden.
    Gennings, Chris
    Icahn School of Medicine at Mount Sinai, United States.
    A Novel Approach to Chemical Mixture Risk Assessment—Linking Data from Population-Based Epidemiology and Experimental Animal Tests2019Inngår i: Risk Analysis, ISSN 0272-4332, E-ISSN 1539-6924, Vol. 39, nr 10, s. 2259-2271Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Humans are continuously exposed to chemicals with suspected or proven endocrine disrupting chemicals (EDCs). Risk management of EDCs presents a major unmet challenge because the available data for adverse health effects are generated by examining one compound at a time, whereas real-life exposures are to mixtures of chemicals. In this work, we integrate epidemiological and experimental evidence toward a whole mixture strategy for risk assessment. To illustrate, we conduct the following four steps in a case study: (1) identification of single EDCs (“bad actors”)—measured in prenatal blood/urine in the SELMA study—that are associated with a shorter anogenital distance (AGD) in baby boys; (2) definition and construction of a “typical” mixture consisting of the “bad actors” identified in Step 1; (3) experimentally testing this mixture in an in vivo animal model to estimate a dose–response relationship and determine a point of departure (i.e., reference dose [RfD]) associated with an adverse health outcome; and (4) use a statistical measure of “sufficient similarity” to compare the experimental RfD (from Step 3) to the exposure measured in the human population and generate a “similar mixture risk indicator” (SMRI). The objective of this exercise is to generate a proof of concept for the systematic integration of epidemiological and experimental evidence with mixture risk assessment strategies. Using a whole mixture approach, we could find a higher rate of pregnant women under risk (13%) when comparing with the data from more traditional models of additivity (3%), or a compound-by-compound strategy (1.6%).

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  • 176.
    Bornehag, Carl-Gustaf
    et al.
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper (from 2013). Icahn School of Medicine at Mount Sinai.
    Lindh, C.
    Lunds universitet.
    Reichenberg, A.
    Mount Sinai School of Medicine, New York.
    Wikström, S.
    Örebro University.
    Unenge Hallerbäck, Maria
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper (from 2013).
    Evans, S. F.
    Icahn School of Medicine at Mount Sinai.
    Sathyanarayana, S.
    University of Washington, Seattle.
    Barrett, E. S.
    Rutgers School of Public Health, Piscataway, NJ.
    Nguyen, R. H. N.
    University of Minnesota.
    Bush, N. R.
    University of California, San Francisco.
    Swan, S. H.
    Icahn School of Medicine at Mount Sinai.
    Association of Prenatal Phthalate Exposure with Language Development in Early Childhood2018Inngår i: JAMA pediatrics, ISSN 2168-6203, E-ISSN 2168-6211, Vol. 172, nr 12, s. 1169-1176Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Importance: Prenatal exposure to phthalates has been associated with neurodevelopmental outcomes, but little is known about the association with language development. Objective: To examine the association of prenatal phthalate exposure with language development in children in 2 population-based pregnancy cohort studies. Design, Setting, and Participants: Data for this study were obtained from the Swedish Environmental Longitudinal Mother and Child, Asthma and Allergy (SELMA) study conducted in prenatal clinics throughout Värmland county in Sweden and The Infant Development and the Environment Study (TIDES) conducted in 4 academic centers in the United States. Participants recruited into both studies were women in their first trimester of pregnancy who had literacy in Swedish (SELMA) or English or Spanish (TIDES). This study included mothers and their children from both the SELMA study (n = 963) and TIDES (n = 370) who had complete data on prenatal urinary phthalate metabolite levels, language delay, and modeled covariables. For SELMA, the data were collected from November 1, 2007, to June 30, 2013, and data analysis was conducted from November 1, 2016, to June 30, 2018. For TIDES, data collection began January 1, 2010, and ended March 29, 2016, and data analysis was performed from September 15, 2016, to June 30, 2018. Main Outcomes and Measures: Mothers completed a language development questionnaire that asked the number of words their children could understand or use at a median of 30 months of age (SELMA) and 37 months of age (TIDES). The responses were categorized as fewer than 25, 25 to 50, and more than 50 words, with 50 words or fewer classified as language delay. Results: In the SELMA study, 963 mothers, 455 (47.2%) girls, and 508 [52.8%] boys were included. In TIDES, 370 mothers, 185 (50.0%) girls, and 185 (50.0%) boys were included in this analysis. The prevalence of language delay was 10.0% in both SELMA (96 reported) and TIDES (37 reported), with higher rates of delay in boys than girls (SELMA: 69 [13.5%] vs 27 [6.0%]; TIDES: 12 [12.4%] vs 14 [7.6%]). In crude analyses, the metabolite levels of dibutyl phthalate and butyl benzyl phthalate were statistically significantly associated with language delay in both cohorts. In adjusted analyses, a doubling of prenatal exposure of dibutyl phthalate and butyl benzyl phthalate metabolites increased the odds ratio (OR) for language delay by approximately 25% to 40%, with statistically significant results in the SELMA study (dibutyl phthalate OR, 1.29 [95% CI, 1.03-1.63; P =.03]; butyl benzyl phthalate OR, 1.26 [95% CI, 1.07-1.49; P =.003]). A doubling of prenatal monoethyl phthalate exposure was associated with an approximately 15% increase in the OR for language delay in the SELMA study (OR, 1.14; 95% CI, 1.00-1.31; P =.05), but no such association was found in TIDES (OR, 0.98; 95% CI, 0.79-1.23). Conclusions and Relevance: In findings from this study, prenatal exposure to dibutyl phthalate and butyl benzyl phthalate was statistically significantly associated with language delay in children in both the SELMA study and TIDES. These findings, along with the prevalence of prenatal exposure to phthalates, the importance of language development, and the inconsistent results from a 2017 Danish study, suggest that the association of phthalates with language delay may warrant further examination.

  • 177.
    Bornehag, Carl-Gustaf
    et al.
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper (from 2013).
    Reichenber, A.
    Icahn School of Medicine at Mount Sinai, New York, NY, United States.
    Swan, S. H.
    Icahn School of Medicine at Mount Sinai, New York, NY, United States.
    Language Development of Young Children Is Not Linked to Phthalate Exposure: Reply2019Inngår i: JAMA pediatrics, ISSN 2168-6203, E-ISSN 2168-6211, Vol. 173, nr 5, s. 499-499Artikkel i tidsskrift (Annet vitenskapelig)
  • 178.
    Bornehag, Carl-Gustaf
    et al.
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper (from 2013). Icahn School of Medicine at Mount Sinai, NY, USA.
    Reichenberg, Avi
    Icahn School of Medicine at Mount Sinai, NY, USA.
    Unenge Hallerbäck, Maria
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper (from 2013).
    Wikström, Sverre
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper (from 2013).
    Koch, Holger M.
    Institute of the Ruhr-University, Bochum, Germany.
    Jonsson, B. A.
    Lund University.
    Swan, Shanna H.
    Icahn School of Medicine at Mount Sinai, NY, USA.
    Prenatal exposure to acetaminophen and children's language development at 30 months2018Inngår i: European psychiatry, ISSN 0924-9338, E-ISSN 1778-3585, Vol. 51, s. 98-103Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: To examine prenatal APAP exposure in relation to language development in offspring at 30 months of age. Method: A population-based pregnancy cohort study including 754 women who enrolled in the Swedish Environmental Longitudinal, Mother and child, Asthma and allergy (SELMA) study in pregnancy week 8-13. Two exposure measures were used: (1) maternally reported number of APAP tablets taken between conception and enrollment; (2) APAP urinary concentration at enrollment. Language development at 30 months was assessed by nurse's evaluation and parental questionnaire, including the number of words the child used (<25, 25-50 and >50). Main study outcome; parental report of use of fewer than 50 words, termed language delay (LD). Results: 59.2% of women enrolled in weeks 8-13 reported taking APAP between conception and enrollment. APAP was measurable in all urine samples and urinary APAP was correlated with the number of APAP taken during pregnancy (P < 0.01). Language delay was more prevalent in boys (12.6%) than girls (4.1%) (8.5% in total). Both the number of APAP tablets and urinary APAP concentration were associated with greater LD in girls but not in boys. The adjusted odds ratio (OR) for LD among girls whose mothers reported >6 vs. 0 APAP tablets was 5.92 (95% confidence interval (CI) 1.10-31.94). The OR for LD in girls whose mothers' urinary APAP was in the highest compared to the lowest quartile was 10.34 (95% CI 1.37-77.86). While it cannot be ruled out, our available data do not support confounding by indication. Conclusions: Given the prevalence of prenatal APAP use and the importance of language development, these findings, if replicated, would suggest that pregnant women should limit their use of this analgesic during pregnancy. (C) 2017 Elsevier Masson SAS. All rights reserved.

  • 179.
    Bornehag, Carl-Gustaf
    et al.
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper (from 2013). Icahn School of Medicine at Mount Sinai, NY, USA.
    Reichenberg, Avi
    Icahn School of Medicine at Mount Sinai, NY, USA.
    Unenge Hallerbäck, Maria
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper (from 2013).
    Wikström, Sverre
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper (from 2013).
    Koch, Holger M.
    Institute of the Ruhr-University, Bochum, Germany.
    Swan, Shanna H.
    Icahn School of Medicine at Mount Sinai, NY, USA.
    Reply to Shukla et al., Commentary on: Prenatal exposure to acetaminophen and children's language development at 30 months2018Inngår i: European psychiatry, ISSN 0924-9338, E-ISSN 1778-3585, Vol. 51, s. 86-86Artikkel i tidsskrift (Fagfellevurdert)
  • 180.
    Bornehag, Carl-Gustaf
    et al.
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper.
    Sundel, Jan
    Tech Univ Denmark, Copenhagen, Denmark..
    The Full Chain Model Following SVOCs Indoor From Sources to Health Effects2011Inngår i: Epidemiology, ISSN 1044-3983, E-ISSN 1531-5487, Vol. 22, nr 1, s. S160-S160Artikkel i tidsskrift (Annet vitenskapelig)
  • 181.
    Bornehag, Carl-Gustaf
    et al.
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper.
    Sundell, J.
    Lundgren, B.
    Weschler, C.
    Sigsgaard, T.
    Hägerhed-Engman, L.
    Phthalates in indoor dust indoor and their association to building characteristics2005Inngår i: Journal of Environmental Health Perspectives, ISSN 0091-6765, E-ISSN 1552-9924, Vol. 113, nr 10, s. 1399-1404-Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    In a recent study of 198 Swedish children with persistent allergic symptoms and 202 controls without such symptoms, we reported associations between the symptoms and the concentrations of n-butyl benzyl phthalate (BBzP) and di(2-ethylhexyl) phthalate (DEHP) in dust taken from the childrens' bedrooms. In the present study we examined associations between the concentrations of different phthalate esters in the dust from these bedrooms and various characteristics of the home. The study focused on BBzP and DEHP because these were the phthalates associated with health complaints. Associations have been examined using parametric and nonparametric tests as well as multiple logistic regression. For both BBzP and DEHP, we found associations between their dust concentrations and the amount of polyvinyl chloride (PVC) used as flooring and wall material in the home. Furthermore, high concentrations of BBzP (above median) were associated with self-reported water leakage in the home, and high concentrations of DEHP were associated with buildings constructed before 1960. Other associations, as well as absence of associations, are reported. Both BBzP and DEHP were found in buildings with neither PVC flooring nor wall covering, consistent with the numerous additional plasticized materials that are anticipated to be present in a typical home. The building characteristics examined in this study cannot serve as complete proxies for these quite varied sources. However, the associations reported here can help identify homes where phthalate concentrations are likely to be elevated and can aid in developing mitigation strategies.

  • 182.
    Bornehag, Carl-Gustaf
    et al.
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper.
    Sundell, J.
    Weschler, C.
    Sigsgaard, T.
    Potential selection biases2005Inngår i: Journal of Environmental Health Perspectives, ISSN 0091-6765, E-ISSN 1552-9924, Vol. 112, s. 1393-1397Artikkel i tidsskrift (Fagfellevurdert)
  • 183.
    Boström, Anne-Marie
    et al.
    Karolinska institutet.
    Nordström, GunKarlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper (from 2013).Wilde-Larsson, BodilKarlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper (from 2013).
    Kvalitetsarbete för bättre och säkrare vård2017Collection/Antologi (Fagfellevurdert)
  • 184.
    Boström, Ann-Marie
    et al.
    Karolinska institutet.
    Nordström, Gun
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper (from 2013).
    Wilde-Larsson, Bodil
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper (from 2013).
    Andvändning av forskningsresultat i vården2017Inngår i: Kvalitetsarbete för bättre och säkrare vård / [ed] Ann-Marie Boström, Gun Nordström, Bodil Wilde Larsson, Lund: Studentlitteratur AB, 2017, 2, s. 195-218Kapittel i bok, del av antologi (Fagfellevurdert)
  • 185.
    Brazdeikis, Sara
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper.
    Biologiska läkemedel: Litteraturstudie angående tillverkning, kvalitetssäkring, kliniska prövningar och användning2015Independent thesis Basic level (degree of Bachelor), 10 poäng / 15 hpOppgave
  • 186.
    Bringhed, Ulrika
    et al.
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper.
    Telhede, Caroline
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper.
    Kompartmentsyndrom: operationssjuksköterskans förebyggande omvårdnad2015Independent thesis Advanced level (degree of Master (One Year)), 10 poäng / 15 hpOppgave
    Abstract [sv]

    Introduktion: Omvårdnad är operationssjuksköterskans huvudområde. Operationssjuksköterskan ska förebygga skador och komplikationer som kan uppstå vid en operation. En sådan komplikation kan vara kompartmentsyndrom. Kompartmentsyndrom är en ovanlig komplikation men kan leda till allvarliga skador. Det är därför viktigt att operationssjuksköterskan beaktar det i sitt arbete. Syfte: Detta arbete syftar till att belysa operationssjuksköterskans erfarenheter av att arbeta med att förebygga kompartmentsyndrom i den perioperativa omvårdnaden. Metod: En kvalitativ ansats tillämpades och data samlades in via intervjuer. Insamlade data analyserades genom kvalitativ innehållsanalys. I arbetet deltog 11 operationssjuksköterskor, tio kvinnor och en man, som arbetade på fyra olika operationsavdelningar vid två olika sjukhus. Resultat: I den kvalitativa innehållsanalysen av texten framkom två kategorier, Att arbeta förebyggande samt Att handla på osäker grund. I den förstnämnda kategorin beskrevs hur operationssjuksköterskorna genomförde en individuell riskbedömning, var noggranna i positioneringen och utförde lägesändring samt massage av patientens ben för att förebygga kompartmentsyndrom. I den andra kategorin, Att handla på osäker grund, beskrevs en osäkerhet i den perioperativa omvårdnaden kring kompartmentsyndrom. Det belystes en osäkerhet runt ämnet, omvårdnadsinterventionerna ifrågasattes och en brist på vetenskaplig evidens framkom. Konklusion: Det fanns brister i riktlinjer och rutiner gällande omvårdnad kring kompartmentsyndrom. Det fanns även en brist i att implementera ny kunskap i operationssjuksköterskans omvårdnad för att kunna arbeta evidensbaserat.

    Fulltekst (pdf)
    fulltext
  • 187.
    Brodin, Elin
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper.
    Vet kvinnor att NSAID kan ge negativa effekter på graviditet, förlossning och fosterutveckling?2014Independent thesis Basic level (professional degree), 10 poäng / 15 hpOppgave
  • 188.
    Broman, Natasja
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper (from 2013).
    Validering av en realtids-PCR metod för analys av NF-κB1 mRNA-uttryck i HT29-celler2018Independent thesis Basic level (degree of Bachelor), 10 poäng / 15 hpOppgave
  • 189.
    Brosius, Ewa
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper (from 2013).
    En jämförande studie mellan Harpagophytum procumbens, Boswellia serrata, Symphytum officinale och Non-steroidal anti-inflammatory drugs med avseende på farmakodynamik, farmakokinetik och försäljning - En litteraturstudie2015Independent thesis Basic level (degree of Bachelor), 10 poäng / 15 hpOppgave
  • 190.
    Brus, Annelie
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper.
    Är det någon skillnad mellan odlingsplattorna för MRSA, ESBL och VRE?: Från två olika tillverkare av kromogena odlingsplattor för MRSA, ESBL och VRE.2016Independent thesis Basic level (degree of Bachelor), 10 poäng / 15 hpOppgave
  • 191.
    Bruun, Fredrik
    et al.
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper.
    Svensson, Peter
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper.
    Omvårdnadsinterventioners betydelse för strokedrabbade patienters autonomi och delaktighet.: - En litteraturstudie.2016Independent thesis Basic level (degree of Bachelor), 10 poäng / 15 hpOppgave
    Abstract [sv]

    Introduktion: Stroke är en sjukdom som kan komma plötsligt och innebära svåra förändringar i det vardagliga livet till följd av funktionsnedsättningar fysiskt, psykiskt och socialt. Inte sällan har det konsekvenser för hur det går att klara av att hantera vardagen och arbetslivet. Genom adekvata omvårdnadsinterventioner kan sjuksköterskan genom sitt kunnande förbättra utfallet för patienter som drabbats av stroke, avseende hälsa och livskvalité. Omvårdnadens primära målsättning är att för den enskilde individen skapa förutsättningar för att denne ska bibehålla autonomi, oberoende och hälsa samt delaktighet. Syfte: Att identifiera omvårdnadsinterventioners betydelse för strokedrabbade patienters autonomi och delaktighet. Metod: Litteraturstudie baserad på Polit och Beck’s (2012) niostegsmodell. Databaser som använts för sökning efter vetenskaplig forskning rörande syftet är CINAHL och PubMed. Antalet artiklar som svarade mot syftet var 14. Resultat: Genom granskning av 14 artiklar skapades två huvudteman Effekter på det dagliga livet och Patientundervisning förstärker egenvårdsförmågan. Båda huvudtemana är av betydelse för strokepatienternas återhämtning fysisk, psykiskt och socialt. Slutsats: Sjuksköterskan har en viktig roll i vården av strokedrabbade patienter, både i den akuta fasen och i eftervården. Oberoende och självkänsla hos strokedrabbade patienter är nedsatt i relation till att de har en försämrad autonomi och möjlighet till delaktighet. Genom olika omvårdnadsinterventioner ökar deras autonomi och möjlighet till delaktighet.

    Fulltekst (pdf)
    fulltext
  • 192.
    Bråby, Agneta
    et al.
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper.
    Dedushi, Violeta
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013).
    Distriktssköterskors erfarenheter av palliativ vård i livets slutskede inom hemsjukvård2016Independent thesis Advanced level (degree of Master (One Year)), 10 poäng / 15 hpOppgave
    Abstract [sv]

    Introduktion: Den döende människan behöver bli sedd, hjälpt och känna sig bekräftad. För distriktssköterskor är palliativ vård vid livets slut en arbetsuppgift som innebär att genom omtanke och engagemang åstadkomma bästa möjliga förebyggande och lindrande behandling för den enskilde patienten. Syfte är att belysa distriktssköterskors erfarenheter av palliativ vård av patienter i livets slutskede i hemsjukvård. Metoden är en kvalitativ studie med innehållsanalys. Semistrukturerade intervjuer genomfördes med tio distriktssköterskor verksamma inom kommunal hemsjukvård i tre olika kommuner. Resultat: Studien resulterade i fyra huvudkategorier och nio underkategorier enligt följande: Ett välfungerande teamarbete i kommunen är värdefull med underkategorierna Samverkan med andra yrkesgrupper inom kommunen är vital och Kompetent personal och tid saknas. Den andra huvudkategorin var Samverkan med landstinget är viktig med underkategorierna Palliativa teamet skapar trygghet för patienten och Omvårdnaden är beroende av samarbetet med distriktsläkare. Den tredje huvudkategorin var Anhöriga är en betydelsefull del av vården med underkategorierna Viktigt att etablera relation att stödja anhöriga och Anhöriga kan svikta. Resultatets fjärde huvudkategori blev Viktig uppdrag att vårda vid livets slut med tre underkategorier enligt följande: Uppdraget kräver specifikt kompetens, Kan ge känsla av otillräcklighet och Att sätta den sjukes behov i centrum. Konklusion: I studien visades att distriktssköterskor i hemsjukvården efterstävar ett välfungerande samarbete med kommunens och landstingens yrkesgrupper för att etablera en god vård vid livet slut för patienter som dör i hemmet

    Fulltekst (pdf)
    fulltext
  • 193.
    Bui, Eva
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper.
    Framtagning av betulinsyra ur skogsvara till farmakologiska tester: Extraktion och syntetisering av betulinsyra2014Independent thesis Basic level (professional degree), 10 poäng / 15 hpOppgave
  • 194.
    Bunlang, Sawai
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper.
    Effekt av ftalaterna DiNP och MiNP på morfologi och celltillväxt i SH-SY5Y humana neuroblastom celler2016Independent thesis Basic level (degree of Bachelor), 10 poäng / 15 hpOppgave
  • 195.
    Burrows, Harry
    et al.
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper (from 2013).
    Joelsson, Johan
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper (from 2013).
    Identifiering av smärta hos personer med demenssjukdom: En litterarturstudie2018Independent thesis Basic level (degree of Bachelor), 10 poäng / 15 hpOppgave
    Abstract [sv]

    Introduktion: Demenssjukdom är ett samlingsnamn för flera sjukdomar som orsakar kognitiva symtom. Förekomsten av demenssjukdom ökar bland befolkningen. I motsats till personer utan demenssjukdom, är det en större utmaning att identifiera smärta för vårdpersonal på grund av personer med demenssjukdoms nedsatta kognitiva förmåga att själva rapportera smärta. Syfte: Att belysa hur vårdpersonal kan identifiera smärta hos personer med demenssjukdom. Metod: Litteraturstudien använde Polit och Becks (2012) niostegs flödesschema. En sökning i två databaser (CINAHL och PubMed) och en manuell sökning producerade 10 artiklar (tre kvantitativa artiklar och sju kvalitativa artiklar) vilka resultatet baseras på efter genomförd databearbetning.  Resultat: Resultatet presenteras i tre kategorier relaterat till hur vårdpersonal kan identifiera smärta hos personer med demenssjukdom – Identifiera smärta genom samtal, Identifiera smärta genom beteendeförändring och Identifiera smärta genom fysiska tecken. Slutsats: Vårdpersonal kan identifiera smärta hos personer med demenssjukdom genom samtal, beteendeförändring och fysiska tecken. En helhetssyn och kännedom om personen med demenssjukdom skapar förutsättningar att identifiera smärta.

    Fulltekst (pdf)
    fulltext
  • 196.
    Bååth, Carina
    et al.
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper.
    Engström, Maria
    Högskolan i Gävle.
    Gunningberg, Lena
    Uppsala universitet.
    Muntlin Athlin, Åsa
    Uppsala universitet.
    Prevention of heel pressure ulcers among older patients-from ambulance care to hospital discharge: A multi-centre randomized controlled trial2016Inngår i: Applied Nursing Research, ISSN 0897-1897, E-ISSN 1532-8201, Vol. 30, s. 170-175Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Abstract

    The aim was to investigate the effect of an early intervention, a heel suspension device boot, on the incidence of heel pressure ulcers among older patients (aged 70+).

    BackgroundPressure ulcers are a global healthcare issue; furthermore, the heel is an exposed location. Research indicates that preventive nursing interventions starting during the ambulance care and used across the acute care delivery chain are seldom used.

    MethodsA multi-centre randomized control study design was used. Five ambulance stations, two emergency departments and 16 wards at two Swedish hospitals participated. Altogether, 183 patients were transferred by ambulance to the emergency department and were thereafter admitted to one of the participating wards.

    ResultsSignificantly fewer patients in the intervention group (n=15 of 103; 14.6%) than the control group (n=24 of 80; 30%) developed heel pressure ulcers during their hospital stay (p=0.017).

    ConclusionsPressure ulcer prevention should start early in the acute care delivery chain to increase patient safety.

  • 197.
    Bååth, Carina
    et al.
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper.
    Idvall, Ewa
    Faculty of Health and Society, Malmö University.
    Gunningberg, Lena
    Department of Public Health and Caring Sciences, Uppsala University.
    Hommel, Ami
    Lund University.
    Pressure reducing intervention among persons with pressure ulcers: results from the first three national pressure ulcer prevalence surveys in Sweden2014Inngår i: Journal of Evaluation In Clinical Practice, ISSN 1356-1294, E-ISSN 1365-2753, Vol. 20, nr 1, s. 58-65Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Rationale, aims and objectivesThe overall aim of this study was to describe preventive interventions among persons with pressure ulcer (PU) in three nationwide PU prevalence surveys in Sweden.

    Methods

    A cross-sectional research design was used; more than 70 000 persons from different hospitals and nursing homes participated in the three prevalence surveys conducted in March 2011, October 2011 and March 2012.

    The methodology used was that recommended by the European Pressure Ulcers Advisory Panel.

    Results

    The overall prevalence of PU categories I–IV in hospitals was 16.6%, 14.4% and 16.1%, respectively. Corresponding figures for nursing homes were 14.5%, 14.2% and 11.8%, respectively. Heel protection/floating heels and sliding sheets were more frequently planned for persons with PU category I.

    Conclusions

    Despite the three prevalence studies that have showed high prevalence of PU the use of preventing interventions is still not on an acceptable level. Heel protection/floating heels and sliding sheets were more frequently planned for persons with PUs, and individual-planned repositioning also increased. However, when persons already have a PU they should all have pressure-reducing preventive interventions to prevent the development of more PUs. Preventing PUs presents a challenge even when facilities have prevention programmes. A PU prevention programme requires an enthusiastic leader who will maintain the team's focus and direction for all staff involved in patient care.

  • 198.
    Bååth, Carina
    et al.
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper.
    Larsson, Maria
    Karlstads universitet, Fakulteten för samhälls- och livsvetenskaper, Avdelningen för omvårdnad.
    Akuten och omvärlden – ett förbättringsprojekt i samarbete mellan Landstinget i Värmland och Karlstads universitet2014Inngår i: Universitetens, Högskolornas och Svensk sjuksköterskeförenings årliga konferens, Verksamhetsförlagd utbildning: Lärande i en föränderlig värld, 2014Konferansepaper (Annet vitenskapelig)
  • 199.
    Bååth, Carina
    et al.
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper.
    Larsson, Maria
    Karlstads universitet, Fakulteten för samhälls- och livsvetenskaper, Avdelningen för omvårdnad.
    Akuten och omvärlden- ett förbättringsprojekt i samarbete mellan Landstinget i Värmland och Karlstads universitet, Malmö 20142014Inngår i: Akuten och omvärlden- ett förbättringsprojekt i samarbete mellan Landstinget i Värmland och Karlstads universitet, 2014Konferansepaper (Annet vitenskapelig)
  • 200.
    Bååth, Carina
    et al.
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper.
    Stensson, M
    Sund, A-K
    Preventative care: knowledge and attitudes among nurses for pressure ulcers prevention2015Konferansepaper (Fagfellevurdert)
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