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  • 251.
    Dell’Anno, Irene
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper.
    The fusion of single-chain antibodies and cell-penetrating peptides: Construction, expression and characterization2014Independent thesis Basic level (degree of Bachelor), 10 poäng / 15 hpOppgave
  • 252.
    Demirel, Juliana
    et al.
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper.
    Jäderkvist, Jenny
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper.
    Faktorer som påverkar upplevelsen av svensk tandvård hos individer med utländsk bakgrund2014Independent thesis Basic level (degree of Bachelor), 10 poäng / 15 hpOppgave
    Abstract [sv]

    Introduktion: Sverige är idag ett mångkulturellt land där en stor del av befolkningen har utländsk bakgrund. Flera av dem skattar sin munhälsa sämre än personer födda i Sverige och besöker tandvården mer sällan, trots att tandvårdsbehov finns. Genom att beskriva vilka faktorer som påverkar upplevelsen av svensk tandvård hos individer med utländsk bakgrund kan förståelsen för hur den upplevs öka.

    Syfte: Att beskriva faktorer som påverkar upplevelsen av svensk tandvård hos individer med utländsk bakgrund.

    Metod: Kvalitativ studie med enskilda intervjuer i en stad i Mellansverige. Urvalet bestod av fyra vuxna informanter i åldrarna 25-50 år med utländsk bakgrund. Intervjuerna analyserades med kvalitativ innehållsanalys.

    Resultat: Fyra huvudkategorier framkom vilka var bemötande, kommunikation, tandvårdsorganisation och vårdkvalitet. Bemötandet upplevs som professionellt, dock förekommer vissa motsättningar i patientmötet. Kommunikationen mellan personal och patient upplevs som god men information på andra språk än svenska efterfrågas. Gällande tandvårdsorganisation anses svensk tandvård som dyr och tidskrävande. Den svenska tandvården håller dock en god vårdkvalitet.

    Konklusion: Bemötande, ekonomi, kommunikation och vårdkvalitet är faktorer som påverkar upplevelsen av svensk tandvård hos individer med utländsk bakgrund. I de flesta fall var upplevelsen positiv men informanterna framförde vissa brister. 

    Fulltekst (pdf)
    Studentuppsats Juliana Demirel & Jenny Jäderkvist
  • 253.
    Deng, Qihong
    et al.
    Cent S Univ, Sch Energy Sci & Engn, Changsha 410083, Hunan, Peoples R China.;Cent S Univ, Inst Environm Hlth, Changsha 410083, Hunan, Peoples R China..
    Lu, Chan
    Cent S Univ, Sch Energy Sci & Engn, Changsha 410083, Hunan, Peoples R China..
    Norback, Dan
    Uppsala Univ, Dept Med Sci Occupat & Environm Med, Uppsala, Sweden..
    Bornehag, Carl-Gustaf
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper.
    Zhang, Yinping
    Tsinghua Univ, Sch Architecture, Beijing 100084, Peoples R China..
    Liu, Weiwei
    Cent S Univ, Sch Energy Sci & Engn, Changsha 410083, Hunan, Peoples R China.;Cent S Univ, Inst Environm Hlth, Changsha 410083, Hunan, Peoples R China..
    Yuan, Hong
    Cent S Univ, Inst Environm Hlth, Changsha 410083, Hunan, Peoples R China.;Cent S Univ, Xiangya Hosp 3, Changsha 410083, Hunan, Peoples R China..
    Sundell, Jan
    Cent S Univ, Sch Energy Sci & Engn, Changsha 410083, Hunan, Peoples R China.;Tsinghua Univ, Sch Architecture, Beijing 100084, Peoples R China..
    Early life exposure to ambient air pollution and childhood asthma in China2015Inngår i: Environmental Research, ISSN 0013-9351, E-ISSN 1096-0953, Vol. 143, s. 83-92Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Early life is suggested to be a critical time in determining subsequent asthma development, but the extent to which the effect of early-life exposure to ambient air pollution on childhood asthma is unclear. Objectives: We investigated doctor-diagnosed asthma in preschool children due to exposure to ambient air pollution in utero and during the first year of life. Methods: In total 2490 children aged 3-6 years participated in a questionnaire study regarding doctor-diagnosed asthma between September 2011 and January 2012 in China. Children's exposure to critical air pollutants, sulfur dioxide (SO2) as proxy of industrial air pollution, nitrogen dioxide (NO2) as proxy of traffic pollution, and particulate matter <= 10 mu m in diameter (PM10) as a mixture, was estimated from the concentrations measured at the ambient air quality monitoring stations by using an inverse distance weighted (IDW) method. Logistic regression analysis was employed to determine the relationship between early-life exposure and childhood asthma in terms of odds ratio (OR) and 95% confidence interval (CI). Results: Association between early-life exposure to air pollutants and childhood asthma was observed. SO2 and NO2 had significant associations with adjusted OR (95% CI) of 1.45 (1.02-2.07) and 1.74 (1.15-2.62) in utero and 1.62 (1.01-2.60) and 1.90 (1.20-3.00) during the first year for per 50 mu g/m(3) and 15 mu g/m(3) increase respectively. Exposure to the combined high level of SO2 and NO2 in China significantly elevated the asthmatic risk with adjusted OR (95% CI) of 1.76 (1.18-2.64) in utero and 1.85 (1.22-2.79) during the first year compared to the low level exposure. The associations were higher for males and the younger children aged 3-4 than females and the older children aged 5-6. Conclusions: Early-life exposure to ambient air pollution is associated with childhood asthma during which the level and source of air pollution play important roles. The high level and nature of combined industrial and traffic air pollution in China may contribute to the recent rapid increase of childhood asthma. (C) 2015 Elsevier Inc. All rights reserved.

  • 254.
    Derakhshan, A.
    et al.
    Academic Center for Thyroid Diseases, Erasmus MC, Dr. Molewaterplein 15, Rotterdam.
    Shu, H.
    Department of Environmental Science and Analytical Chemistry, Stockholm University, Sweden.
    Peeters, R. P.
    Academic Center for Thyroid Diseases, Erasmus MC, Dr. Molewaterplein 15, Rotterdam, 3051 GE, Netherlands.
    Kortenkamp, A.
    Institute of Environment, Health and Societies, Brunel University, London, Uxbridge, United Kingdom.
    Lindh, C. H.
    Division of Occupational and Environmental Medicine, Lund University, Lund, 22363, Sweden.
    Demeneix, B.
    Laboratoire d'Evolution des Régulations Endocriniennes, Muséum National d'Histoire Naturelle, 57 Rue Cuvier, Paris,.
    Bornehag, Carl-Gustaf
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper (from 2013). Icahn School of Medicine at Mount Sinai, New York City, NY, United States.
    Korevaar, T. I. M.
    Academic Center for Thyroid Diseases, Erasmus MC, Dr. Molewaterplein 15, Rotterdam, 3051 GE, Netherlands.
    Association of urinary bisphenols and triclosan with thyroid function during early pregnancy2019Inngår i: Environment International, ISSN 0160-4120, E-ISSN 1873-6750, Vol. 133, artikkel-id 105123Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Bisphenols and triclosan are considered as potential thyroid disruptors. While mild alterations in maternal thyroid function can result in adverse pregnancy and child developmental outcomes, there is still uncertainty whether bisphenols or triclosan can interfere with thyroid function during pregnancy. Objectives: We aimed to investigate the association of urinary bisphenol A (BPA), bisphenol S (BPS), bisphenol F (BPF) and triclosan with early pregnancy thyroid function. Methods: This study was embedded in the Swedish Environmental Longitudinal, Mother and child, Asthma and allergy study (SELMA), a population-based prospective pregnancy cohort. In total, 1996 participants were included in the current study. Maternal urinary concentrations of three bisphenols and triclosan, collected at median (95% range) 10 (6–14) weeks of pregnancy as well as serum concentrations of thyroid stimulating hormone (TSH), free thyroxine (FT4), free triiodothyronine (FT3), total thyroxine (TT4), and total triiodothyronine (TT3) were measured. Results: Higher BPA levels were associated with lower TT4 concentrations (non-monotonic, P = 0.03), a lower FT4/FT3 ratio (β [SE] -0.02 [0.01], P = 0.03) and a lower TT4/TT3 ratio (β [SE] -0.73 [0.27], P = 0.008). Higher BPF levels were associated with a higher FT3 (β [SE] 0.01 [0.007], P = 0.04). There were no associations between other bisphenols or triclosan and absolute TSH, (F)T4 or (F)T3 concentrations. The association of BPA with thyroid function differed with gestational age. The negative association of BPA with FT4/FT3 and TT4/TT3 ratios was only apparent in early but not late gestation (P for interaction: 0.003, 0.008, respectively). Conclusion: These human data during pregnancy substantiate experimental findings suggesting that BPA could potentially affect thyroid function and deiodinase activities in early gestation.

    Fulltekst (pdf)
    Derakhshan2019
  • 255.
    Derakhshan, Arash
    et al.
    rasmus MC, Acad Ctr Thyroid Dis, NL-3051 GE Rotterdam, Netherland.
    Shu, Huan
    Stockholms universitet.
    Broeren, Maarten A. C.
    Maxima Med Ctr, Lab Clin Chem & Haematol, NL-5504 DB Veldhoven, Netherlands.
    de Poortere, Ralph A.
    Maxima Med Ctr, Lab Clin Chem & Haematol, NL-5504 DB Veldhoven, Netherlands.
    Wikstrom, Sverre
    Örebro University.
    Peeters, Robin P.
    rasmus MC, Acad Ctr Thyroid Dis, NL-3051 GE Rotterdam, Netherland.
    Demeneix, Barbara
    Museum Natl Hist Nat, Lab Evolut Regulat Endocriniennes, Paris.
    Bornehag, Carl-Gustaf
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper (from 2013). Icahn Sch Med Mt Sinai, New York, NY.
    Korevaar, Tim I. M.
    Erasmus MC, Acad Ctr Thyroid Dis, NL-3051 GE Rotterdam, Netherlands.
    Reference Ranges and Determinants of Thyroid Function During Early Pregnancy: The SELMA Study2018Inngår i: Journal of Clinical Endocrinology and Metabolism, ISSN 0021-972X, E-ISSN 1945-7197, Vol. 103, nr 9, s. 3548-3556Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Context: Establishing reference ranges as well as identifying and quantifying the determinants of thyroid function during pregnancy is important for proper clinical interpretation and optimizing research efforts. However, such data are sparse, specifically for triiodothyronine measurements, and most studies do not take into account thyroid antibodies or human chorionic gonadotropin. Objective: To determine reference ranges and to identify/quantify determinants of TSH, free T4 (FT4), free triiodothyronine (FT3), total T4 (TT4), and total triiodothyronine (TT3). Design, Setting, and Participants: This study included 2314 participants of the Swedish Environmental Longitudinal, Mother and child, Asthma and allergy study, a population-based prospective pregnancy cohort of mother-child pairs. Reference ranges were calculated by 2.5th to 97.5th percentiles after excluding thyroperoxidase antibody (TPOAb)-positive and/or thyroglobulin antibody (TgAb)-positive women. Intervention: None. Main Outcome Measures: TSH, FT4, FT3, TT4, and TT3 in prenatal serum. Results: After exclusion of TPOAb-positive women, reference ranges were as follows: TSH, 0.11 to 3.48 mU/L; FT4, 11.6 to 19.4 pmol/L; FT3, 3.72 to 5.92 pg/mL; TT4, 82.4 to 166.2 pmol/L; and TT3, 1.28 to 2.92 nmol/L. Additional exclusion of TgAb-positive women did not change the reference ranges substantially. Exposure to tobacco smoke, as assessed by questionnaires and serum cotinine, was associated with lower TSH and higher FT3 and TT3. Body mass index (BMI) and gestational age were the main determinants of TSH (only for BMI), FT4, FT3, TT4, and TT3. Conclusions: We show that the exclusion of TgAb-positive women on top of excluding TPOAb-positive women hardly affects clinical reference ranges. We identified various relevant clinical determinants of TSH, FT4, FT3, TT4, and TT3 that could reflect endocrine-disrupting effects and/or effects on thyroid hormone transport or deiodination.

  • 256.
    Di Rosa, Sara
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper.
    Effects of combined treatment with Imatinib and leukotriene receptor antagonists on cell number and LTC4 synthase expression in a Chronic Myeloid Leukemia cell-line2014Independent thesis Basic level (degree of Bachelor), 10 poäng / 15 hpOppgave
  • 257.
    Dikkeboom, Helen
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper.
    Antiangiogenesläkemedel s.k. angiogenes-hämmare vid behandling avmetastaserande kastrationsresistent prostatacancer: En litteraturstudie över, -om de senaste årens kliniska studier visar attpatienter med metastaserande kastrationsresistent prostatacancer kan ha nyttaav behandling med angiogenes-hämmare.2016Independent thesis Basic level (degree of Bachelor), 10 poäng / 15 hpOppgave
  • 258.
    Dilén, Sofia
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper.
    Studier av effekter av epigallokatekin-3-gallat och extrakt av grönt te och kråkbär på prostaglandin E2 bildningen i humana monocyter och makrofager2014Independent thesis Basic level (professional degree), 10 poäng / 15 hpOppgave
  • 259.
    Dinha, Lara
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper (from 2013).
    Prolaktinoms effekter och konsekvenser hos gravida kvinnor: - En litteraturstudie2018Independent thesis Basic level (degree of Bachelor), 10 poäng / 15 hpOppgave
  • 260.
    Dirie, Mona
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper (from 2013).
    SJUKSKÖTERSKORS ARBETSMILJÖ: En kvalitativ studie om sjuksköterskors upplevelse av frisk- och riskfaktorer i deras arbetsmiljö2019Independent thesis Advanced level (degree of Master (One Year)), 10 poäng / 15 hpOppgave
    Abstract [sv]

    Bakgrund: Alla människor har rätt till en trygg och hälsosam arbetsmiljö. Hälsan påverkas oundvikligen av olika faktorer i arbetsmiljön som verkar för eller emot hälsan. Att sträva efter att skapa hälsofrämjande arbetsplatser är därför en viktig del av den nationella och globala folkhälsopolitiken. Tidigare forskning, som främst är av kvantitativ karaktär, har visat att det finns frisk- såväl som riskfaktorer i sjuksköterskors arbetsmiljö. Det behövs dock fler kvalitativa studier som belyser sjuksköterskornas egna upplevelser av frisk-och riskfaktorer för att kunna identifiera förbättringsfaktorer i arbetsmiljön och utveckla det framtida hälsofrämjande arbetet.

    Syfte: Syftet med studien var att belysa sjuksköterskors upplevelse av frisk-och riskfaktorer i sin arbetsmiljö, med fokus på förbättringsfaktorer.

    Metod: En kvalitativ studie har genomförts och en kvalitativ innehållsanalys med en induktiv ansats användes för att analysera data från de fem sjuksköterskor i Mellansverige, som intervjuats med hjälp av en semistrukturerad intervjumetod.

    Resultat: Ur analysen framkom två kategorier: ´Arbetstillfredsställelse`, med tillhörande tre subkategorier: Meningsfulla interaktioner, Ett öppet och jämlikt arbetsklimat, Socialt stöd. Vidare kategorin: ´Bemanning och resurser`, som innehöll följande subkategorier: Personalstyrkan och dess konsekvenser, Kompetensutveckling samt Fysisk miljö.

    Slutsats: En god och hållbar arbetsmiljö var av stor vikt för sjuksköterskornas hälsa och välbefinnande på arbetet. Vidare beskrevs det finnas en del riskfaktorer i arbetsmiljön som försämrade arbetsglädjen och sjuksköterskornas välbefinnande. Sammantaget framkom det av intervjuerna att det är viktigt att fortsätta arbeta för att stärka sjuksköterskornas arbetsmiljö, eftersom arbetsmiljön också påverkar vårdkvaliteten och patienternas välmående. Något som är av vikt för folkhälsan och en god hälsa på lika villkor.

    Nyckelord: Arbetsmiljö, Frisk- och riskfaktorer, Hälsofrämjande arbete, Kvalitativ vetenskaplig metod, Sjuksköterskor

    Fulltekst (pdf)
    fulltext
  • 261.
    Dupin, Cecile
    et al.
    French School of Public Health.
    Larsson, Maria
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper.
    Dariel, Odessa
    French School of Public Health.
    Debout, Christophe
    French School of Public Health.
    Rothan-Tondeur, Monique
    French School of Public Health.
    Conceptions of learning research: variations among French and Swedish nurses: A phenomenographic study2015Inngår i: Nurse Education Today, ISSN 0260-6917, E-ISSN 1532-2793, Vol. 35, nr 1, s. 73-79Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND:

    The development of nursing research capacity and interactions with cultural and structural issues is at various stages throughout Europe. This process appears to be remarkably similar irrespective of the country. Sweden has developed this capacity since the 1990s, whereas France is experiencing a transition. Nevertheless, knowledge about how nurses conceive their learning about nursing research and transitioning toward being researchers is scarce.

    OBJECTIVES:

    The aim of this study was to explore French and Swedish RNs' conceptions of research education and educational passage toward research and to describe how learning research contributes to the understanding of their norms and practices.

    DESIGN:

    A phenomenographic approach was used to understand and describe the qualitatively different ways in which French and Swedish RNs conceive research and its apprenticeship.

    SETTINGS AND PARTICIPANTS:

    A purposive maximum variation sampling of five French and five Swedish Nurse Researchers with PhDs.

    METHODS:

    Individual in-depth interviews conducted in France and Sweden between November 2012 and March 2013 were analysed using phenomenography.

    FINDINGS:

    The analysis revealed one main category, "Organisational factors to sustain individual apprenticeship". Three descriptive categories have emerged from the data and its variations amongst French and Swedish nurses: (1) entrance into research--modes of commitment; (2) nurses' engagement--the need for dedicated support; and (3) research as the means to resolve nursing situations.

    CONCLUSIONS:

    This study demonstrates how registered nurses have integrated nursing and researcher roles following different efficient paths. Education in nursing research is part of the strategy needed for the development of nursing research and is supported by the integration of research and practic

  • 262.
    Dupin, Cecile-Marie
    et al.
    French School of Public Health, Paris, Frankrike.
    Larsson, Maria
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper (from 2013).
    La phénoménographie, une méthode utile en recherche infirmière2015Inngår i: SOiNS, recherche en soins infirmiers, ISSN 0297-2964, nr 792, s. 56-58Artikkel i tidsskrift (Fagfellevurdert)
  • 263. Dupin, Cécile Marie
    et al.
    Borglin, Gunilla
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper.
    Debout, Christophe
    Rothan-Tondeur, Monique
    An ethnographic study of nurses' experience with nursing research and its integration in practice.2014Inngår i: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 70, nr 9, s. 2128-2139Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    AIM: To report from a study aimed at illuminating how French Registered Nurses experience and engage in nursing research in clinical practice.

    BACKGROUND: Nursing research in France is mainly conducted by nurses working at clinical research units rather than by dedicated nurse researchers. Education, i.e. advanced degrees, in the field of nursing research is still in its infancy and not yet consistent with the international context. Outside France, the general perception is that nursing research is a unified part of professional nursing. Consequently, in-depth knowledge about how nurses in a French clinical context might experience and engage in nursing research is still lacking.

    DESIGN: The design of this study was influenced by an ethnographic approach as described by the French anthropologists Beaud and Weber.

    METHOD: Data, participatory observations, field notes and interviews (n = 6) were collected in a teaching hospital between April-August 2012. The field consisted of a wound-care unit and clinical research units. Collected data were analysed based on Beaud and Weber's description of analysis.

    RESULTS: Three beliefs were identified: being a unified part of a research team, being an integral part of 'crosswise - across' activities and being part of research activities.

    CONCLUSION/IMPLICATION FOR RESEARCH: Commitment to nursing research was strengthened by patient-related issues. Based on this context, nursing research would likely benefit from the support of a naturalized reciprocity between clinical practice and research.

  • 264.
    Eckerblad, J.
    et al.
    Linkoping Univ, Dept Social & Welf Studies, Linkoping, Sweden..
    Hellstrom, I.
    Linkoping Univ, Dept Social & Welf Studies, Linkoping, Sweden..
    Ekdahl, A.
    Vrinnevi Hosp, Dept Geriatr, Norrkoping, Sweden..
    Theander, Kersti
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper.
    Jaarsma, T.
    Linkoping Univ, Dept Social & Welf Studies, Linkoping, Sweden..
    Symptom burden in elderly patients with cardiac disease and multimorbidity2014Inngår i: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 13, s. S52-S53Artikkel i tidsskrift (Annet vitenskapelig)
  • 265.
    Eckerblad, J
    et al.
    Linköping University.
    Theander, Kersti
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper.
    Ekdahl, A
    Linköping University, Karolinska Institutet.
    Jaarsma, T
    Linköping University.
    Hellstrom, I
    Linköping University, Ersta Sköndal University College.
    To adjust and endure: a qualitative study of symptom burden in older people with multimorbidity.2015Inngår i: Applied Nursing Research, ISSN 0897-1897, E-ISSN 1532-8201, Vol. 28, nr 4, s. 322-327Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    CONTEXT: Older people with multimorbidity are vulnerable and often suffer from conditions that produce a multiplicity of symptoms and a reduced health-related quality of life.

    OBJECTIVES: The aim of this study is to explore the experience of living with a high symptom burden from the perspective of older community-dwelling people with multi-morbidity.

    METHOD: A qualitative descriptive design with semi-structured interviews, including 20 community-dwelling older people with multi-morbidity and a high symptom burden. The participants were 79-89 years old with a mean of 12 symptoms per person. Data were analyzed using content analyses.

    RESULTS: The experience of living with a high symptom burden revealed the overall theme, "To adjust and endure" and three sub-themes. The first sub-theme was "To feel inadequate and limited". Participants reported that they no longer had the capacity or the ability to manage, and they felt limited and isolated from friends or family. The second sub-theme was "To feel dependent". This was a new and inconvenient experience; the burden they put on others caused a feeling of guilt. The final sub-theme was "To feel dejected". The strength to manage and control their conditions was gone; the only thing left to do was to sit or lie down and wait for it all to pass.

    CONCLUSION: This study highlights the importance of a holistic approach when taking care of older people with multi-morbidity. This approach should employ a broad symptom assessment to reveal diseases and conditions that are possible to treat or improve.

  • 266.
    Eckerblad, J
    et al.
    Linköping university.
    Tödt, K
    Linköping university.
    Jakobsson, P
    Linköping university hospital.
    Unosson, M
    Department of Social and Welfare Studies, Faculty of Health Sciences, Linkoping University, Linkoping, Sweden.
    Skargren, E
    Linköping university.
    Kentsson, M
    Ryhov Hospital Jönköping.
    Theander, Kersti
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper (from 2013).
    Symptom burden in stable COPD patients with moderate or severe airflow limitation2014Inngår i: Heart & Lung, ISSN 0147-9563, E-ISSN 1527-3288, Vol. 43, nr 4, s. 351-357Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVES: To describe a multidimensional symptom profile in patients with stable chronic obstructive pulmonary disease (COPD) and determine whether symptom experience differed between patients with moderate or severe airflow limitations.

    BACKGROUND: Patients with severe airflow limitation experience numerous symptoms, but little is known regarding patients with moderate airflow limitation.

    METHODS: A multidimensional symptom profile (Memorial Symptom Assessment Scale) was assessed in 42 outpatients with moderate and 49 with severe airflow limitations.

    RESULTS: The mean number of symptoms in the total sample was 7.9 (±4.3) with no difference between patients with moderate and severe airflow limitations. The most prevalent symptoms with the highest MSAS symptom burden scores were shortness of breath, dry mouth, cough, sleep problems, and lack of energy in both groups.

    CONCLUSIONS: Patients with moderate or severe airflow limitations experience multiple symptoms with high severity and distress. An assessment of their multidimensional symptom profile might contribute to better symptom management.

  • 267.
    Eckerblad, Jeanette
    et al.
    Linkoping Univ, Dept Social & Welf Studies, Linkoping, Sweden..
    Theander, Kersti
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper (from 2013).
    Ekdahl, Anne
    Linkoping Univ, Dept Geriatr Med, Norrkoping, Sweden.;Linkoping Univ, Dept Social & Welf Studies, Norrkoping, Sweden.;Karolinska Inst KI, Div Clin Geriatr, Dept Neurobiol Care Sci & Soc NVS, Solna, Sweden..
    Unosson, Mitra
    Linkoping Univ, Dept Social & Welf Studies, Linkoping, Sweden..
    Wirehn, Ann-Britt
    Linkoping Univ, Cty Council Ostergotland, Local Hlth Care Res & Dev Unit, Linkoping, Sweden..
    Milberg, Anna
    Linkoping Univ, Dept Social & Welf Studies, Linkoping, Sweden.;Linkoping Univ, Dept Social & Welf Studies, Norrkoping, Sweden.;Linkoping Univ, Dept Adv Home Care, Norrkoping, Sweden.;Linkoping Univ, Palliat Educ & Res Ctr, Norrkoping, Sweden..
    Krevers, Barbro
    Linkoping Univ, Dept Med & Hlth Sci, Linkoping, Sweden..
    Jaarsma, Tiny
    Linkoping Univ, Dept Social & Welf Studies, Linkoping, Sweden..
    Symptom burden in community-dwelling older people with multimorbidity: a cross-sectional study2015Inngår i: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 15, artikkel-id 1Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Globally, the population is ageing and lives with several chronic diseases for decades. A high symptom burden is associated with a high use of healthcare, admissions to nursing homes, and reduced quality of life. The aims of this study were to describe the multidimensional symptom profile and symptom burden in community-dwelling older people with multimorbidity, and to describe factors related to symptom burden. Methods: A cross-sectional study including 378 community-dwelling people >= 75 years, who had been hospitalized >= 3 times during the previous year, had >= 3 diagnoses in their medical records. The Memorial Symptom Assessment Scale was used to assess the prevalence, frequency, severity, distress and symptom burden of 31 symptoms. A multiple linear regression was performed to identify factors related to total symptom burden. Results: The mean number of symptoms per participant was 8.5 (4.6), and the mean total symptom burden score was 0.62 (0.41). Pain was the symptom with the highest prevalence, frequency, severity and distress. Half of the study group reported the prevalence of lack of energy and a dry mouth. Poor vision, likelihood of depression, and diagnoses of the digestive system were independently related to the total symptom burden score. Conclusion: The older community-dwelling people with multimorbidity in this study suffered from a high symptom burden with a high prevalence of pain. Persons with poor vision, likelihood of depression, and diseases of the digestive system are at risk of a higher total symptom burden and might need age-specific standardized guidelines for appropriate management.

    Fulltekst (pdf)
    fulltext
  • 268.
    Eckerblad, Jeanette
    et al.
    Linkoping Univ, Fac Med & Hlth Sci, Dept Social & Welf Studies, S-58183 Linkoping, Sweden..
    Theander, Kersti
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper (from 2013).
    Ekdahl, Anne W.
    Helsingborg Hosp, Dept Res & Educ, Geriatr Med, Helsingborg, Sweden.;Karolinska Inst, Dept Neurobiol Caring Sci & Soc, Div Clin Geriatr, Stockholm, Sweden..
    Jaarsma, Tiny
    Linkoping Univ, Fac Med & Hlth Sci, Dept Social & Welf Studies, Caring Sci, S-58183 Linkoping, Sweden..
    Symptom trajectory and symptom burden in older people with multimorbidity, secondary outcome from the RCT AGe-FIT study2016Inngår i: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 72, nr 11, s. 2773-2783Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aim. The aim of this study was to follow the symptom trajectory of community-dwelling older people with multimorbidity and to explore the effect on symptom burden from an ambulatory geriatric care unit, based on comprehensive geriatric assessment. Background. Older community-dwelling people with multimorbidity suffer from a high symptom burden with a wide range of co-occurring symptoms often resulting to decreased health-related quality of life. There is a need to move from a single-disease model and address the complexity of older people living with multimorbidity. Design. Secondary outcome data from the randomized controlled Ambulatory Geriatric Assessment Frailty Intervention Trial (AGe-FIT). Methods. Symptom trajectory of 31 symptoms was assessed with the Memorial Symptom Assessment Scale. Data from 247 participants were assessments at baseline, 12 and 24 months, 2011-2013. Participants in the intervention group received care from an ambulatory geriatric care unit based on comprehensive geriatric assessment in addition to usual care. Results. Symptom prevalence and symptom burden were high and stayed high over time. Pain was the symptom with the highest prevalence and burden. Over the 2-year period 68-81% of the participants reported pain. Other highly prevalent and persistent symptoms were dry mouth, lack of energy and numbness/tingling in the hands/feet, affecting 38-59% of participants. No differences were found between the intervention and control group regarding prevalence, burden or trajectory of symptoms. Conclusions. Older community-dwelling people with multimorbidity had a persistent high burden of symptoms. Receiving advanced interdisciplinary care at an ambulatory geriatric unit did not significantly reduce the prevalence or the burden of symptoms.

  • 269.
    Ekberg Andersson, Annelie
    et al.
    Karlstads universitet, Universitetsbiblioteket.
    Karlsson, Ingela
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper (from 2013).
    Persenius Wentzel, Mona
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper (from 2013).
    Collaboration between researchers and librarians2016Konferansepaper (Annet vitenskapelig)
  • 270.
    Ekbåge, Daniel
    et al.
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för ingenjörs- och kemivetenskaper (from 2013).
    Nilsson, Lars
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för ingenjörs- och kemivetenskaper (from 2013).
    Håkansson, Helena
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för ingenjörs- och kemivetenskaper (from 2013).
    Lin, Ping-I
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper (from 2013).
    Multiple linear regression modelling of pulp and handsheet properties based on fiber morphology measurements and process data2020Inngår i: BioResources, ISSN 1930-2126, E-ISSN 1930-2126, Vol. 15, nr 1, s. 654-676Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    A multiple regression model was evaluated to predict pulp and handsheet properties including z-directional tensile strength (z-strength) and Scott bond values. One hypothesis that was central for the model evaluation was that the crill content, as measured with ultraviolet and infrared lights, would improve the statistical models. A chemi-thermomechanical pulp (CTMP) mill designed with two parallel primary refining lines and a reject refiner was the basis for this study, and all process data and pulp samples were gathered from the specific process. Pulp was extracted from the process for an extended period from a position after the latency chest (primary refined pulp) and from the pulp-stream exiting the mill to the board machine (accept pulp). The crill content was positively correlated to the z-strength of the accept pulp, explaining 55% of the variance with a linear regression model with the drill content as the sole predictor. The estimation model of the z-strength of accept pulp was based on a combination of the crill content, freeness, fibril perimeter for longer fibers, and mean kink angle, and resulted in an R-2 of 0.79. When applying cross-validation to determine the predictive model performance, the highest R-2 obtained was 0.67. This latter model included the crill content, fibril perimeter, and mean kink angle as predictors.

    Fulltekst (pdf)
    fulltext
  • 271.
    Ekfeldt, Martina
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper.
    Samtidig användning av melatonin och ADHD-läkemedel hos barn: Vilka samband finns mellan regelbunden användning av ADHD-läkemedel och melatonin hos barn?2015Independent thesis Basic level (degree of Bachelor), 10 poäng / 15 hpOppgave
  • 272.
    Eklo, Niklas
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper.
    Bestämning av cytokinproduktion i nasala borstprov som respons på LPS- eller R848-stimulering2017Independent thesis Basic level (degree of Bachelor), 10 poäng / 15 hpOppgave
  • 273.
    Eklund, Anna Josse
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper.
    Sjuksköterskor som patienters företrädare: Med huvudsakligt fokus på företrädarskap för äldre patienter i kommunal hälso- och sjukvård2013Doktoravhandling, med artikler (Annet vitenskapelig)
    Abstract [en]

    The overall aim was to study nurses’ and managers’ attitudes towards micro social patient advocacy (I) and factors related to patient advocacy (II, III) with the main focus being on advocacy in the care of older patients in community health care together with psychometric testing of the instrument 'Attitudes toward Patient Advocacy Scale-Attitudes toward MIcrosocial Advocacy' (IV).

    Methods: A quantiative cross-sectional study and a qualitative study were carried out. Nurses (n=207) and managers (n=23) in community health care responded to a questionnaire about patient advocacy, nursing competence, personal traits, quality of care and organisational climate (I, II, IV). Nurses' (n=18) perceptions of influencers of patient advocacy was studied in a phenomenographic study (III).

    The results showed that nurses and managers reported positive attitudes to patient advocacy (I, II), especially for patients unable to speak for themselves (I). Two areas of nursing competence (Performing the nursing process, Supervision and cooperation) and a dimension of quality of care of older patients were positively associated with attitudes towards patient advocacy (II). Two organisational dimensions were, negatively (dynamism) respectively positively (playfulness), associated with attitudes towards patient advocacy. The nurses' perceptions of influencers of patient advocacy consist of three hierarchically related levels: The nurse's character traits, The nurse’s bond with the patient and The organisational conditions (III). The Swedish version of APAS-AMIA consists of 33 items in a four-factor structure (APAS-AMIA/SE): Support patients’ beliefs and decision-making, Safeguard patients' health care, Support patients to communicate their wishes and Respect patients’ wishes not to participate in decisions regarding care (IV).

    Conclusions: Maintaining the continuing professional competence of nurses is important, and is ensuring the organisational prerequisites to enable nurses' advocacy for patients.

    Fulltekst (pdf)
    Sjuksköterskor som patienters företrädare
  • 274.
    Eklund, Anna Josse
    et al.
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper.
    Jossebo, Marie
    Karlskoga lasarett, Örebro läns landsting.
    Sandin-Bojö, Ann-Kristin
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper. Karlskoga Hospital, Sweden.
    Wilde-Larsson, Bodil
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper. Norway.
    Petzäll, Kerstin
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper. Norway.
    Swedish nurses’ perceptions of influencers on patient advocacy – a phenomenographic study2014Inngår i: Nursing Ethics, ISSN 0969-7330, E-ISSN 1477-0989, Vol. 21, nr 6, s. 673-683Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: A limited number of studies have shown that patient advocacy can be influenced by both facilitators and barriers which can encourage and discourage nurses to act as patient advocates. Objective: This study’s aim was to describe Swedish nurses’ perceptions of influencers on patient advocacy.

    Research design and context: Interviews with 18 registered nurses from different Swedish clinical contexts were analysed using the phenomenographic method.

    Ethical considerations: Ethical revisions were made in accordance with national legislation and guidelines by committees for research ethics at Karlstad University. Findings: Three levels of hierarchically related influencers on patient advocacy were found in the descriptive categories. The fundamental influencer, the nurse’s character traits, was described in the perceptions that advocacy is influenced by nurse’s having a moral compass, having control over the care situation, being protective and feeling secure as a nurse. The second most vital influencer, the nurse’s bond with the patient, was expressed in the perceptions of knowing the patient and feeling empathy for the patient. The third level of influencers, the organisational conditions, was described in the perceptions that the organisational structures and organisational culture influence patient advocacy.

    Discussion: The results correspond with findings from earlier research but add an understanding that influencers on patient advocacy exist at three hierarchically related levels. Conclusion: The nurse’s character traits are the fundamental influencer to patient advocacy, but in order to be comfortable and secure when advocating for patients, nurses also need to be familiar with both the patient and the situation. A supposition could be that all influencers interact, which needs to be further addressed in future studies.

  • 275.
    Eklund, Anna Josse
    et al.
    Karlstads universitet, Fakulteten för samhälls- och livsvetenskaper, Avdelningen för omvårdnad.
    Petzäll, Kerstin
    Karlstads universitet, Fakulteten för samhälls- och livsvetenskaper, Avdelningen för omvårdnad.
    Räty, Lena
    Karlstads universitet, Fakulteten för samhälls- och livsvetenskaper, Avdelningen för omvårdnad.
    Wilde-Larsson, Bodil
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper.
    Sandin-Bojö, Ann-Kristin
    Karlstads universitet, Fakulteten för samhälls- och livsvetenskaper, Avdelningen för omvårdnad.
    Sjuksköterskans advokatskap för patienter inom kommunal vård2011Konferansepaper (Annet (populærvitenskap, debatt, mm))
  • 276.
    Eklund, Anna Josse
    et al.
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper.
    Wilde-Larsson, Bodil
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper. Norway.
    Petzäll, Kerstin
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper. Norway.
    Sandin-Bojö, Ann-Kristin
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper. City Council Värmland.
    Individual and organisational factors influencing registered nurses' attitudes towards patient advocacy in Swedish community health care of elders2014Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 28, nr 3, s. 486-495Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aim: The aim of this study was to describe and explore individual and organisational factors potentially influencing registered nurses' (RNs) attitudes towards patient advocacy. Methods and Sample: In a quantitative cross-sectional study, data were collected from 226 RNs in community health care of elders. A questionnaire was used to measure a number of factors including attitudes towards patient advocacy, nursing competence, personality traits, individual preferences regarding the quality of health care and working climate. A multiple regression analysis was performed. Results: The results showed that individual factors of nursing competence and individual preferences of the quality of health care, as well as organisational factors of the working climate, explained 26.2% of the variance in the RNs' attitudes towards patient advocacy. Conclusions: Although the mentioned individual factors may be intertwined, the conclusion is that both individual and organisational factors influenced RNs' attitudes towards patient advocacy. The results do not verify that nursing experience, workplace experience, educational level or personality traits influence the RNs' attitudes towards patient advocacy. The proportion of explained variance indicates that additional factors also influence attitudes towards patient advocacy, and more research is needed to shed further light on these factors.

  • 277.
    Eklund, Hanna
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper.
    Gravida kvinnor med substanssyndrom: hälsa, graviditets- och förlossningsutfall samt tidigt utfall hos barnen2014Independent thesis Advanced level (degree of Master (One Year)), 10 poäng / 15 hpOppgave
    Abstract [en]

    Introduction: In order to achieve better health and to cope with illness and suffering, the goal of nursing should be to support the individual to find meaning in the experience, and to establish interpersonal relationships. For pregnant women with substance use syndrome, which often has multiple risk factors such as impaired physical health, higher proportion of mental disorders, and increased psychosocial needs, this often means need of support from different professional categories. The prevalence of drug use during pregnancy in Sweden is not known, nor have any methods for treatment during pregnancy been evaluated, however, women is generally supposed to decrease their consumption during pregnancy. The knowledge of drugs and alcohol and their effects on pregnancy requires continuous attention, in order to facilitate identification of women in need of additional support. Purpose: The aim of the study was to describe and compare pregnant women with substance use syndrome and pregnant women with alcohol use syndrome regarding backgrounds, health, pregnancy- and delivery outcome and the early outcome of their children. Method: The study was conducted as a retrospective, quantitative registry study with a comparative design including pregnant women with substance use syndrome (n=78) and pregnant women with alcohol use syndrome (n=49). The women were enrolled in a specialized antenatal care center and had been identified with the screening instruments AUDIT and DUDIT. Result: The study showed that significantly more pregnant women with substance use syndrome relapsed in substance use, more often was smoking during the pregnancy and that their children were more frequently treated in neonatal clinics, compared to pregnant women with only alcohol use syndrome. The result also showed that women with only alcohol use syndrome showed a higher frequency of pregnancy complications. No significant differences were seen among women with different substance disorder concerning their background variables or delivery outcome. Conclusions: The results suggest that it could be useful for pregnant women with individual care plan and specific care programs, based on dependence diagnosis, so if possible assure a drug-free pregnancy.

    Fulltekst (pdf)
    fulltext
  • 278.
    Eklund, Therese
    et al.
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper.
    Nordmark, Cecilia
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper.
    Omvårdnadsteamets arbete intraoperativt beträffande patientsäkerheten: En integrerad systematisk litteraturstudie2016Independent thesis Advanced level (degree of Master (One Year)), 10 poäng / 15 hpOppgave
    Abstract [sv]

    Introduktion: Hälften av alla vårdskador uppkommer i samband med operation. Operationsteamet är ett multidisciplinärt samarbete där många människor från flera yrkeskategorier arbetar tillsammans i olika konstellationer med patientsäkerheten som en av de viktigaste delarna. Operationssjuksköterskan och anestesisjuksköterskan ansvarar för patientens omvårdnad före, under och efter operationen.

    Syfte: Att beskriva hur omvårdnadsteamet arbetar intraoperativt beträffande patientsäkerheten.

    Metod: En integrerad systematisk litteraturstudie där artiklar söktes i databaserna Cinahl och PubMed. Elva artiklar med kvantitativ, kvalitativ och mixed method valdes ut och analyserades.

    Resultat: Materialet resulterade i tre kategorier: Att vara förberedd, att utbyta information med varandra och att vara förtrogen med varandras färdigheter.

    Konklusion: En stor del av resultatet visade på att förberedelser där hela omvårdnadsteamet involveras, kontinuerligt utbyter information med varandra och är förtrogna med varandras yrkesprofessionella färdigheter stärker patientsäkerheten. Resultatet av denna litteraturstudie kan leda till en ökad förståelse för operationsteamets betydelse för patientsäkerheten intraoperativt. 

    Fulltekst (pdf)
    fulltext
  • 279.
    Ekman, Robert
    et al.
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper. Karolinska Institute; Swedish Civil Contingencies Agency, Karlstad.
    Ekman, Diana Stark
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper.
    Schyllander, Jan
    Schelp, Lothar
    Karolinska Institute.
    A comparison of unintentional injury patterns occurring in two Swedish communities in 1978 and in 20082015Inngår i: International Journal of Injury Control and Safety Promotion, ISSN 1745-7300, E-ISSN 1745-7319, Vol. 22, nr 3, s. 254-259Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Surveillance and analyses of unintentional injuries can be used to help prioritise community prevention efforts. This study describes changes in local patterns for unintentional injuries resulting in deaths, hospitalisations, and outpatient visits to health care clinics and emergency rooms, comparing information from two different study periods, 1978 and 2008, in the Swedish communities of Falköping and Lidköping. Injury cases were analysed, and confidence intervals were derived. The study results show that while most injuries decreased comparing the first study period to the second, these changes were only significant in terms of decreases in outpatient care. This study points to the importance of more systematic collection data of injury events treated at the outpatient level, particularly for communities where there are relatively low numbers of injury-related deaths and hospitalisations.

  • 280.
    Ekros, Helena
    et al.
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper.
    Lindvall, Jenny
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper.
    Utvärdering av patientens postoperativa smärta, illamående och informationsbehov efter införandet av en ny dagkirurgisk modell2014Independent thesis Advanced level (degree of Master (One Year)), 10 poäng / 15 hpOppgave
    Abstract [sv]

    Introduktion: Fler och fler opereras inom den dagkirurgiska verksamheten i Sverige. För att bevara patientsäkerheten och kvaliteten i vården, bör den ständigt utvärderas och vid behov förbättras. Alternativ i detta förbättringsarbete kan vara användandet av olika dagkirurgiska fast-track modeller, där den perioperativa omvårdnaden, medicineringen och anestesimetoden anpassas efter individen och det kirurgiska ingreppet. De två vanligaste postoperativa komplikationerna patienter drabbas av efter kirurgi är smärta och illamående. Syfte med studien var att undersöka hur patienterna mådde postoperativt med fokus på smärta och illamående efter införandet av en ny dagkirurgisk fast-trackmodell. Ytterligare ett syfte var att undersöka om patienterna tyckte sig ha fått tillräckligt med information och om de hade förbättringsförslag på den perioperativa vården. Metod: Data samlades in med strukturerade postoperativa telefonintervjuer av 72 patienter. Resultatet visade att patienterna skattade sin smärta och sitt illamående lågt, de visade sig må som de hade förväntat sig postoperativt. Av studiens patienter upplevde de flesta att de hade fått tillräckligt med information i samband med den perioperativa vården. Konklusion: Resultatet i studien kan ligga till grund för vidareutveckling av den perioperativa vården. För ytterligare utvärdering av den nya dagkirurgiska fast-track modellen kan jämförande telefonintervjuer genomföras på klinikens övriga dagkirurgiska patienter. 

    Fulltekst (pdf)
    Ekros/Lindvall
  • 281.
    Ekstrand, Magnus
    et al.
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper.
    Hed, Kristina
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper.
    Ambulanssjuksköterskors upplevelser av smärtlindring av barn i en prehospital kontext - en kvalitativ intervjustudie2014Independent thesis Advanced level (degree of Master (One Year)), 10 poäng / 15 hpOppgave
    Abstract [sv]

    Syftet med denna studie är att studera ambulanssjuksköterskors upplevelser av att bedöma och vårda barn under tio års ålder med akut smärta i en prehospital kontext.

     

    Metod: Studien utfördes som en kvalitativ empirisk intervjustudie baserad på fem öppna frågor. Tio ambulanssjuksköterskor intervjuades och fick beskriva positiva och negativa upplevelser av att omhänderta barn 0-10 år med akut smärta i prehospital kontext. Materialet analyserades genom en kvalitativ innehållsanalys med en manifest och latent ansats.

     

    Resultat: Upplevelser av det vårdande mötet var en utmaning. Ambulanssjuksköterskan förberedde sig inför smärtbehandling under framkörningen till barnet. En bra smärtlindring var förenad med ett gott omhändertagande men smärtbehandlingen var svår och mångfacetterad. Vikten av stöd och samarbete prehospitalt från kollegorna och andra personalgrupper framkom liksom frustration som följd av kommunikationssvårigheter med barnet. Vikten av att skapa en god kontakt med barnet och dess anhöriga betonades och det fanns en upplevelse av otillräcklighet och utrymme för förbättring kring barn och smärta. Ambulanssjuksköterskan upplevde otillräcklighet i sitt yrkesutövande och mer utbildning önskades. Behovet av alternativa behandlingsprinciper lämpliga för barn där ambulanssjuksköterskan inte behöver sticka barnet efterfrågades.

     

    Slutsats: Den prehospitala vården behöver utvecklas ytterligare på flera områden avseende riktlinjer, metoder för att skatta barns smärta och vid omhändertagandet av de yngsta barnen. Mera utbildning kring barn och smärta är önskvärt samt utveckling kring andra administrationssätt än perifer venkateter.

    Fulltekst (pdf)
    Ambulanssjuksköterskors upplevelser av smärtlindring av barn i en prehospital kontext - en kvalitativ intervjustudie
  • 282.
    Ekvall, Lovisa
    et al.
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper.
    Kvist, Elin
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper.
    Patienter med cancer i ett palliativt skede - vilka faktorer påverkar livskvaliteten?2017Independent thesis Basic level (degree of Bachelor), 10 poäng / 15 hpOppgave
    Fulltekst (pdf)
    fulltext
  • 283.
    Eldemene, Maged
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper.
    M1-makrofager utrycker mer IL-8, IL-10 och IL-12:s mRNA jämfört med M0 och M2-makrofager: Uttrycket av IL-8, IL-10 och IL-12 mRNA i M1-makrofager kan eventuellt sänkas med somatostatin analogen Oktreotid2015Independent thesis Basic level (degree of Bachelor), 10 poäng / 15 hpOppgave
  • 284.
    Eliasson, Jonas
    et al.
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper (from 2013).
    Hedlund, Jörgen
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper (from 2013).
    Finns det evidens för en prehospital luftvägsalgoritm?2020Independent thesis Advanced level (degree of Master (One Year)), 10 poäng / 15 hpOppgave
    Fulltekst (pdf)
    Prehospital Luftvägsalgortim
  • 285.
    Ellonen, Noora
    et al.
    Police Coll Finland, Tampere, Finland..
    Jernbro, Carolina
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper.
    Janson, Staffan
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper.
    Tindberg, Ylva
    Sormland Cty Council, Ctr Res & Dev, Eskilstuna, Sweden.;Uppsala Univ, Dept Womens & Childrens Hlth, Uppsala, Sweden..
    Lucas, Steven
    Uppsala Univ, Dept Womens & Childrens Hlth, Uppsala, Sweden..
    Current Parental Attitudes Towards Upbringing Practices in Finland and Sweden 30 Years after the Ban on Corporal Punishment2015Inngår i: Child Abuse Review, ISSN 0952-9136, E-ISSN 1099-0852, Vol. 24, nr 6, s. 409-417Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Thirty years have now passed since Sweden and Finland, as the first countries in the world, enacted national legislation against corporal punishment. This study examines the current attitudes towards corporal punishment among Finnish and Swedish parents of newborn to 12-year-old children. Differences between the countries in parents' attitudes towards upbringing practices in relation to socio-demographic background factors were also analysed. The study was based on identical survey data collected separately in Finland and Sweden in 2011 and later merged for analysis. The survey included questions regarding parental behaviour and attitudes towards upbringing practices. Data were analysed using univariate tests (chi-2) and logistic regression. The analysis showed that a significantly larger proportion of Finnish parents approved of slapping or hitting their children compared to Swedish parents (OR = 6.20). Swedish parents, on the other hand, approved of shaking more than Finnish parents (OR = 0.54). Furthermore, a larger proportion of Finnish parents had positive attitudes towards non-violent types of punishments compared to Swedish parents. The socio-demographic background factors did not explain the differences between the countries. Cultural factors that may plausibly influence these attitudes are discussed. Copyright (c) 2014 John Wiley & Sons, Ltd.

  • 286.
    Ellonen, Noora
    et al.
    University of Tampere, Tampere, Finland.
    Lucas, Steven
    Department of Women's and Children's Health, Uppsala University, Uppsala Sweden.
    Tindberg, Ylva
    Department of Women's and Children's Health and Centre for Clinical Research Sörmland, Uppsala University, Uppsala, Sweden.
    Janson, Staffan
    Karlstads universitet, Fakulteten för samhälls- och livsvetenskaper, Avdelningen för hälsa och miljö. Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper (from 2013). Karlstads universitet, Fakulteten för humaniora och samhällsvetenskap (from 2013), Institutionen för sociala och psykologiska studier (from 2013).
    Parents' Self-Reported Use of Corporal Punishment and Other Humiliating Upbringing Practices in Finland and Sweden: A Comparative Study2017Inngår i: Child Abuse Review, ISSN 0952-9136, E-ISSN 1099-0852, Vol. 26, nr 4, s. 289-304Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Sweden and Finland were the first countries to ban corporal punishment 30years ago. Since then, the prevalence of attitudes supporting the use of corporal punishment and the practice itself have decreased. This study examines the current frequencies of corporal punishment and other humiliating upbringing practices in Finnish and Swedish families. The analysis is based on survey data among 3170 Finnish and 1358 Swedish parents with children from newborn to 12years of age. Data were analysed using univariate tests (chi-square) and logistic regression. According to the analysis, a larger proportion of Finnish parents, and especially mothers, use humiliating upbringing practices compared to Swedish parents. This difference is not found with regard to corporal punishment. A larger proportion of Finnish parents push their children compared to Swedish parents, while a larger proportion of Swedish parents shake their children. In both countries, corporal punishment is more frequently used by fathers, boys are more often victimised than girls, toddlers are more often exposed to corporal punishment and school-age children are more often subjected to psychologically abusive practices. Corporal punishment and other humiliating upbringing practices are strongly correlated in both countries. The differences found between countries were not explained by socio-demographic factors.

  • 287. Ellonen, Noora
    et al.
    Peltonen, Kirsi
    Poso, Tarja
    Janson, Staffan
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper (from 2013). Karlstads universitet, Fakulteten för humaniora och samhällsvetenskap (from 2013), Institutionen för sociala och psykologiska studier (from 2013).
    A multifaceted risk analysis of fathers' self-reported physical violence toward their children2017Inngår i: Aggressive Behavior, ISSN 0096-140X, E-ISSN 1098-2337, Vol. 43, nr 4, s. 317-328Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Existing research has shown that child maltreatment is carried out by both mothers and fathers. There is also an extensive body of literature analyzing reasons for mothers' violent behavior. Among fathers, reasons are less well studied, resulting in the lack of a comprehensive picture of paternal child abuse. In this study, 20 child-, parent-, and family-related factors have been included in a combined analysis to assess which of these may pose a risk for fathers' severe violent behavior toward their children. The study is based on merged data from Finland and Sweden, in which an anonymous survey was answered by parents, based on representative samples of parents with 0-12-year-old children. The merged data set included 679 fathers and analyses were carried out using logistic regression models. Six percent of the fathers had committed severe violent acts, that is, slapped, hit, punched, kicked, bit, hit/tried to hit their child with an object or shook (under 2-year-old) their child at least once during the 12 months preceding the survey. Corporal punishment experienced by the fathers when they were children, or used by the father as a method of discipline, strongly increased the likelihood of severe violent acts. The findings emphasize the importance of preventing all forms of corporal punishment in seeking to minimize the occurrence of severe physical violence by fathers toward their children. Aggr. Behav. 43:317-328, 2017. (c) 2016 Wiley Periodicals, Inc.

  • 288.
    Emini Eriksson, Sanije
    et al.
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper (from 2013).
    Ryhr, Jaqline
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper (from 2013).
    Faktorer som påverkar sjuksköterskans attityd till patienter som är suicidnära2018Independent thesis Basic level (degree of Bachelor), 10 poäng / 15 hpOppgave
    Abstract [sv]

    Introduktion: Suicid är ett allvarligt folkhälsoproblem. I Sverige år 2015

    avled 1175 personer i suicid. Suicid är en konsekvens av ett långvarigt psykiskt

    och känslomässigt lidande. Många patienter beskriver upplevelsen att befinna

    sig i ett kaosliknande tillstånd, ett tunnelseende som inte lämnar rum för

    konsekvenstänk. Suicidriskidentifiering är en viktig uppgift för sjuksköterskor

    men initiativet till riskidentifiering kan påverkas av sjuksköterskans attityd till

    dessa patienter.

    Syfte: Belysa faktorer som påverkar sjuksköterskans attityd till patienter som

    är suicidnära.

    Metod: Litteraturstudien utformades utifrån Polit och Beck (2017) niostegsprocess.

    Databassökningen utfördes i CINAHL, PsycINFO samt PubMed

    och resulterade i 11 artiklar.

    Resultat: I resultatet framkom olika faktorer som påverkar sjuksköterskans

    attityd. Dessa faktorer är samhällets normer, religion, erfarenhet, kunskap,

    arbetsmiljö samt kön och ålder.

    Slutsats: Generellt visade sjuksköterskorna en negativ attityd till patienter som

    är suicidnära. Genom att belysa de faktorer som påverkar sjuksköterskans

    attityd kan interventioner vidtas för att förebygga attityder som för patienter

    som är suicidnära ger en negativt betingad upplevelse av vården.

    Fulltekst (pdf)
    fulltext
  • 289.
    Engh Kraft, Lisbet
    et al.
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper (from 2013).
    Eriksson, Ulla-Britt
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper (from 2013).
    The School Nurse's Ability to Detect and Support Abused Children: A Trust-Creating Process2015Inngår i: Journal of School Nursing, ISSN 1059-8405, E-ISSN 1546-8364, Vol. 31, nr 5, s. 353-362Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Child abuse has negative health consequences. Early detection and preventive measures lead to avoidance of prolonged and more complex problems. School nurses have a child protection role and should pay attention to vulnerable children. Through health dialogues and other interactions with pupils, school nurses have the opportunity to detect child abuse. The aim of the study was to explore how school nurses detect child abuse and initiate support measures. Focus group interviews were conducted with 23 school nurses. The data were analyzed using a grounded theory approach. Results showed that the main concern of the school nurses was support and assistance to children who are abused which was preceded by a trust-creating and trust-strengthening process. Trust contains self-confidence and confidence in the system and trust can be strengthened or undermined. Building trustful relations is time consuming and is facilitated by networking, refined assessment instruments, and collaboration.

  • 290.
    Engh Kraft, Lisbet
    et al.
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper (from 2013).
    Rahm, GullBritt
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper (from 2013).
    Eriksson, Ulla-Britt
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper (from 2013).
    School Nurses Avoid Addressing Child Sexual Abuse2017Inngår i: Journal of School Nursing, ISSN 1059-8405, E-ISSN 1546-8364, Vol. 33, nr 2, s. 133-142Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Child sexual abuse (CSA) is a global public health problem with major consequences for the individual child and society. An earlier Swedish study showed that the school nurses did not initially talk about nor mention CSA as one form of child abuse. For the child to receive adequate support, the disclosure is a precondition and is dependent on an available person prepared to listen. The aim of the study was to explore the ability of the school nurses to detect and support sexually abused children. It is a secondary analysis of focus group interviews with school nurses. Thematic analysis was performed. Results showed that the school nurses avoided addressing CSA due to arousal of strong emotions, ambivalence, and a complicated disclosure process. In order to detect CSA and support abused children, attentiveness of sexual abuse as a possible cause of physical and mental illhealth is crucial.

    Fulltekst (pdf)
    fulltext
  • 291.
    Engh, Lisbet
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper (from 2013).
    Skolsköterskans möjlighet att upptäcka och stödja barn som far illa eller riskerar att fara illa2018Doktoravhandling, med artikler (Annet vitenskapelig)
    Abstract [en]

    Since children are a vulnerable group, the society has a special responsibility to protect them. The school nurse sees all pupils at school at regular health visits and thereby gains knowledge of their health and living conditions. The overall aim of the thesis was to develop empirical knowledge and understanding of the ability of the school nurse to detect and support children who are maltreated or at risk to be maltreated. The thesis is based on four studies. Study I was based on focus group interviews with school nurses. Data was analysed in accordance with Grounded Theory. Study II was a secondary analysis of study I and performed with Thematic Analysis. Studies III and IV were based on population data which was analysed by univariate and multivariate logistic regressions. The results showed that the school nurse has ability to detect children who are maltreated or at risk to be maltreated. However, also obstacles for detection were found such as lack of trust, avoidance, strong feelings and insufficient documentation. The obstacles were partly due to organisational shortcomings and dearth of resources affecting also internal and external collaboration. The school nurse strived for building trustful relations to pupils, to parents and to professionals. If the school nurse failed to report suspected child maltreatment to the child protection services it was because of worries that the reporting did not benefit the child. The school nurse avoided addressing child sexual abuse because of its particular sensitiveness, which affected the possibility to detect the abuse. Pupils in foster care were at higher risk of health problems, a more risky lifestyle, a lower degree of school attachment and lower school performance compared to pupils not in foster care. The results emphasize the potential of the school nurse to detect and support maltreated children through regular contacts with pupils, their confidence in the school nurse and trustful relations with other professionals.

    Fulltekst (pdf)
    fulltext_KAPPAN
    Download (jpg)
    preview image
  • 292.
    Engh, Lisbet
    et al.
    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).
    Svensson, Birgitta
    Örebro universitet.
    Bornehag, Carl-Gustaf
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper (from 2013).
    Eriksson, Ulla-Britt
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper (from 2013).
    Swedish population-based study of pupils showed that foster children faced increased risks for ill health, negative lifestyles and school failure.2017Inngår i: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 106, nr 10, s. 1635-1641Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    AIM: This population-based study explored whether foster children faced a higher risk of health problems than children of the same age who were not in foster care.

    METHODS: Data for 13 739 pupils aged 10, 13 and 16 years were obtained from the Pupil Health Database in the county of Värmland, Sweden, for the school years 2012/2013 and 2013/2014. These included data on school performance, health, lifestyle and social relationships, based on children's interviews with school nurses.

    RESULTS: Of all the pupils, 171 (1.2%) were in foster care. Children in foster care were generally unhealthier than other children. Both girls and boys were at higher risk of chronic health problems, daily smoking, use of drugs and school failure. When the girls in foster care were compared to other girls, we found that they faced a higher risk of psychological and psychosomatic symptoms. This difference was not found for boys. Foster children were also more likely to express a more negative view on life.

    CONCLUSION: We confirmed earlier studies that children in foster care tended to have inferior health and well-being than other children. These findings emphasise that health, risky behaviour and school performance should be considered together when assessing foster children.

    Fulltekst (pdf)
    fulltext
  • 293.
    Engh, Lisbet
    et al.
    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).
    Lin, Ping-I
    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).
    Eriksson, Ulla-Britt
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper (from 2013).
    Can school attachment modify the relation between foster care placement and school achievement?2018Inngår i: British Journal of School Nursing, ISSN 1752-2803, E-ISSN 2052-2827, Vol. 13, nr 4, s. 175-185Artikkel i tidsskrift (Fagfellevurdert)
  • 294.
    Englund, Malin
    et al.
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper (from 2013).
    Karlqvist, Ulrika
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper (from 2013).
    Att vårda svårt sjuka eller skadade prehospitalt på landsbygden: Sjuksköterskors upplevelser och erfarenheter2020Independent thesis Advanced level (degree of Master (One Year)), 10 poäng / 15 hpOppgave
    Abstract [sv]

    Introduktion: Den senaste tidens medicinska utveckling har medfört en centralisering av akutmottagningar och sjukhus med specialistsjukvård. Det betyder fler och längre ambulanstransporter som i sin tur ställer högre krav på den prehospitala personalen. Sverige är överlag ett glest befolkat land och för den svårt sjuke eller skadade patienten kan tiden in till sjukhus vara livsavgörande.

    Syfte: Att undersöka sjuksköterskors upplevelser och erfarenheter av att vårda svårt sjuka eller skadade patienter prehospitalt på landsbygden.

    Metod: Data insamlades genom en webbaserad enkät besvarad av 21 deltagare från nio stationer belägna på landsbygden i mellersta Sverige. Materialet analyserades med kvalitativ innehållsanalys.

    Resultat: Analysprocessen resulterade i fem huvudkategorier: vikten av förberedelser och planering under framkörning till patient, vikten av god handlingsberedskap under transport med patient, känsla av ensamhet och maktlöshet att arbeta på landsbygden, möjligheten att utvärdera given behandling och ge god omvårdnad under transport samt vikten av att extra resurser finns att tillgå. Arbetet på landsbygden kan upplevas ensamt och det är värdefullt att kunna diskutera medicinska beslut med en annan sjuksköterska eller medicinskt bakre stöd.

    Konklusion:  Arbete på landsbygden medför längre transporter in till sjukhus och det är viktigt med en god planering och en god handlingsberedskap både i behandlingen av patienten samt vid behov av extra resurser. Arbetet kan medföra både en känsla av ensamhet och maktlöshet samt en känsla av glädje. Längre transporter ger möjlighet till god omvårdnad och utvärdering av given behandling. Att arbeta på stationer belägna på landsbygden kan vara både utmanande och utvecklande, och att ha några års erfarenhet av ambulanssjukvård innan man börjar på landsbygden anses positivt. 

    Fulltekst (pdf)
    fulltext
  • 295.
    Engström, Alexander
    et al.
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper (from 2013).
    Erlandsson, Ann
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper (from 2013).
    Delbro, Dick
    Örebro universitet.
    Wijkander, Jonny
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper (from 2013).
    Conditioned media from M1 but not M2 macrophage phenotype inhibits proliferation of thr colon cancer cell lines HT29 and CACO-22013Konferansepaper (Fagfellevurdert)
    Abstract [en]

    Background

    Tumor associated macrophages (TAMs) are often present at a high level in colorectal cancer (CRC) but whether the presence of TAMs in CRC is good or bad is unclear. Macrophages can be categorized into two main subgroups, M1 or M2, that display pro – and anti-inflammatory properties respectively. An improved knowledge of the different macrophage phenotypes will broaden the understanding of their involvement in CRC. We have used an in vitro model to study the effects of human M1 and M2 macrophages on the growth and cell cycle of colon cancer cell lines.

     

    Method

    Human monocytes were differentiated into M1 or M2 macrophages and conditioned media was collected. Effects of the conditioned media were measured on the colon cancer cell lines HT-29 and CACO-2 in regards to proliferation, cell cycle distribution and apoptosis. A protein array was used to analyze the released amount of 42 different cytokines from M1 and M2 macrophages into the collected conditioned media.

     

    Results

    Growth arrest was induced in HT-29 and CACO-2 by M1 conditioned media, while M2 conditioned media had no major effect. Analysis of cell cycle distribution and apoptosis in HT-29 cells revealed that treatment with M1 conditioned media on these cells increased apoptosis and caused a disturbed cell cycle with accumulation in G0/G1 and G2/M and a corresponding reduction in S-phase. The protein array revealed several cytokines expressed in M1 with potential inhibitory growth effects. We treated HT-29 cells with two of the candidates, TNF-a and CXCL9, but neither induced growth arrest.

     

    Conclusion

    M1 – but not M2-macrophages had a major inhibitory effect on the growth of the colon cancer cell lines HT-29 and CACO-2 and suggest a role for M1 macrophages in anti-tumor activity and possible favorable outcome for CRC patients.

  • 296.
    Engström, Alexander
    et al.
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper (from 2013).
    Erlandsson, Ann
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper (from 2013).
    Delbro, Dick
    School of Health and Medical Sciences, Örebro University.
    Wijkander, Jonny
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper (from 2013).
    Conditioned media from macrophages of M1, but not M2 phenotype, inhibit the proliferation of the colon cancer cell lines HT-29 and CACO-22014Inngår i: International Journal of Oncology, ISSN 1019-6439, Vol. 44, nr 2, s. 385-392Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Solid tumors are infiltrated by stroma cells including macrophages and these cells can affect tumor growth, metastasis and angiogenesis. We have investigated the effects of conditioned media (CM) from different macrophages on the proliferation of the colon cancer cell lines HT-29 and CACO-2. CM from THP-1 macrophages and monocyte-derived human macrophages of the M1 phenotype, but not the M2 phenotype, inhibited proliferation of the tumor cells in a dose-dependent manner. Lipopolysaccaharide and interferon γ was used for differentiation of macrophages towards the M1 phenotype and CM were generated both during differentiation (M1DIFF) and after differentiation (M1). M1 and M1DIFF CM as well as THP-1 macrophage CM resulted in cell cycle arrest in HT-29 cells with a decrease of cells in S phase and an increase in G2/M phase. Treatment of HT-29 cells with M1DIFF, but not M1 or THP-1 macrophage CM, resulted in apoptosis of about 20% of the tumor cells and this was accompanied by lack of recovery of cell growth after removal of CM and subsequent culture in fresh media. A protein array was used to identify cytokines released from M1 and M2 macrophages. Among the cytokines released by M1 macrophages, tumor necrosis factor α and CXCL9 were tested by direct addition to HT-29 cells, but neither affected proliferation. Our results indicate that M1 macrophages inhibit colon cancer cell growth and have the potential of contributing to reducing tumor growth in vivo.

    Fulltekst (pdf)
    fulltext
  • 297.
    Engström, Johanna
    et al.
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper.
    Carmland, Lina
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper.
    Coping hos kvinnor som drabbats av bröstcancer2013Independent thesis Basic level (degree of Bachelor), 10 poäng / 15 hpOppgave
    Fulltekst (pdf)
    Coping hos kvinnor som drabbats av bröstcancer
  • 298.
    Enström, Jennifer
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper.
    Kan tillskott av vitamin D förebygga och/eller minska depressiva symtom?: En litteraturstudie2017Independent thesis Basic level (degree of Bachelor), 10 poäng / 15 hpOppgave
  • 299.
    Entrambasaguas Leifsdotter, Kristina
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper.
    Stress och parodontal sjukdom2015Independent thesis Basic level (degree of Bachelor), 10 poäng / 15 hpOppgave
    Abstract [sv]

    Introduktion: Påverkan av stress på immunförsvarsresponsen kan leda till mer kraftfullt inflammatoriskt svar som leder till parodontal vävnadsnedbrytning. Enligt hypotesen kan psykologiska faktorer, såsom stress, i kombination med förändrat munhygienbeteende ha betydelse för parodontala sjukdomstillstånd (Genco et al. 1998).

    Syfte: Att beskriva samband mellan stress och parodontal sjukdom.

    Frågeställning: Vilka samband föreligger mellan stress och parodontal sjukdom?

    Metod: Litteraturstudie

    Resultat: Föreliggande litteraturstudie visar att det kan föreligga samband mellan stress och parodontal sjukdom genom förändrat munhygienbeteende och genom förhöjda nivåer av stresshormoner, såsom cortisol och dehydroepiandrosterone (DHEA) i saliv, gingivalvätska och blodserum.

    Konklusion: Det kan föreligga samband mellan stress och parodontal sjukdom genom förändrat munhygienbeteende samt genom förhöjda nivåer av stresshormoner i saliv, gingivalvätska och blodserum. Dock kan inga definitiva slutsatser fastställas med denna litteraturstudie.

    Fulltekst (pdf)
    Stress och parodontal sjukdom
  • 300.
    Erdegard, Tine Svingen
    et al.
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper (from 2013).
    Andersson, Marie
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper (from 2013).
    Ambulanssjuksköterskors upplevelse av att vårda barn i en prehospital miljö: En kvalitativ intervjustudie2020Independent thesis Advanced level (degree of Master (One Year)), 10 poäng / 15 hpOppgave
    Abstract [sv]

    SAMMANFATTNING 

    Titel: Ambulanssjuksköterskors upplevelse av att vårda barn i en prehospital miljö

    Fakultet: Hälsa, natur – och teknikvetenskap 

    Kurs: Examensarbete med inriktning mot ambulanssjukvård- 15 hp 

    Författare: Marie Andersson & Tine Svingen Erdegard 

    Handledare: Anders Sidenblad 

    Examinerande lärare: Ingrid From 

    Examinator: Carina Bååth 

    Sidor: 34

    Datum för examination: 2020-03-27 

    Nyckelord: Ambulans, specialistsjuksköterska, upplevelse, vård av barn, prehospital. 

    Syfte: Syftet var att belysa ambulanssjuksköterskors upplevelser av att vårda barn i en prehospital miljö. Bakgrund: Ambulanssjuksköterskor upplever ofta en stress och känner osäkerhet i samband med ambulansuppdrag som involverar barn. Barn och vuxna skiljer sig åt vilket innebär att ambulanssjuksköterskan måste ha god kunskap om hur barn ter sig, hur de ska kunna närma sig dem och hur de ska kunna vårda dem på bästa sätt. Barn har även ofta anhöriga som kan påverka situationen och det faktum att ambulansuppdrag som involverar barn är så pass sällan förekommande ger ofta ambulanssjuksköterskan en brist på viktig erfarenhet. Metod: Studien genomfördes som en empirisk intervjustudie med kvalitativt design, där metoden Critical Incident Technique (CIT) användes. Studien genomfördes på ambulansstationer i Sverige under hösten 2019. Tio specialistutbildade ambulanssjuksköterskor deltog i studien. Kvalitativ innehållsanalys användes för att analysera resultatet från intervjuerna. Resultat: Innehållsanalysen av resultatet resulterade i nio huvudkategorier; Minoritet av ambulansuppdrag involverar barn, Information inför ambulansuppdrag, Viktigt med kollegialt stöd i en svår situation, Närstående påverkar situationen, Vinna barns förtroende är avgörande, Egen erfarenhet lugnar och skapar trygghet, Egna barn som närstående uppkallar känslor, Upplevelser som lämnar intryck och Möten med olika kulturer och språk. Några av huvudkategorierna bestod av ett antal underkategorier. Konklusion: Ambulanssjuksköterskor upplever det komplext och stressfullt att vårda barn i en prehospital miljö. Främsta anledningen till detta är brist på förberedande kunskap och brist på erfarenhet att vårda just barn. Det finns ett behov av fortsatt forskning och utbildning inom detta område för att ambulanssjuksköterskan ska erhålla de kunskaper och träning som krävs för att undvika stress och osäkerhet. Det kommer i sin tur leda till ökad patientsäkerhet.

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