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  • 1. A, Borgström
    et al.
    P, Nerfeldt
    Friberg, Danielle
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Öron-, näs- och halssjukdomar.
    Questionnaire OSA-18 has poor validity compared to polysomnography in pediatric obstructive sleep apnea.2013Inngår i: International Journal of Pediatric Otorhinolaryngology, ISSN 0165-5876, E-ISSN 1872-8464Artikkel i tidsskrift (Fagfellevurdert)
  • 2.
    A Hulten, Maj
    et al.
    University Warwick, Warwick Med Sch, Coventry CV4 7AL, W Midlands England .
    Patel, Suketu
    University Warwick, Department Biol Science, Coventry CV4 7AL, W Midlands England .
    Jonasson, Jon
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Molekylär och immunologisk patologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Laboratoriemedicinskt centrum, Klinisk patologi och klinisk genetik.
    Iwarsson, Erik
    Karolinska University Hospital, Karolinska Institute, Department Mol Med and Surg, Clin Genet Unit, S-17176 Stockholm, Sweden .
    On the origin of the maternal age effect in trisomy 21 Down syndrome: the Oocyte Mosaicism Selection model2010Inngår i: Reproduction, ISSN 1470-1626, E-ISSN 1476-3990, Vol. 139, nr 1, s. 1-9Artikkel, forskningsoversikt (Fagfellevurdert)
    Abstract [en]

    We have recently documented that trisomy 21 mosaicism is common in human foetal ovaries. On the basis of this observation we propose that the maternal age effect in Down syndrome (DS) is caused by the differential behaviour of trisomy 21 in relation to disomy 21 oocytes during development from foetal life until ovulation in adulthood. in particular, we suggest that trisomy 21 oocytes, lagging behind those that are disomic, may escape the timed pruning of the seven million in foetal life to the 300-400 finally selected for ovulation. The net effect of this preferential elimination will be an accumulation of trisomy 21 oocytes in the ovarian reserve of older women. We here highlight the implications of this Oocyte Mosaicism Selection (OMS) model with respect to the prevalent view that the maternal age effect is complex, dependent on many different biological and environmental factors. We examine conclusions drawn from recent large-scale studies in families, tracing DNA markers along the length of chromosome 21q between parents and DS children, in comparison to the OMS model. We conclude that these family linkage data are equally compatible with the maternal age effect originating from the accumulation of trisomy 21 oocytes with advancing maternal age. One relatively straightforward way to get to grips with what is actually going on in this regard would be to compare incidence of trisomy 21 oocytes (and their pairing configurations) in foetal ovaries with that in oocytes at the meiosis I stage from adult women.

  • 3. A Molarius, A
    et al.
    Granström, F
    Feldman, Inna
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Kalander Blomqvist, M
    Pettersson, H
    Ello, S
    Can financial insecurity and condescending treatment explain the higher prevalence of poor self-rated health in women than in men? A population-based cross-sectional study in Sweden2012Konferansepaper (Annet vitenskapelig)
  • 4.
    A. Proko, Romina
    Örebro universitet, Institutionen för medicinska vetenskaper.
    Deskriptiv studie av Multimodal Rehabilitering 1-deltagare i västra Region Örebro Län: - förändring i självskattning av ångest/depression och basal kroppskännedom efter åtta veckors intervention2019Independent thesis Basic level (degree of Bachelor of Fine Arts), 10 poäng / 15 hpOppgave
  • 5.
    Aabel, Peder
    et al.
    Oslo Univ Hosp, Dept Med Biochem, Oslo, Norway;Akershus Univ Hosp, Ear Nose & Throat Dept, Div Surg, Lorenskog, Norway;Univ Oslo, Inst Clin Med, Div Surg, Oslo, Norway.
    Utheim, Tor Paaske
    Oslo Univ Hosp, Dept Med Biochem, Oslo, Norway;Univ Oslo, Inst Oral Biol, Fac Dent, Oslo, Norway.
    Olstad, Ole Kristoffer
    Oslo Univ Hosp, Dept Med Biochem, Oslo, Norway.
    Rask-Andersen, Helge
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Öron-, näs- och halssjukdomar.
    Dilley, Rodney James
    Ear Sci Inst Australia, Perth, WA, Australia;Univ Western Australia, Ear Sci Ctr, Nedlands, WA, Australia;Univ Western Australia, Ctr Cell Therapy & Regenerat Med, Nedlands, WA, Australia.
    von Unge, Magnus
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning, Västerås. Akershus Univ Hosp, Ear Nose & Throat Dept, Div Surg, Lorenskog, Norway;Univ Oslo, Inst Clin Med, Div Surg, Oslo, Norway.
    Transcription and microRNA Profiling of Cultured Human Tympanic Membrane Epidermal Keratinocytes2018Inngår i: Journal of the Association for Research in Otolaryngology, ISSN 1525-3961, E-ISSN 1438-7573, Vol. 19, nr 3, s. 243-260Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The human tympanic membrane (TM) has a thin outer epidermal layer which plays an important role in TM homeostasis and ear health. The specialised cells of the TM epidermis have a different physiology compared to normal skin epidermal keratinocytes, displaying a dynamic and constitutive migration that maintains a clear TM surface and assists in regeneration. Here, we characterise and compare molecular phenotypes in keratinocyte cultures from TM and normal skin. TM keratinocytes were isolated by enzymatic digestion and cultured in vitro. We compared global mRNA and microRNA expression of the cultured cells with that of human epidermal keratinocyte cultures. Genes with either relatively higher or lower expression were analysed further using the biostatistical tools g:Profiler and Ingenuity Pathway Analysis. Approximately 500 genes were found differentially expressed. Gene ontology enrichment and Ingenuity analyses identified cellular migration and closely related biological processes to be the most significant functions of the genes highly expressed in the TM keratinocytes. The genes of low expression showed a marked difference in homeobox (HOX) genes of clusters A and C, giving the TM keratinocytes a strikingly low HOX gene expression profile. An in vitro scratch wound assay showed a more individualised cell movement in cells from the tympanic membrane than normal epidermal keratinocytes. We identified 10 microRNAs with differential expression, several of which can also be linked to regulation of cell migration and expression of HOX genes. Our data provides clues to understanding the specific physiological properties of TM keratinocytes, including candidate genes for constitutive migration, and may thus help focus further research.

  • 6.
    Aaberg, Alma
    et al.
    Högskolan i Borås, Akademin för vård, arbetsliv och välfärd.
    Olsson Piittisjärvi, Patricia
    Högskolan i Borås, Akademin för vård, arbetsliv och välfärd.
    Nyutexaminerade sjuksköterskors upplevelser av kliniskt introduktionsår: En litteraturstudie2019Independent thesis Basic level (degree of Bachelor), 10 poäng / 15 hpOppgave
    Abstract [sv]

    Ett påtagligt samhällsproblem idag är den rådande brist på legitimerade sjuksköterskor som arbetar inom den svenska sjukvården. I takt med att befolkningen ökar och medelåldern blir allt högre blir vikten av att bibehålla verksamma legitimerade sjuksköterskor allt mer påtaglig. Att komma ut i verksamheten som nyutbildad sjuksköterska kan upplevas som en stor utmaning och första tiden i yrket kan ses som en intensiv och krävande process. För att underlätta transitionen från student till yrkesverksam sjuksköterska har ett introduktionsprogram utformats i syfte att vägleda och stödja de nyblivna sjuksköterskorna.

    Författarnas syfte med studien är att beskriva nyutexaminerade sjuksköterskors upplevelser av ett kliniskt introduktionsår. Examensarbetet grundar sig i en litteraturstudie som utgår från Fribergs analysprocess där tio artiklar granskas och analyseras. Analysen resulterar i fyra identifierade huvudteman med tillhörande tretton subteman som tillsammans sammanfattar upplevelser av kliniskt introduktionsår som nyutexaminerad sjuksköterska. Identifierade huvudteman i arbetet är: ”Möjligheten till att få växa personligt och professionellt”, ”Att vara i rum för reflektion”, ”Att existera i en kravfylld tillvaro” samt ”Vikten av att ha kollegialt stöd inom räckhåll”. Resultatet påvisar flera fördelar med deltagandet i kliniskt introduktionsprogram men även vissa brister identifieras. Resultatet påvisar att upplevelser av krav under övergångsprocessen är återkommande hos de flesta nyutexaminerade sjuksköterskorna som genomgår kliniskt introduktionsår. För att underlätta övergångsprocessen är faktorer så som en stödjande miljö, tillhörighet i personalgruppen och reflektion som verktyg viktiga komponenter. Författarna anser att vidare fördjupning kring upplevelser av ett introduktionsprogram och hur detta introduktionsprogram erfars ur ett sjuksköterskeperspektiv är av stor vikt i syfte att möta sjuksköterskans behov under det första yrkesverksamma året.

    Fulltekst (pdf)
    K2018:90
  • 7.
    Aaberg, Oddveig Reiersdal
    et al.
    Norwegian Univ Sci & Technol, Dept Hlth Sci, Fac Med & Hlth Sci, Teknologivegen 22, N-2815 Gjovik, Norway.;Univ Stavanger, Dept Qual & Hlth Technol, Fac Hlth Sci, Stavanger, Norway.;Univ Agder, Fac Hlth & Sport Sci, Dept Hlth & Nursing Sci, Norway..
    Ballangrud, Randi
    Norwegian Univ Sci & Technol, Dept Hlth Sci, Fac Med & Hlth Sci, Teknologivegen 22, N-2815 Gjovik, Norway..
    Husebo, Sissel Iren Eikeland
    Univ Stavanger, Dept Qual & Hlth Technol, Fac Hlth Sci, Stavanger, Norway.;Stavanger Univ Hosp, Gerd Ragna Bloch Thorsens Gate 8, N-4011 Stavanger, Norway..
    Hall-Lord, Marie Louise
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper (from 2013).
    An interprofessional team training intervention with an implementation phase in a surgical ward: A controlled quasi-experimental study2019Inngår i: Journal of Interprofessional Care, ISSN 1356-1820, E-ISSN 1469-9567, s. 1-10Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Despite a growing awareness of the importance of interprofessional teamwork in relation to patient safety, many hospital units lack effective teamwork. The aim of this study was to explore if an interprofessional teamwork intervention in a surgical ward changed the healthcare personnel's perceptions of patient safety culture, perceptions of teamwork, and attitudes toward teamwork over 12 months. Healthcare personnel from surgical wards at two hospitals participated in a controlled quasi-experimental study. The intervention consisted of six hours of TeamSTEPPS team training and 12 months for the implementation of teamwork tools and strategies. The data collection was conducted among the healthcare personnel in the intervention group and the control group at baseline and at the end of the 12 month study period. The results within the intervention group showed that there were significantly improved scores in three of 12 patient safety culture dimensions and in three of five perceptions of teamwork dimensions after 12 months. When comparing between groups, significant differences were found in three patient safety culture measures in favor of the intervention group. The results of the study suggest that the teamwork intervention had a positive impact on patient safety culture and teamwork in the surgical ward.

    Fulltekst (pdf)
    fulltext
  • 8.
    Aaberg, Oddveig Reiersdal
    et al.
    University Agder, NOR;Norwegian University of Science & Technology, NOR ; University of Stavanger, NOR..
    Hall-Lord, Marie Louise
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper (from 2013). Norwegian University of Science & Technology, NOR.
    Husebo, Sissel Iren Eikeland
    University Stavanger, NOR; Stavanger University Hospital, NOR .
    Ballangrud, Randi
    Norwegian University of Science & Technology, NOR.
    A human factors intervention in a hospital-evaluating the outcome of a TeamSTEPPS program in a surgical ward2021Inngår i: BMC Health Services Research, E-ISSN 1472-6963, Vol. 21, nr 1, artikkel-id 114Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Patient safety in hospitals is being jeopardized, since too many patients experience adverse events. Most of these adverse events arise from human factors, such as inefficient teamwork and communication failures, and the incidence of adverse events is greatest in the surgical area. Previous research has shown the effect of team training on patient safety culture and on different areas of teamwork. Limited research has investigated teamwork in surgical wards. The aim of this study was to evaluate the professional and organizational outcomes of a team training intervention among healthcare professionals in a surgical ward after 6 and 12 months. Systems Engineering Initiative for Patient Safety 2.0 was used as a conceptual framework for the study. Methods: This study had a pre-post design with measurements at baseline and after 6 and 12 months of intervention. The intervention was conducted in a urology and gastrointestinal surgery ward in Norway, and the study site was selected based on convenience and the leaders' willingness to participate in the project. Survey data from healthcare professionals were used to evaluate the intervention. The organizational outcomes were measured by the unit-based sections of the Hospital Survey of Patient Safety Culture Questionnaire, and professional outcomes were measured by the TeamSTEPPS Teamwork Perceptions Questionnaire and the Collaboration and Satisfaction about Care Decisions in Teams Questionnaire. A paired t-test, a Wilcoxon signed-rank test, a generalized linear mixed model and linear regression analysis were used to analyze the data. Results: After 6 months, improvements were found in organizational outcomes in two patient safety dimensions. After 12 months, improvements were found in both organizational and professional outcomes, and these improvements occurred in three patient safety culture dimensions and in three teamwork dimensions. Furthermore, the results showed that one of the significant improved teamwork dimensions "Mutual Support" was associated with the Patient Safety Grade, after 12 months of intervention. Conclusion: These results demonstrate that the team training program had effect after 12 months of intervention. Future studies with larger sample sizes and stronger study designs are necessary to examine the causal effect of a team training intervention in this context.

    Fulltekst (pdf)
    fulltext
  • 9.
    Aaberg, Oddveig Reiersdal
    et al.
    Norwegian University of Science and Technology, Norway; University of Stavanger, Norway.
    Hall-Lord, Marie Louise
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper (from 2013). Norwegian University of Science and Technology, Norway.
    Husebo, Sissel Iren Eikeland
    University of Stavanger, Norway; Stavanger University Hospital, Norway.
    Ballangrud, Randi
    Norwegian University of Science and Technology, Norway.
    Collaboration and Satisfaction About Care Decisions in Team questionnaire: Psychometric testing of the Norwegian version, and hospital healthcare personnel perceptions across hospital units2019Inngår i: Nursing Open, E-ISSN 2054-1058, Vol. 6, nr 2, s. 642-650Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aim To translate "The Collaboration and Satisfaction About Care Decisions in Team" questionnaire (CSACD-T) into Norwegian and test it for psychometric properties. The further aim was to describe and compare healthcare personnel's collaboration and satisfaction about team decision-making (TDM) across hospital units. Design A cross-sectional study. Methods The questionnaire was translated into Norwegian. A total of 247 healthcare personnel at two hospitals responded to the questionnaire. An explorative factor analysis was performed to test the factor structure of the questionnaire, while a Cronbach's alpha analysis was used to test for internal consistency. A one-way ANOVA analysis and a Kruskal-Wallis test were applied to test for differences between hospital units. Results The results demonstrate that the Norwegian version of the CSACD-T has promising psychometric properties regarding construct validity and internal consistency. The mean score of the CSACD-T was significantly higher in the maternity ward group than in the emergency room group.

    Fulltekst (pdf)
    fulltext
  • 10.
    Aaby, Anders
    et al.
    Specialized Hosp Polio & Accid Victims, Roedovre, Denmark.;Univ Southern Denmark, Dept Psychol, InCoRE, Odense, Denmark..
    Ravn, Sophie L.
    Specialized Hosp Polio & Accid Victims, Roedovre, Denmark.;Univ Southern Denmark, Dept Psychol, InCoRE, Odense, Denmark.;Univ Southern Denmark, Dept Psychol, ThRIVE, Odense, Denmark..
    Elfström, Magnus L.
    Mälardalens universitet, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Kasch, Helge
    Aarhus Univ Hosp, Dept Neurol, Aarhus, Denmark.;Aarhus Univ, Dept Clin Med, Aarhus, Denmark..
    Andersen, Tonny E.
    Univ Southern Denmark, Dept Psychol, InCoRE, Odense, Denmark..
    Does the Danish version of the Spinal Cord Lesion-related Coping Strategies Questionnaire measure what we think it measures?: A triangulated mixed-methods validation approach2022Inngår i: Spinal Cord, ISSN 1362-4393, E-ISSN 1476-5624Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Study design: Triangulated mixed-methods validation study.

    Objectives: To validate the Danish version of the Spinal Cord Lesion-related Coping Strategies Questionnaire (SCL-CSQ).

    Setting: Community in Denmark.

    Methods: Participants were invited via a patient organization and its specialized hospital. Eligibility criteria were having a spinal cord injury (SCI), being 18 years or older, and able to understand and respond in Danish. Quantitative data were collected to determine internal consistency and criterion validity of the three subscales of SCL-CSQ, i.e., acceptance, fighting spirit, and social reliance. The Three-Step Test-Interview approach was employed to determine whether items measured what they were intended to measure (i.e., construct validity based on response processes).

    Results: The quantitative sample consisted of 107 participants, and the interview sample comprised 11 participants. The acceptance and fighting spirit subscales showed adequate internal consistency (Cronbach's alpha of 0.72 and 0.76 respectively) and satisfactory criterion validity (expected correlations with quality of life and depression). The social reliance subscale showed inadequate internal consistency (Cronbach's alpha of 0.58) and criterion validity. All fighting spirit items and all but one acceptance items were interpreted congruently by most participants. Conversely, two social reliance items were only interpreted congruently by 9 and 27%.

    Conclusion: The acceptance and fighting spirit subscales of the Danish version of the SCL-CSQ showed good psychometric properties, while the social reliance subscale showed serious issues and should be revised. Researchers and clinicians are urged to reflect on these findings when revising the SCL-CSQ or adapting it to other languages, cultural contexts, and rehabilitation settings.

  • 11.
    Aaby, Jacqueline
    et al.
    Linnéuniversitetet, Fakulteten för samhällsvetenskap (FSV), Institutionen för idrottsvetenskap (ID).
    Ekblom, Jakob
    Linnéuniversitetet, Fakulteten för samhällsvetenskap (FSV), Institutionen för idrottsvetenskap (ID).
    Hur blev det med hälsan?: En kvalitativ studie om elevers syn på hälsa i ämnet Idrott och hälsa i årskurs nio.2013Independent thesis Basic level (degree of Bachelor), 10 poäng / 15 hpOppgave
    Abstract [sv]

    Syftet med denna studie är att undersöka vilken uppfattning elever i årskurs nio har om hälsa. Ämnet Idrott och hälsa bedrivs på olika sätt och syftet med studien är även att få en klarare bild över hur eleverna upplever att de arbetar med hälsa i undervisningen. Genom intervjuer vill vi höra elevernas tankar och erfarenheter om hälsa och vad de skulle vilja lära sig mer om. Vi vill även veta vad de tycker är viktigt för att kunna påverka sin framtida hälsa.

    Fulltekst (pdf)
    Självständigt arbete 2IDÄ06
    Fulltekst (pdf)
    Bilaga 1
    Fulltekst (pdf)
    Bilaga 2
    Fulltekst (pdf)
    Bilaga 3
  • 12.
    Aaby Orellana, Tanja
    et al.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad.
    Kirkegaard, Betina
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad.
    Sjuksköterskors upplevelser av att implementera personcentrerad omvårdnad i slutenvården: -         En Empirisk Studie2016Independent thesis Basic level (degree of Bachelor), 10 poäng / 15 hpOppgave
    Abstract [sv]

    Bakgrund: Personcentrerad omvårdnad (PCO) är när den vårdsökande personen är delaktig i sin vård och blir sedd som mer än sin sjukdom eller åkomma. Förhållningssättet PCO grundade sig först inom demensvården men har numera blivit ett förhållningssätt som de flesta vårdinstitutioner eftersträvar. För att uppnå den förbättrande vården som PCO kan medföra, behövs en välplanerad och tydlig implementeringsplan från ledningen.

    Syfte: Att beskriva sjuksköterskors upplevelser av att implementera ett personcentrerat arbetssätt på en slutenvårdsavdelning.

    Metod: En induktiv kvalitativ studie där elva intervjuer genomfördes. Därefter utfördes en innehållsanalys av åtta strategiskt utvalda intervjuer.

    Resultat: Det finns förhoppningar hos deltagarna att implementeringen ska leda till en bättre och säkrare vård, men också farhågor om rädsla för förändring bland vårdpersonalen samt en ökad arbetsbelastning. Att arbeta personcentrerat upplevs av deltagarna kommer ställa högre krav på vårdteamet, framför allt sjuksköterskorna, när det gälller tid, kunskap och kommunikation.

    Slutsats: För att kunna ge vårdsökande personen den bästa vården, behövs det engagerad och kompetent personal som har stöd och förståelse från ledningen. Trots de hinder som tycks finnas så lever en positiv anda bland sjuksköterskorna om implementeringen av PCO. Förhoppningarna är att ett personcentrerat arbetssätt bland annat ska öka delaktigheten som kan leda till kortare vårdtider samt minskar risken för återbesök tätt efter vårdtiden. Det i slutändan ger en bättre vård i helhet för den enskilda vårdsökande personen.

    Fulltekst (pdf)
    Sjuksköterskors upplevelser av att implementera personcentrerad omvårdnad i slutenvården
  • 13.
    Aadland, Lena
    et al.
    Högskolan Väst, Institutionen för omvårdnad, hälsa och kultur, Avd för vårdvetenskap på grundnivå.
    Ekelund, Anna-Karin
    Högskolan Väst, Institutionen för omvårdnad, hälsa och kultur, Avd för vårdvetenskap på grundnivå.
    Livet efter att ha drabbats av en hjärtinfarkt2015Independent thesis Basic level (professional degree), 10 poäng / 15 hpOppgave
    Abstract [en]

    Cardiac care has developed during the last years. The lengths of stay for patients who have suffered a myocardial infarction have been shortened thanks to more effective medical treatment. The short period of care means that patients have to absorb a lot of information on limited time and they may have difficulties absorbing everything before they leave the hospital.

    The aim of this study is to highlight how men and women experience and manage their daily lives three to 12 month after a myocardial infarction. The study is literature based including both qualitative and quantitative studies.

    The analysis revealed three themes with subthemes: 1) to no longer be able to rely on the body 2) managing daily life 3) support. It turns out that men and women have numerous emotional experiences and that fatigue plays a big role in their recovery. Men and women deal with their situation differently. Family and friends mean a lot in the rehabilitation and nurses play an important role in supporting those affected and this is an area with a lot of work to develop.

    Conclusion: Nurses need knowledge and understanding of how patients manage and experience their situation after a myocardial infarction, as well as learning the importance of meeting each individual differently, depending on where he or she is in life and what his or her nearest environment look like. A more individualized follow-up and rehabilitation over time need to be developed.

  • 14.
    Aagaard, Hanne
    et al.
    Lovisenberg Diaconal University College, Oslo, Norway.
    Hall, ElisabethO.C.
    Health, Aarhus University, Aarhus, Denmark; Faculty of Health Sciences and Nursing University of Faroe Islands, Torshavn, Faroe Islands.
    Audulv, Åsa
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Ludvigsen, Mette S.
    Department of Clinical Medicine - Randers Regional Hospital, Aarhus University, Aarhus, Denmark; Faculty of Nursing and Health Sciences, Nord University, Bodø, Norway.
    Westergren, Thomas
    Department of Public Health, University of Stavanger, Norway; Department of Nursing Science, University of Agder, Norway.
    Fegran, Liv
    Department of Nursing Science, University of Agder, Norway.
    Parents’ experiences of transitioning to home with a very-low-birthweight infant: a meta-ethnography2023Inngår i: Journal of Neonatal Nursing, ISSN 1355-1841, E-ISSN 1878-089X, Vol. 29, nr 3, s. 444-452Artikkel, forskningsoversikt (Fagfellevurdert)
    Abstract [en]

    Medical-technological advances and neurodevelopmental care have improved the survival of extremely- and very-low-birthweight infants born before 32 weeks' gestation. After months in neonatal care, the infants are discharged, and parents exited but full of anxiety. This review is designed as a meta-ethnography, addressing parents' discharge experiences to comprehend the synthesised research, which includes 12 eligible studies. From the analysis, we constructed three themes: ‘approaching discharge with both uncertainty and confidence’; ‘discharge as a longed-for though disordering turning point’; and ‘facing joys, worries and multiple challenges when at home’. The overarching interpretation was ‘discharge as double-edged sword’. We conclude that bringing home very-low-birthweight infants is a joyful event, yet parents also experience discharge as never-endingly worrying, as a time filled with challenges to which parents must adapt and as necessitating continuous support from knowledgeable providers.

  • 15.
    Aagaard, Knut E.
    et al.
    Helsingborg Hosp, Sweden; Lund Univ, Sweden.
    Björnsson, Hanna
    Linköpings universitet, Institutionen för biomedicinska och kliniska vetenskaper, Avdelningen för kirurgi, ortopedi och onkologi. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Centrum för kirurgi, ortopedi och cancervård, Ortopedkliniken i Linköping.
    Lunsjö, Karl
    Helsingborg Hosp, Sweden.
    Frobell, Richard
    Lund Univ, Sweden.
    No differences in histopathological degenerative changes found in acute, trauma-related rotator cuff tears compared with chronic, nontraumatic tears2022Inngår i: Knee Surgery, Sports Traumatology, Arthroscopy, ISSN 0942-2056, E-ISSN 1433-7347, Vol. 30, nr 7, s. 2521-2527Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Purpose Acute trauma-related rotator cuff tears are believed to have better healing potential than chronic tears due to less degenerative changes of the tendons. However, the histopathological condition of tendons from trauma-related tears is not well investigated. The purpose of this study was to explore specific histopathological features in tendons from acute trauma-related full-thickness rotator cuff tears and to compare them to findings in tendons from nontraumatic, chronic tears. Methods In a prospective cohort study, 62 previously asymptomatic patients [14 women, median age 61 years (range 42-75)] with trauma-related full-thickness rotator cuff tears were consecutively included. Arthroscopic repair was performed within 30 (median, IQR 25-37) days after the injury. During surgery, tissue biopsies were harvested from the supraspinatus tendons in 53 (86%) of the patients. In addition, similar biopsies were harvested from 10 patients undergoing surgery for chronic tears without history of trauma. All tissue samples were examined by a well-experienced pathologist under light microscope. Tendon degeneration was determined using the Bonar score whereas immunostaining was used for proliferation (Ki67), inflammation (CD45), apoptosis (p53) and haemosiderin staining to study traces of bleeding. Results The median (IQR) Bonar score for the acute trauma-related biopsies was 10.5 (7.5-14.5) compared to 11 (5-12.8) for the control group with no statistically significant difference between the groups. No statistically significant between-group difference was found for the inflammatory index whereas tendons from patients with trauma-related full-thickness rotator cuff tears had statistically significantly higher apoptosis [3.1 (0.5-8.9) vs. 0.1 (0-1.5), p = 0.003] and proliferation [4.0 (1.8-6.9) vs. 0.4 (0-2.0), p = 0.001) indices than those undergoing surgery for chronic tears. Positive haemosiderin staining was found in 34% of tissue samples from patients with trauma-related tears compared to 10% in the control group (n.s). Conclusion This study suggests that there is no difference with regard to degenerative changes between supraspinatus tendons harvested from patients with acute, trauma-related rotator cuff tears and patients with nontraumatic, chronic tears.

    Fulltekst (pdf)
    fulltext
  • 16.
    Aagaard, Knut E.
    et al.
    Helsingborg Hosp, Sweden; Lund Univ, Sweden.
    Lunsjo, Karl
    Helsingborg Hosp, Sweden; Lund Univ, Sweden.
    Adolfsson, Lars
    Linköpings universitet, Institutionen för biomedicinska och kliniska vetenskaper, Avdelningen för kirurgi, ortopedi och onkologi. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Centrum för kirurgi, ortopedi och cancervård, Ortopedkliniken i Linköping.
    Frobell, Richard
    Lund Univ, Sweden.
    Björnsson Hallgren, Hanna
    Linköpings universitet, Institutionen för biomedicinska och kliniska vetenskaper, Avdelningen för kirurgi, ortopedi och onkologi. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Centrum för kirurgi, ortopedi och cancervård, Ortopedkliniken i Linköping.
    Factors associated with healing failure after early repair of acute, trauma-related rotator cuff tears2023Inngår i: Journal of shoulder and elbow surgery, ISSN 1058-2746, E-ISSN 1532-6500, Vol. 32, nr 10, s. 2074-2081Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Healing failure after rotator cuff repair is a challenging problem. Acute, trauma-related tears are considered a separate entity and are often treated surgically. The aim of this study was to identify factors associated with healing failure in previously asymp-tomatic patients with trauma-related rotator cuff tears treated with early arthroscopic repair. Methods: This study included 62 consecutively recruited patients (23% women; median age, 61 years; age range, 42-75 years) with acute symptoms in a previously asymptomatic shoulder and a magnetic resonance imaging-verified full-thickness rotator cuff tear after shoulder trauma. All patients were offered, and underwent, early arthroscopic repair, during which a biopsy specimen was har-vested from the supraspinatus tendon and analyzed for signs of degeneration. Of the patients, 57 (92%) completed 1-year follow-up and underwent assessment of repair integrity on magnetic resonance images according to the Sugaya classification. Risk factors for heal-ing failure were investigated using a causal-relation diagram where age, body mass index, tendon degeneration (Bonar score), diabetes mellitus, fatty infiltration (FI), sex, smoking, tear location regarding integrity of the rotator cable, and tear size (number of ruptured tendons and tendon retraction) were included and analyzed. Results: Healing failure at 1 year was identified in 37% of patients (n = 21). A high degree of FI of the supraspinatus muscle (P = .01), a tear location including disruption of rotator cable integrity (P = .01), and old age (P = .03) were associated with healing failure. Tendon degeneration as determined by histopathology was not associated with healing failure at 1-year follow-up (P = .63). Conclusion: Older age, increased FI of the supraspinatus muscle, and a tear including disruption of the rotator cable increased the risk of healing failure after early arthroscopic repair in patients with trauma-related full-thickness rotator cuff tears. Level of evidence: Level I; Prospective Cohort Design; Prognosis Study

    Fulltekst (pdf)
    fulltext
  • 17.
    Aagaard, Lise
    et al.
    University of So Denmark, Denmark FKL Research Centre Qual Medical Use, Denmark Danish Pharmacovigilance Research Project DANPREP, Denmark .
    Strandell, Johanna
    Linköpings universitet, Institutionen för medicin och hälsa, Klinisk farmakologi. Linköpings universitet, Hälsouniversitetet.
    Melskens, Lars
    University of Copenhagen, Denmark .
    Petersen, Paw S. G.
    University of Copenhagen, Denmark .
    Holme Hansen, Ebba
    FKL Research Centre Qual Medical Use, Denmark Danish Pharmacovigilance Research Project DANPREP, Denmark University of Copenhagen, Denmark .
    Global Patterns of Adverse Drug Reactions Over a Decade Analyses of Spontaneous Reports to VigiBase (TM)2012Inngår i: Drug Safety, ISSN 0114-5916, E-ISSN 1179-1942, Vol. 35, nr 12, s. 1171-1182Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Although systems to collect information about suspected adverse drug reactions (ADRs) were established in many countries and by the WHO in the 1960s, few studies have examined reported ADRs related to national income. Objective: The aim of the study was to characterize ADRs reported to the WHO-ADR database, VigiBase (TM), and to relate data to national income. Methods: We analysed ADR reports submitted to VigiBase (TM) from 2000 to 2009 with respect to reporting rate, age and sex of patient, type, seriousness and medications. Reports were also analysed with respect to national income level, classified in accordance with the World Bank definition: low, lower-middle, upper-middle and high. Results: We analysed 1 359 067 ADR reports including 3 013 074 ADRs. Overall, 16% of reports were serious and 60% were reported for females. High-income countries had the highest ADR reporting rates (range 3-613 reports/million inhabitants/year) and low-income countries the lowest (range 0-21). Distribution of ADRs across income groups with respect to age group, seriousness and sex was non-significant. Overall, the majority of ADRs were reported for nervous system medications, followed by cardiovascular medicines. Low-income countries reported relatively more ADRs for antiinfectives for systemic use than high-income countries, and high-income countries reported more ADRs for antineoplastic and immunomodulating agents than lower-income groups. Conclusion: This study showed that high-income countries had the highest ADR reporting rates and low-income countries the lowest, with large variations across countries in each group. Significant differences in ADR reporting rates were only found for ADRs of the type skin and subcutaneous tissue disorders and for the therapeutic groups antiinfectives for systemic use and antineoplastic and immunomodulation agents. To strengthen ADR reporting rates, especially in low-income countries, more research is needed about the impact of organizational structures and economic resources of national pharmacovigilance centres and ADR reporting practices on the large variations in ADR reporting rates within income groups.

  • 18.
    Aagesson, Ingela
    et al.
    Blekinge Tekniska Högskola, Sektionen för hälsa.
    Hammarström, Matilda
    Blekinge Tekniska Högskola, Sektionen för hälsa.
    Vad är det för vits med humor i vården?2006Independent thesis Basic level (degree of Bachelor)Oppgave
    Abstract [sv]

    Bakgrund. Skratt och humor inom vården kan minska stress, oro, rädsla och utbrändhet. Humor kan även bygga relationer och lätta upp stämningen. Humor kan användas som kommunikationsmedel mellan människor. Syfte. Syftet med studien var att belysa hur humor i vården påverkar patienter och personal. Metod. Litteraturstudie där sju vetenskapliga artiklar granskades och analyserades med inspiration av Graneheim och Lundmans (2004) analysmodell. Resultat. Studiens resultat påvisade att humor ansågs ha en viktig funktion i vården. Humor hjälpte till att bemästra svåra situationer, att hantera känslor, bidra till välbefinnande och påverka relationen och kommunikationen. Slutsats. Inom vården uppfattades humor vara viktig för både vårdpersonal och patienter. Humor ansågs kunna påverka patienter och vårdpersonal genom att vara en hjälp till att bemästra situationer, bidra till välbefinnande, hantera känslor och underlätta relationen och kommunikationen.

    Fulltekst (pdf)
    FULLTEXT01
  • 19.
    Aahlin, Eirik K
    et al.
    Department of GI and HPB Surgery, University Hospital Northern Norway, Breivika, Tromsø, Norway; Institute of Clinical Medicine, University of Tromsø, Tromsø, Norway .
    von Meyenfeldt, Maarten
    Department of Surgery, University Hospital Maastricht, Maastricht, The Netherlands; NUTRIM School for Nutrition, Toxicology and Metabolism, Maastricht University, Maastricht, The Netherlands.
    Dejong, Cornelius Hc
    Department of Surgery, University Hospital Maastricht, Maastricht, The Netherlands; NUTRIM School for Nutrition, Toxicology and Metabolism, Maastricht University, Maastricht, The Netherlands.
    Ljungqvist, Olle
    Örebro universitet, Institutionen för läkarutbildning. Department of Surgery, Örebro University Hospital, Örebro; Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.
    Fearon, Kenneth C
    Clinical Surgery, University of Edinburgh, Royal Infirmary of Edinburgh, Edinburgh, UK .
    Lobo, Dileep N
    Division of Gastrointestinal Surgery, Nottingham Digestive Diseases Centre, National Institute for Health Research, Biomedical Research Unit, Nottingham University Hospitals, Queen's Medical Centre, Nottingham, UK .
    Demartines, Nicolas
    Hospital of Lausanne (CHUV), Lausanne, Switzerland .
    Revhaug, Arthur
    Department of GI and HPB Surgery, University Hospital Northern Norway, Breivika, Tromsø, Norway; Institute of Clinical Medicine, University of Tromsø, Tromsø, Norway .
    Wigmore, Stephen J
    Clinical Surgery, University of Edinburgh, Royal Infirmary of Edinburgh, Edinburgh, UK .
    Lassen, Kristoffer
    Department of GI and HPB Surgery, University Hospital Northern Norway, Breivika, Tromsø, Norway; Institute of Clinical Medicine, University of Tromsø, Tromsø, Norway .
    Functional recovery is considered the most important target: a survey of dedicated professionals2014Inngår i: Perioperative medicine, ISSN 2047-0525, Vol. 3, artikkel-id 3:5Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: The aim of this study was to survey the relative importance of postoperative recovery targets and perioperative care items, as perceived by a large group of international dedicated professionals.

    Methods: A questionnaire with eight postoperative recovery targets and 13 perioperative care items was mailed to participants of the first international Enhanced Recovery After Surgery (ERAS) congress and to authors of papers with a clear relevance to ERAS in abdominal surgery. The responders were divided into categories according to profession and region.

    Results: The recovery targets 'To be completely free of nausea', 'To be independently mobile' and 'To be able to eat and drink as soon as possible' received the highest score irrespective of the responder's profession or region of origin. Equally, the care items 'Optimizing fluid balance', 'Preoperative counselling' and 'Promoting early and scheduled mobilisation' received the highest score across all groups.

    Conclusions: Functional recovery, as in tolerance of food without nausea and regained mobility, was considered the most important target of recovery. There was a consistent uniformity in the way international dedicated professionals scored the relative importance of recovery targets and care items. The relative rating of the perioperative care items was not dependent on the strength of evidence supporting the items.

  • 20. Aahlin, Kristofer
    et al.
    Arvidsson, Per I.
    Huerta, Fernando
    Yngve, Ulrika.
    Preparation of 1-(4-(5-amino-6-(oxazolo[4,5-c]pyridin-2-yl)pyrazin-2-yl)benzoyl)piperazine derivatives as glycogen synthase kinase 3 inhibitors.2011Patent (Annet (populærvitenskap, debatt, mm))
    Abstract [en]

    Title compds. I [R1 = H or Me], and their pharmaceutically acceptable salts, are prepd. and disclosed as glycogen synthase kinase 3 (GSK3) inhibitors. Thus, e.g., II was prepd. by cyclization of 3-amino-N-(4-hydroxypyridin-3-yl)pyrazine-2-carboxamide (prepn. given) to get intermediate 3-(oxazolo[4,5-c]pyridin-2-yl)pyrazin-2-amine, which underwent bromination followed by Suzuki reaction with (4-methylpiperazin-1-yl)(4-(4,4,5,5-tetramethyl-1,3,2-dioxaborolan-2-yl)phenyl)methanone. Compds. of the invention were tested for their selective inhibitory activity of GSK3β, e.g., II exhibited Ki value of 2.3 nM. The invention compds. are useful for the treatment of cognitive disorders, diabetes, cancer, etc. [on SciFinder(R)]

  • 21.
    Aaka, Linda
    et al.
    Mälardalens universitet, Akademin för hälsa, vård och välfärd.
    Silvnäs, Kjell
    Mälardalens universitet, Akademin för hälsa, vård och välfärd.
    ATT VÅRDA TRYCKSÅRSFÖREBYGGANDE: En allmän litteraturöversikt ur ett sjuksköterskeperspektiv2024Independent thesis Basic level (degree of Bachelor), 10 poäng / 15 hpOppgave
    Abstract [sv]

    Bakgrund: Tidigare forskning visar att trycksår är smärtsamt och orsakar ett stort lidande för patienterna. Trycksår ger en ökad risk för infektioner och förlängd vårdtid vilket även leder till ökade kostnader för samhället. Trycksår som drabbar patienter inom vården räknas som en vårdskada och en av sjuksköterskans arbetsuppgifter är att förhindra vårdskador. Syfte: Var att beskriva sjuksköterskors erfarenheter av att vårda trycksårsförebyggande.Metod: En allmän litteraturöversikt enligt Friberg med totalt tio artiklar fördelat på fyra kvantitativa artiklar och sex kvalitativa artiklar. Samtliga artiklar analyserades utifrån likheter och skillnader i syfte, metod och resultat. Resultat: Det framträdde tre olika teman “Betydelsen av kunskap och kompetens”, ”Betydelsen av delaktighet och kommunikation”och “Betydelsen av arbetsmiljön och resursbrist”. Sjuksköterskorna hade även erfarenheter av att trycksårförebyggande åtgärder var prioriterat men att det var svårt att genomföra på grund av en hög arbetsbelastning och brist på vårdpersonalresurser. Sjuksköterskorna erfor även att brister i kommunikationen kunde leda till en ökad risk för trycksår. När sjuksköterskorna involverade patient och anhöriga i omvårdnaden ökades förståelsen för sjuksköterskans åtgärder och samarbetet underlättades. Slutsats: Sjuksköterskorna behöver mer kunskap och kompetens för att bli mer effektiva i det trycksårförebyggande arbetet. Tid-och resursbrist gjorde att sjuksköterskorna inte kunde prioritera trycksårsförebyggande åtgärder. Risken för trycksår minskade när sjuksköterskorna involverade patienten och anhöriga i omvårdnaden.

    Fulltekst (pdf)
    fulltext
  • 22.
    Aakjær, Mia
    et al.
    Department of Drug Design and Pharmacology, Pharmacovigilance Research Center, University of Copenhagen, Copenhagen, Denmark.
    De Bruin, Marie Louise
    Department of Pharmacy, Copenhagen Centre for Regulatory Science (CORS), University of Copenhagen, Copenhagen, Denmark; Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht University, Utrecht, The Netherlands.
    Kulahci, Murat
    Luleå tekniska universitet, Institutionen för ekonomi, teknik, konst och samhälle, Industriell ekonomi. Department of Applied Mathematics and Computer Science, Technical University of Denmark, Lyngby, Denmark.
    Andersen, Morten
    Department of Drug Design and Pharmacology, Pharmacovigilance Research Center, University of Copenhagen, Copenhagen, Denmark.
    Surveillance of Antidepressant Safety (SADS): Active Signal Detection of Serious Medical Events Following SSRI and SNRI Initiation Using Big Healthcare Data2021Inngår i: Drug Safety, ISSN 0114-5916, E-ISSN 1179-1942, Vol. 44, s. 1215-1230Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Introduction The current process for generating evidence in pharmacovigilance has several limitations, which often lead to delays in the evaluation of drug-associated risks.

    Objectives In this study, we proposed and tested a near real-time epidemiological surveillance system using sequential, cumulative analyses focusing on the detection and preliminary risk quantification of potential safety signals following initiation of selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs).

    Methods We emulated an active surveillance system in an historical setting by conducting repeated annual cohort studies using nationwide Danish healthcare data (1996–2016). Outcomes were selected from the European Medicines Agency's Designated Medical Event list, summaries of product characteristics, and the literature. We followed patients for a maximum of 6 months from treatment initiation to the event of interest or censoring. We performed Cox regression analyses adjusted for standard sets of covariates. Potential safety signals were visualized using heat maps and cumulative hazard ratio (HR) plots over time.

    Results In the total study population, 969,667 new users were included and followed for 461,506 person-years. We detected potential safety signals with incidence rates as low as 0.9 per 10,000 person-years. Having eight different exposure drugs and 51 medical events, we identified 31 unique combinations of potential safety signals with a positive association to the event of interest in the exposed group. We proposed that these signals were designated for further evaluation once they appeared in a prospective setting. In total, 21 (67.7%) of these were not present in the current summaries of product characteristics.

    Conclusion The study demonstrated the feasibility of performing epidemiological surveillance using sequential, cumulative analyses. Larger populations are needed to evaluate rare events and infrequently used antidepressants.

  • 23.
    Aakre, Nina
    Linnéuniversitetet, Fakulteten för Hälso- och livsvetenskap (FHL), Institutionen för hälso- och vårdvetenskap (HV).
    Anestesisjuksköterskans uppfattningar av lärande till yrkesprofession: -en fenomenografisk studie.2019Independent thesis Advanced level (degree of Master (One Year)), 10 poäng / 15 hpOppgave
    Abstract [sv]

    Bakgrund: Anestesisjuksköterskan arbetar i en komplex vårdmiljö med självständigt ansvar för patientens anestesi under operation och förväntas bedöma och hantera komplexa vårdsituationer. Lärande till yrkesprofession sker delvis under utbildningen till specialistsjuksköterska inom anestesi och delvis inom ramen för det yrkeskollektiv som anestesisjuksköterskan arbetar. För att uppnå kompetens som anestesisjuksköterska krävs vissa komponenter i lärandet till yrkesprofession.

    Syfte: Att beskriva anestesisjuksköterskors uppfattningar av lärandet till yrkesprofession.

    Metod: Studien har en kvalitativ design med fenomenografisk forskningsansats.  Anestesisjuksköterskor från en operationsavdelning i sydöstra Sverige har intervjuats kring temat lärande till yrkesprofession. Intervjumaterialet har analyserats enligt fenomenografisk metod.

    Resultat: Fyra beskrivningskategorier som handlade om lärande till yrkesprofession identifierades. Att lära sig utföra anestesisjukvård, att lära sig tänka och agera som anestesisjuksköterska, att lära sig bemöta patienter och att lära sig samarbeta.

    Slutsats: Resultatet visar att för att lära sig vårda en patient i en anestesikontext krävs vissa komponenter. Det är viktigt att vara medveten om dessa komponenter när studenter eller nyanställda skall lära sig yrkesprofessionen. Genom klinisk träning och teoretisk förankring kan anestesisjuksköterskan lära sig vårda komplexa sjukdomstillstånd där patientens säkerhet och integritet bibehålls.

  • 24. Aalborg, T.
    et al.
    Strandmark, Margaretha
    Karlstads universitet, Fakulteten för samhälls- och livsvetenskaper, Avdelningen för hälsa och miljö.
    The baby was the focus of attention: First-time patients' experiences of their marital relationship2001Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 15, s. 318-325Artikkel i tidsskrift (Fagfellevurdert)
  • 25. Aalborg, T.
    et al.
    Strandmark, Margaretha
    Karlstads universitet, Fakulteten för samhälls- och livsvetenskaper, Avdelningen för hälsa och miljö.
    Dahlöf, LG
    First time parents' sexual relationschips2000Inngår i: Scandinavian Journal of Sexology 3; 127-139Artikkel i tidsskrift (Fagfellevurdert)
  • 26.
    Aalhuizen, Therése
    et al.
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Eriksson, Per
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Språkbarriärer och tolkanvändning i vården ur sjuksköterskans perspektiv: En litteraturöversikt2019Independent thesis Basic level (degree of Bachelor), 10 poäng / 15 hpOppgave
    Abstract [sv]

    Bakgrund: Under år 2014 fanns över 200 olika språk i Sverige och i slutet av år 2017 bestod Sverige av cirka 20 % utlandsfödda. Svensk sjuksköterskeförenings rapport (2017) visade att av 110 000 vårdskador var många till följd av brister i kommunikation. Det saknas tillit och förtroende mellan patienter och sjuksköterskor när de inte förstår varandras språk. För att övervinna språkbarriärer behövs tolkanvändning som ett verktyg för informationsutbyte och för att skapa en tillitsfull relation mellan sjuksköterska och patient.

    Syfte: Att identifiera sjuksköterskans erfarenheter och upplevelser av kommunikation vid språkbarriärer och tolkanvändning i vården.

    Metod: En litteraturöversikt vars resultat bygger på femton vetenskapliga artiklar. Sökningar efter relevanta artiklar med lämpliga sökord användes i databaserna PubMed och Cinahl.

    Resultat: Sjuksköterskor anser att språkbarriärer är det största hindret till god kommunikation vilket kan leda till missförstånd och feltolkningar. Det upplevs som mer tids- och planeringskrävande att vårda patienter med annat modersmål och det är en utmaning att upprätthålla god omvårdnad och få förståelse för patientens berättelse. Sjuksköterskor föredrar fysiskt möte med tolk men telefontolk upplevs som mer tillgängligt. Det identifieras flera bakomliggande orsaker kopplat till sjuksköterskans osäkerhet i tolkanvändning, exempelvis ovissheten om tolken översätter korrekt. Sjuksköterskor upplever att det behöver mer kompetens gällande tolkanvändning.

    Konklusion: Resultatet som identifieras är baserat på sjuksköterskors upplevelser av språkbarriärer och tolkanvändning. Författarna till examensarbetet anser att litteraturöversikten har givit god kunskap och ökad förståelse gällande språkbarriärer och tolkanvändning i vården, vilket kommer att vara en tillgång i kommande arbetsliv.

  • 27.
    Aalto, Anne
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Medicinsk radiologi. Linköpings universitet, Hälsouniversitetet.
    Dahlqvist Leinhard, Olof
    Linköpings universitet, Centrum för medicinsk bildvetenskap och visualisering, CMIV. Linköpings universitet, Institutionen för medicin och hälsa, Medicinsk radiofysik. Linköpings universitet, Hälsouniversitetet.
    Jaworski, M
    Gustavsson, M
    Tisell, Anders
    Linköpings universitet, Centrum för medicinsk bildvetenskap och visualisering, CMIV. Linköpings universitet, Institutionen för medicin och hälsa, Medicinsk radiofysik. Östergötlands Läns Landsting, Centrum för kirurgi, ortopedi och cancervård, Radiofysikavdelningen US. Linköpings universitet, Hälsouniversitetet.
    Landtblom, Anne-Marie
    Linköpings universitet, Centrum för medicinsk bildvetenskap och visualisering, CMIV. Linköpings universitet, Institutionen för klinisk och experimentell medicin, Psykiatri. Östergötlands Läns Landsting, Sinnescentrum, Neurokirurgiska kliniken US. Linköpings universitet, Hälsouniversitetet.
    Lundberg, Peter
    Linköpings universitet, Centrum för medicinsk bildvetenskap och visualisering, CMIV. Linköpings universitet, Institutionen för medicin och hälsa, Medicinsk radiofysik. Linköpings universitet, Institutionen för medicin och hälsa, Medicinsk radiologi. Östergötlands Läns Landsting, Centrum för kirurgi, ortopedi och cancervård, Radiofysikavdelningen US. Östergötlands Läns Landsting, Diagnostikcentrum, Röntgenkliniken i Linköping. Linköpings universitet, Hälsouniversitetet.
    Smedby, Örjan
    Linköpings universitet, Centrum för medicinsk bildvetenskap och visualisering, CMIV. Linköpings universitet, Institutionen för medicin och hälsa, Medicinsk radiologi. Östergötlands Läns Landsting, Diagnostikcentrum, Röntgenkliniken i Linköping. Linköpings universitet, Hälsouniversitetet.
    Effects of Betainterferon treatment in Multiple Sclerosis Studied by Quantitative 1H MRS2009Konferansepaper (Annet vitenskapelig)
  • 28.
    Aalto, Anne
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och hälsa, Medicinsk radiologi. Östergötlands Läns Landsting, Bildmedicinskt centrum, Röntgenkliniken i Linköping. Linköpings universitet, Centrum för medicinsk bildvetenskap och visualisering, CMIV.
    Sjoewall, Johanna
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Klinisk immunologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Medicincentrum, Infektionskliniken i Östergötland.
    Davidsson, Leif
    Linköpings universitet, Institutionen för medicin och vård, Radiologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Bildmedicinskt centrum, Röntgenkliniken i Linköping.
    Forsberg, Pia
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för klinisk och experimentell medicin, Infektionsmedicin. Östergötlands Läns Landsting, Medicincentrum, Infektionskliniken i Östergötland.
    Smedby, Örjan
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och hälsa, Medicinsk radiologi. Östergötlands Läns Landsting, Bildmedicinskt centrum, Röntgenkliniken i Linköping. Linköpings universitet, Centrum för medicinsk bildvetenskap och visualisering, CMIV.
    Brain magnetic resonance imaging does not contribute to the diagnosis of chronic neuroborreliosis2007Inngår i: Acta Radiologica, ISSN 0284-1851, E-ISSN 1600-0455, Vol. 48, nr 7, s. 755-762Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Borrelia infections, especially chronic neuroborreliosis ( NB), may cause considerable diagnostic problems. This diagnosis is based on symptoms and findings in the cerebrospinal fluid but is not always conclusive. Purpose: To evaluate brain magnetic resonance imaging ( MRI) in chronic NB, to compare the findings with healthy controls, and to correlate MRI findings with disease duration. Material and Methods: Sixteen well- characterized patients with chronic NB and 16 matched controls were examined in a 1.5T scanner with a standard head coil. T1- ( with and without gadolinium), T2-, and diffusion- weighted imaging plus fluid- attenuated inversion recovery ( FLAIR) imaging were used. Results: White matter lesions and lesions in the basal ganglia were seen in 12 patients and 10 controls ( no significant difference). Subependymal lesions were detected in patients down to the age of 25 and in the controls down to the age of 43. The number of lesions was correlated to age both in patients ( rho=0.83, P < 0.01) and in controls ( rho=0.61, P < 0.05), but not to the duration of disease. Most lesions were detected with FLAIR, but many also with T2- weighted imaging. Conclusion: A number of MRI findings were detected in patients with chronic NB, although the findings were unspecific when compared with matched controls and did not correlate with disease duration. However, subependymal lesions may constitute a potential finding in chronic NB.

  • 29.
    Aalto, Heidi
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Föräldrars upplevelser av omvårdnaden av sitt sent underburna barn på BB: En intervjustudie2014Independent thesis Advanced level (degree of Master (One Year)), 10 poäng / 15 hpOppgave
    Abstract [sv]

    Bakgrund: Sent underburna barn vårdas ofta på BB-avdelning för fullgångna barn. De har högre frekvens av återinläggningar på sjukhus än fullgångna barn. De flesta studier kring underburna barns vistelse på sjukhus är inte gjorda specifikt på sent underburna barn. Syfte: Syftet är att utforska föräldrars upplevelser av omvårdnaden av sent underburna barn på en BB-avdelning i Sverige. I analysen användes det teoretiska begreppet empowerment. Metod: Studien är deskriptiv med en kvalitativ ansats. Telefonintervjuer användes som datainsamlingsmetod. Fem mammor och två pappor deltog i studien. Intervjuerna analyserades med innehållsanalys. Resultat/Slutsats: Föräldrarna upplevde att personalen antingen förmedlade empowerment eller inte. Omvårdnadsåtgärder kring barnet som gjorde föräldrarna mer delaktiga upplevdes mer positivt och omvårdnadsåtgärder som orsakade en separation mellan föräldrar och barn upplevdes mer negativt. Föräldrarna hade svårt att ifrågasätta personal, även om de upplevde att något kring omvårdnadsåtgärden kändes fel. Omvårdnadsåtgärder, utfördes inte alltid i enlighet med vetenskap och beprövad erfarenhet. Personalen kan utbildas mer i att främja empowerment i föräldrarollen och därmed även öka föräldradelaktigheten i barnets omvårdnad och möjligheten att se varje familjs unika behov. Mer forskning behövs om hur detta ska ske.

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    Bilaga 1
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  • 30.
    Aalto, K
    et al.
    Hospital for Children and Adolescents, University of Helsinki, Helsinki, Finland.
    Korhonen, L
    Department of Neuroscience, Neurobiology, Uppsala University, Box 587, S-75123, Uppsala, Sweden.
    Lahdenne, P
    Hospital for Children and Adolescents, University of Helsinki, Helsinki, Finland.
    Pelkonen, P
    Hospital for Children and Adolescents, University of Helsinki, Helsinki, Finland.
    Lindholm, D
    Department of Neuroscience, Neurobiology, Uppsala University, Box 587, S-75123, Uppsala, Sweden.
    Nerve growth factor in serum of children with systemic lupus erythematosus is correlated with disease activity2002Inngår i: Cytokine, ISSN 1043-4666, E-ISSN 1096-0023, Vol. 20, nr 3, s. 136-139Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Nerve growth factor (NGF) is a neurotrophic factor, which is expressed both in the nervous system and in peripheral organs. NGF is also present in mast cells, and in B- and T-lymphocytes, and may play a role in the immune cell development and differentiation. Various cytokines have been shown to affect NGF expression, and NGF is elevated in inflammation and in some autoimmune diseases. Here we have studied NGF concentrations in serum of pediatric patients with systemic lupus erythematosus (SLE) using a two-site enzyme-linked immunosorbent assay (ELISA). We have further correlated the levels of NGF to the inflammatory state of the disease. The mean value of serum NGF in SLE patients was significantly increased compared with controls (3346 vs 627 pg/ml). There was a correlation between the activity of SLE and the levels of NGF. The results show that NGF is elevated in childhood SLE and that the levels are correlated with disease activity. The present results suggest that NGF may play a role in the pathogenesis of SLE and may have a prognostic value in evaluating the course of the disease and in outlining the medication. (C) 2002 Elsevier Science Ltd. All rights reserved.

  • 31.
    Aalto, Lina
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Fysioterapi.
    Läckberg Holmquist, Victor
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Fysioterapi.
    Nervrotsblockad i kombination med fysioterapi för patienter med diskbråck - en single subject experimental design2017Independent thesis Basic level (degree of Bachelor), 10 poäng / 15 hpOppgave
    Abstract [sv]

    Introduktion: Diskbråck i ländryggen med symtom av ischias, bensmärta, är en vanlig orsak till specifika ryggbesvär. Konservativa behandlingsmetoder rekommenderas före kirurgi. Diagnosen diskbråck är förknippad med kraftig smärta och begränsningar och är en vanlig orsak till att söka vård och behandling. Trots detta finns det idag ingen konsensus kring vilka behandlingsmetoder som är mest effektiva vid diskbråck.

    Syfte: Att undersöka effekten av nervrotsblockad i kombination med individanpassad fysioterapi på smärta och aktivitetsförmåga för patienter med symtomgivande lumbosakralt diskbråck.

    Metod: Studiens utformning var en Single Subject Experimental Design (SSED), med en A-B design. Under baslinjefasen, A och interventionsfasen, B utfördes systematiska och upprepade mätningar av smärtintensitet och aktivitetsförmåga över tid. Totalt fem patienter med lumbosakralt diskbråck rekryterades från en klinik. Studien omfattades av två interventioner. Två patienter behandlades med nervrotsblockad (NRB) i kombination med individanpassad fysioterapi och tre patienter behandlades endast med NRB. Mätdata presenteras med grafer i linjediagram och analyserades visuellt.

    Resultat: De två patienterna som fick NRB i kombination med individanpassad fysioterapi förbättrades avseende smärta respektive aktivitetsförmåga, under nio respektive fem veckors interventionsfas. Av de tre patienter som behandlades enbart med NRB upplevde en patient en försämring avseende smärta och aktivitetsförmåga, en valde att avsluta sin medverkan och en behandlades som bortfall.

    Slutsats: NRB i kombination med individanpassad fysioterapi kan minska smärta och förbättra aktivitetsförmåga för enskilda patienter med symtomgivande lumbosakralt diskbråck.

     

  • 32.
    Aalto, Maarit
    et al.
    Nordiska ministerrådet, Nordens Velfærdscenter (NVC).
    Stankovic, Nenad
    Sällsynt samverkan för nordisk välfärd: Kartläggning av möjliga nordiska samarbetsområden anknutna till små och sällsynta diagnosgrupper2010Annet (Annet (populærvitenskap, debatt, mm))
    Fulltekst (pdf)
    fulltext
  • 33.
    Aalto, Mervi Anneli
    Högskolan i Kalmar, Naturvetenskapliga institutionen.
    Vill kunder handla receptfria läkemedel i dagligvaruhandeln?: - En enkätundersökning2008Independent thesis Basic level (degree of Bachelor), 10 poäng / 15 hpOppgave
    Abstract [sv]

    Sammanfattning

    I Sverige har det statliga apoteketsmonopolet ifrågasatts en längre tid och regeringen utreder nu möjligheten att konkurrensutsätta läkemedelsförsäljningen. Det har även föreslagits i den statliga utredningen (SOU 2008:4 del 2) att ett begränsat sortiment av OTC läkemedel (over the counter = receptfria läkemedel) ska få säljas i dagligvaruhandeln utan farmaceutiskt kompetenskrav. Vid korrekt användning och tillgång till rätt rådgivning kan OTC läkemedel vara till en stor hjälp för den enskilde individen vid egenvård och därigenom också bidra till avlastning på sjukvårdens resursers. Vid felanvändning av OTC läkemedel (över/underdosering, fel indikationsområde etc.), kan de istället få motsatt effekt. Syftet med denna enkätstudie var därför att utforska om konsumenter av OTC läkemedel i Sverige önskar få tillgång till dessa läkemedel i t ex livsmedelsbutiker, där de inte har tillgång till personlig farmaceutisk rådgivning, vidare var avsikten att undersöka hur de i dagligvaruhandeln önskade få läkemedelsinformation. I februari 2008 gjordes en enkätstudie i Västervik som inkluderade 48 deltagare varav 29 kvinnor och 19 män. Studien visade att 71 % av deltagarna hade en positiv inställning till att köpa OTC läkemedel i livsmedelsbutiker, 58 % skulle skaffa information genom läkemedelsförpackning och bipacksedel i kombination med att de tidigare använt läkemedlet. Önskan om tillgång till personlig rådgivning på inköpsstället var störst i åldern ≤ 35 år, där 38 % ansåg sig vilja det. Slutsats av studien är att majoriteten vill kunna handla OTC läkemedel i dagligvaruhandeln och information skulle de få främst från läkemedelsförpackning/bipacksedel i kombination med erfarenheter från tidigare användning.

    2008:F5

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    FULLTEXT01
  • 34. Aalto, Mikko
    et al.
    Kukka, Antti
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, SWEDESD - Centrum för forskning och utbildning om lärande för hållbar utveckling. Gävle sjukhus, Region Gävleborg.
    Elmi, Hassan Abdirahman
    Yared, Solomon
    Viskeraalinen leishmaniaasi tunnistamattomana tappavana tautina: [Visceral leishmaniasis as an unrecognized deadly disease]2023Inngår i: Duodecim, ISSN 0012-7183, E-ISSN 2242-3281, Vol. 139, nr 11, s. 885-891Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Visceral leishmaniasis is a disease caused by Leishmania parasites and transmitted by Phlebotomine sandflies. It affects primarily children and is fatal without treatment but curable with early treatment. Its clinical features are prolonged fever, wasting, hepatosplenomegaly and pancytopenia. Doctors have limited knowledge about its diagnostics. This leads to incorrect diagnoses and deaths, and the disease remains unrecognized. To break this vicious circle, active search of the disease is needed also where environmental factors are conductive to its presence, but it has never been reported. We describe discovering new foci of visceral leishmaniasis in Northern Somalia, Somaliland and Tanzania. 

  • 35. Aaltonen, Kirsimari
    et al.
    Ahlin, Cecilia
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för onkologi, radiologi och klinisk immunologi.
    Amini, Rose-Marie
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för genetik och patologi.
    Salonen, Laura
    Fjällskog, Marie Louise
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för onkologi, radiologi och klinisk immunologi.
    Heikkilä, Pävi
    Nevanlinna, Heli
    Blomqvist, Carl
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för onkologi, radiologi och klinisk immunologi.
    Reliability of cyclin A assessment on tissue microarrays in breast cancer compared to conventional histological slides2006Inngår i: British Journal of Cancer, ISSN 0007-0920, E-ISSN 1532-1827, Vol. 94, nr 11, s. 1697-1702Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Cyclin A has in some studies been associated with poor breast cancer survival, although all studies have not confirmed this. Its prognostic significance in breast cancer needs evaluation in larger studies. Tissue microarray (TMA) technique allows a simultaneous analysis of large amount of tumours on a single microscopic slide. This makes a rapid screening of molecular markers in large amount of tumours possible. Because only a small tissue sample of each tumour is punched on an array, the question has arisen about the representativeness of TMA when studying markers that are expressed in only a small proportion of cells. For this reason, we wanted to compare cyclin A expression on TMA and on traditional large sections. Two breast cancer TMAs were constructed of 200 breast tumours diagnosed between 1997-1998. TMA slides and traditional large section slides of these 200 tumours were stained with cyclin A antibody and analysed by two independent readers. The reproducibility of the two readers' results was good or even very good, with kappa values 0.71-0.87. The agreement of TMA and large section results was good with kappa value 0.62-0.75. Cyclin A overexpression was significantly (P<0.001) associated with oestrogen receptor and progesterone receptor negativity and high grade both on TMA and large sections. Cyclin A overexpression was significantly associated with poor metastasis-free survival both on TMA and large sections. The relative risks for metastasis were similar on TMA and large sections. This study suggests that TMA technique could be useful to study histological correlations and prognostic significance of cyclin A on breast cancer on a large scale.

  • 36. Aaltonen, Kirsimari
    et al.
    Amini, Rose-Marie
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för immunologi, genetik och patologi.
    Heikkilä, Päivi
    Aittomäki, Kristiina
    Tamminen, A.
    Nevanlinna, Heli
    Blomqvist, Carl
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för onkologi, radiologi och klinisk immunologi, Enheten för onkologi.
    High cyclin B1 expression is associated with poor survival in breast cancer2009Inngår i: British Journal of Cancer, ISSN 0007-0920, E-ISSN 1532-1827, Vol. 100, nr 7, s. 1055-60Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Cyclin B1 regulates the G(2)-M transition of the cell cycle. Cyclin B1 expression is higher in premalignant and malignant than normal breast lesions. Correlation of cyclin B1 expression with other histopathological variables and prognostic role in breast cancer are not fully understood. Traditionally used prognostic criteria identify large subset of patients to receive adjuvant chemotherapy and to be exposed to adverse effects. A reliable and simple method helping prognostic evaluation in breast cancer is needed. We analysed cyclin B1 expression on 1348 invasive breast cancers and studied correlations with other histopathological variables and survival. High cyclin B1 correlated with high tumour grade, large tumour size and positive nodal status, oestrogen and progesterone receptor negativity, positive HER2 and p53 status, young age at diagnosis, and high cyclin E, cyclin A and Ki67 expression. Among patients not given adjuvant chemotherapy high cyclin B1 was a strong predictor of shorter overall and metastasis-free survival (RR 3.74, P<0.0005 and RR 3.51, P<0.0005, respectively), and remained as an independent prognostic factor also in multivariate analysis (RR 1.80, P=0.04 and RR 2.31, P=0.02, respectively). This study suggests high cyclin B1 associates with aggressive phenotype and is an independent prognostic factor in breast cancer.

  • 37. Aaltonen, Kirsimari
    et al.
    Amini, Rose-Marie
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för immunologi, genetik och patologi.
    Landberg, Göran
    Eerola, Hannaleena
    Aittomäki, Kristiina
    Heikkilä, Päivi
    Nevanlinna, Heli
    Blomqvist, Carl
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för onkologi, radiologi och klinisk immunologi, Enheten för onkologi.
    Cyclin D1 expression is associated with poor prognostic features in estrogen receptor positive breast cancer2009Inngår i: Breast Cancer Research and Treatment, ISSN 0167-6806, E-ISSN 1573-7217, Vol. 113, nr 1, s. 75-82Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Cyclins D1 and E play an important role in breast carcinogenesis. High cyclin E expression is common in hormone receptor negative and high grade aggressive breast cancer, whereas cyclin D1 in hormone receptor positive and low grade breast cancer. Experimental data has suggested that cyclin D1 and E mediate cell proliferation by different mechanisms in estrogen receptor (ER) positive and negative breast cancer. To test this hypotheses in large breast cancer material and to clarify the histopathological correlations of cyclin E and D1, especially the association with proliferation, we analyzed cyclin E and D1 immunohistochemical expression on breast tumour microarrays consisting of 1348 invasive breast cancers. High cyclin D1 expression was associated with high grade (P<0.0005), high cyclin A (P<0.0005) and Ki67 (P<0.0005) expression among ER positive but with low grade (P=0.05) and low Ki67 (P=0.01) expression among ER negative breast cancers. Cyclin E and D1 expression correlated positively in ER positive (P<0.0005) but had a negative correlation in ER negative tumours (P=0.004). Cyclin E associated with high grade among all tumours (P<0.0005). In conclusion, the findings of this study show that cyclin D1 has separate roles, and proliferation is driven by different mechanisms in ER positive and negative breast cancers.

  • 38. Aaltonen, Kirsimari
    et al.
    Blomqvist, Carl
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för onkologi, radiologi och klinisk immunologi, Enheten för onkologi.
    Amini, Rose-Marie
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för immunologi, genetik och patologi.
    Eerola, Hannaleena
    Aittomäki, Kristiina
    Heikkilä, Päivi
    Nevanlinna, Heli
    Familial breast cancers without mutations in BRCA1 or BRCA2 have low cyclin E and high cyclin D1 in contrast to cancers in BRCA mutation carriers2008Inngår i: Clinical Cancer Research, ISSN 1078-0432, E-ISSN 1557-3265, Vol. 14, nr 7, s. 1976-83Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    PURPOSE: We analyzed the expression of critical cell cycle regulators cyclin E and cyclin D1 in familial breast cancer, focusing on BRCA mutation-negative tumors. Cyclin E expression in tumors of BRCA1 or BRCA2 carriers is higher, and cyclin D1 expression lower, than in sporadic tumors. In familial non-BRCA1/2 tumors, cyclin E and cyclin D1 expression has not been studied. EXPERIMENTAL DESIGN: Cyclin E and cyclin D1 immunohistochemical expression was studied in tissue microarrays consisting of 53 BRCA1, 58 BRCA2, 798 familial non-BRCA1/2, and 439 sporadic breast tumors. RESULTS: In univariate analysis, BRCA1 tumors had significantly more frequently high cyclin E (88%) and low cyclin D1 (84%) expression than sporadic (54% and 49%, respectively) or familial non-BRCA1/2 (38% and 45%, respectively) tumors. BRCA2 tumors had significantly more frequently low cyclin D1 expression (68%) than sporadic or familial non-BRCA1/2 tumors and significantly more frequently high cyclin E expression than familial non-BRCA1/2 tumors. In a logistic regression model, cyclin expression, early age of onset, and estrogen receptor (ER) and human epidermal growth factor receptor-2 (HER2) status were the independent factors most clearly distinguishing tumors of BRCA1 mutation carriers from other familial breast cancers. High cyclin E and low cyclin D1 expression were also independent predictors of BRCA2 mutation when compared with familial non-BRCA1/2 tumors. Most interestingly, lower frequency of high cyclin E expression independently distinguished familial non-BRCA1/2 tumors also from sporadic ones. CONCLUSIONS: Cyclin E and cyclin D1 expression distinguishes non-BRCA1/2 tumors from both sporadic and BRCA1- and BRCA2-associated tumors and may reflect different predisposition and pathogenesis in these groups.

  • 39.
    Aaltonen, Kristina E.
    et al.
    Lund University, Sweden.
    Rosendahl, Ann H.
    Lund University, Sweden; Skåne University Hospital, Sweden.
    Olsson, Hans
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för inflammationsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Diagnostikcentrum, Klinisk patologi och klinisk genetik.
    Malmstrom, Per
    Lund University, Sweden; Skåne University Hospital, Sweden.
    Hartman, Linda
    Lund University, Sweden; Regional Cancer Centre South, Sweden.
    Ferno, Marten
    Lund University, Sweden.
    Association between insulin-like growth factor-1 receptor (IGF1R) negativity and poor prognosis in a cohort of women with primary breast cancer2014Inngår i: BMC Cancer, E-ISSN 1471-2407, Vol. 14, nr 794Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Resistance towards endocrine therapy is a great concern in breast cancer treatment and may partly be explained by the activation of compensatory signaling pathways. The aim of the present study was to investigate if the insulin-like growth factor-1 receptor (IGF1R) signaling pathway was activated or deregulated in breast cancer patients and to explore if any of the markers were prognostic, with or without adjuvant tamoxifen. This signaling pathway has been suggested to cause estrogen independent cell growth and thus contribute to resistance to endocrine treatment in estrogen receptor (ER) positive breast cancer. Methods: The protein expression of IGF1R, phosphorylated Mammalian Target of Rapamycin (p-mTOR) and phosphorylated S6 ribosomal protein (p-S6rp) were investigated by immunohistochemistry using tissue microarrays in two patient cohorts. Cohort I (N = 264) consisted of mainly postmenopausal women with stage II breast cancer treated with tamoxifen for 2 years irrespective of ER status. Cohort II (N = 206) consisted of mainly medically untreated, premenopausal patients with node-negative breast cancer. Distant disease-free survival (DDFS) at 5 years was used as end-point for survival analyses. Results: We found that lower IGF1R expression was associated with worse prognosis for tamoxifen treated, postmenopausal women (HR = 0.70, 95% CI = 0.52 - 0.94, p = 0.016). The effect was seen mainly in ER-negative patients where the prognostic effect was retained after adjustment for other prognostic markers (adjusted HR = 0.49, 95% CI = 0.29 - 0.82, p = 0.007). Expression of IGF1R was associated with ER positivity (p less than 0.001) in the same patient cohort. Conclusions: Our results support previous studies indicating that IGF1R positivity reflects a well differentiated tumor with low metastatic capacity. An association between lack of IGF1R expression and worse prognosis was mainly seen in the ER-negative part of Cohort I. The lack of co-activation of downstream markers (p-mTOR and p-S6rp) in the IGF1R pathway suggested that the prognostic effect was not due to complete activation of this pathway. Thus, no evidence could be found for a compensatory function of IGF1R signaling in the investigated cohorts.

    Fulltekst (pdf)
    fulltext
  • 40. Aaltonen, Minna
    et al.
    Soukka, Hanna
    Halkola, Lauri
    Jalonen, Jarmo
    Kalimo, Hannu
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för genetik och patologi.
    Holopainen, Irma E
    Kääpä, Pekka O
    Inhaled nitric oxide treatment inhibits neuronal injury after meconium aspiration in piglets2007Inngår i: Early Human Development, ISSN 0378-3782, E-ISSN 1872-6232, Vol. 83, nr 2, s. 77-85Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Meconium aspiration-induced hypertensive lung injury is frequently associated with neuronal damage. Inhaled nitric oxide (iNO) is widely used in the treatment of pulmonary hypertension, but its effects on the brain are poorly known. Aims: The aim of this study was to determine the effects of iNO treatment on the neuronal tissue after meconium aspiration. Study design: 71 anesthetized, catheterized and ventilated newborn piglets were studied for 6 h. Thirty-five piglets were instilled with a bolus of human meconium intratracheally and 36 piglets with saline instillation served as controls. Nineteen meconium piglets and 17 control piglets were continuously treated with 20 ppm of iNO, started at 30 min after the insult. The extent of neuronal injury was analysed histologically, and the levels of brain tissue lipid peroxidation products, reduced glutathione (GSH), myeloperoxidase activity and oxidized DNA were analysed as indicators of oxidative stress. Results: iNO treatment diminished the pulmonary hypertensive response caused by meconium aspiration, but did not change systemic or carotid hemodynamics. NO administration was associated with reduced neuronal injury and diminished amount of oxidized DNA in the hippocampus of the meconium piglets. Further, iNO treatment was associated with decreased level of GSH in the cortex, but no change in lipid peroxidation production or myeloperoxidase activity was detected in any of the studied brain areas. Conclusions: Our results suggest that iNO treatment may inhibit DNA oxidation and neuronal injury in the hippocampus, associated with newborn meconium aspiration.

  • 41. Aalto-Setälä, Katriina
    et al.
    Palomäki, Heikki
    Miettinen, Helena
    Vuorio, Alpo
    Kuusi, Timo
    Raininko, Raili
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för onkologi, radiologi och klinisk immunologi.
    Salonen, Oili
    Kaste, Markku
    Kontula, Kimmo
    Genetic risk factors and ischemic cerebrovascular disease: role of common variation of the genes encoding apolipoproteins and angiotensin-converting enzyme1998Inngår i: Annals of Medicine, ISSN 0785-3890, E-ISSN 1365-2060, Vol. 30, nr 2, s. 224-33Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    DNA polymorphisms in genes encoding apolipoproteins (apo) A-I, C-III, B and E and angiotensin-converting enzyme (ACE) have been proposed to be associated with the risk of coronary artery disease (CAD). We studied whether the same genetic markers would also be associated with the occurrence and extent of atherosclerosis in cervical arteries. DNA samples from 234 survivors of stroke or a transient ischaemic attack aged 60 years or less were examined. The presence of atherosclerosis was assessed using aortic arch angiograms. The SstI polymorphism of apoA-I/C-III gene locus, the XbaI polymorphism of apoB gene, common apoE phenotypes and the insertion/deletion polymorphism of the ACE gene were analysed. The allele frequencies of the apoA-I/C-III, apoB, apoE or ACE gene did not differ between the groups with (n = 148) or without (n = 85) cervical atherosclerosis. However, when patients with at least one apoE4 allele and one X2 allele of apoB were combined and compared with those without either of them (E2E3 or E3E3 and X1X1), a significant association with the presence of cervical atherosclerosis was found (P = 0.03). The patients having the E2E3 phenotype had a significantly elevated serum triglyceride level compared with those with the E3E3 phenotype (P = 0.03). Serum high-density lipoprotein (HDL) cholesterol was lower in the patients with the E2E3 phenotype than in those with the E3E3 and E3E4 (P = 0.01 and P = 0.06, respectively). The apoB or ACE genotypes were not significantly associated with serum lipid or lipoprotein levels. There was no association between the ACE gene polymorphism and the occurrence of hypertension. In conclusion, the interaction of common apoB and apoE alleles may increase the risk of atherosclerosis in cervical arteries.

  • 42.
    Aam, Stina
    et al.
    Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Science, NTNU-Norwegian University of Science and Technology, Trondheim, Norway; Department of Geriatric Medicine, Clinic of Medicine, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.
    Gynnild, Mari Nordbø
    Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Science, NTNU-Norwegian University of Science and Technology, Trondheim, Norway; Stroke Unit, Clinic of Medicine, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.
    Munthe-Kaas, Ragnhild
    Department of Medicine, Vestre Viken Hospital Trust, Bærum Hospital, Drammen, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
    Saltvedt, Ingvild
    Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Science, NTNU-Norwegian University of Science and Technology, Trondheim, Norway; Department of Geriatric Medicine, Clinic of Medicine, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.
    Lydersen, Stian
    Department of Mental Health, Faculty of Medicine and Health Science, NTNU-Norwegian University of Science and Technology, Trondheim, Norway.
    Knapskog, Anne-Brita
    Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway.
    Ihle-Hansen, Hege
    Department of Medicine, Vestre Viken Hospital Trust, Bærum Hospital, Drammen, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway.
    Ellekjær, Hanne
    Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Science, NTNU-Norwegian University of Science and Technology, Trondheim, Norway; Stroke Unit, Clinic of Medicine, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.
    Eldholm, Rannveig Sakshaug
    Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Science, NTNU-Norwegian University of Science and Technology, Trondheim, Norway; Department of Geriatric Medicine, Clinic of Medicine, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.
    Fure, Brynjar
    Örebro universitet, Institutionen för medicinska vetenskaper. Department of Internal Medicine, Central Hospital, Karlstad, Sweden.
    The Impact of Vascular Risk Factors on Post-stroke Cognitive Impairment: The Nor-COAST Study2021Inngår i: Frontiers in Neurology, E-ISSN 1664-2295, Vol. 12, artikkel-id 678794Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Introduction: Post-stroke cognitive impairment (PSCI) is common, but evidence on the impact of vascular risk factors is lacking. We explored the association between pre-stroke vascular risk factors and PSCI and studied the course of PSCI.

    Materials and Methods: Vascular risk factors were collected at baseline in stroke survivors (n = 635). Cognitive assessments of attention, executive function, memory, language, and the Montreal Cognitive Assessment (MoCA) were performed at 3 and/or 18 months post-stroke. Stroke severity was assessed with the National Institutes of Health Stroke Scale (NIHSS). PSCI was measured with global z; MoCA z-score; and z-score of the four assessed cognitive domains. Mixed-effect linear regression was applied with global z, MoCA z-score, and z-scores of the cognitive domains as dependent variables. Independent variables were the vascular risk factors (hypertension, hypercholesterolemia, smoking, diabetes mellitus, atrial fibrillation, coronary heart disease, previous stroke), time, and the interaction between these. The analyses were adjusted for age, education, and sex. There were between 5 and 25% missing data for the variables for PSCI.

    Results: Mean age was 71.6 years (SD 11.7); 42% were females; and the mean NIHSS score at admittance was 3.8 (SD 4.8). Regardless of vascular risk factors, global z, MoCA, and all the assessed cognitive domains were impaired at 3 and 18 months, with MoCA being the most severely impaired. Atrial fibrillation (AF) was associated with poorer language at 18 months and coronary heart disease (CHD) with poorer MoCA at 18 months (LR =12.80, p = 0.002, and LR = 8.32, p = 0.004, respectively). Previous stroke was associated with poorer global z and attention at 3 and 18 months (LR = 15.46, p < 0.001, and LR = 16.20, p < 0.001). In patients without AF, attention improved from 3 to 18 months, and in patients without CHD, executive function improved from 3 to 18 months (LR = 10.42, p < 0.001, and LR = 9.33, p = 0.009, respectively).

    Discussion: Our findings indicate that a focal stroke lesion might be related to pathophysiological processes leading to global cognitive impairment. The poorer prognosis of PSCI in patients with vascular risk factors emphasizes the need for further research on complex vascular risk factor interventions to prevent PSCI.

  • 43.
    Aamand Grabau, Dorthe
    et al.
    Skåne University Hospital, Sweden .
    Bendahl, Par-Ola
    Lund University, Sweden .
    Ryden, Lisa
    Lund University, Sweden .
    Stål, Olle
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Centrum för kirurgi, ortopedi och cancervård, Onkologiska kliniken US.
    Ferno, Marten
    Lund University, Sweden .
    The prevalence of immunohistochemically determined oestrogen receptor positivity in primary breast cancer is dependent on the choice of antibody and method of heat-induced epitope retrieval - prognostic implications?2013Inngår i: Acta Oncologica, ISSN 0284-186X, E-ISSN 1651-226X, Vol. 52, nr 8, s. 1657-1666Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background. Oestrogen receptor (ER) status is important for the choice of systemic treatment of breast cancer patients. However, most data from randomised trials on the effect of adjuvant endocrine therapy according to ER status are based on the cytosol methods. Comparisons with immunohistochemical methods have given similar results. The aim of the present study was to examine whether different ER antibodies and heat-induced epitope retrieval (HIER) methods influence the prevalence of ER-positivity in primary breast cancer. Material and methods. This study is based on patients included in a clinical trial designed to compare the effect of two years of adjuvant tamoxifen versus no adjuvant systemic treatment in premenopausal women. From 1986 to 1991, 564 patients from two study centres in Sweden were enrolled and randomised. Patients were randomised independently of ER status. In the present study, ER status was assessed on tissue microarrays with the three different ER antibody/HIER combinations: 1D5 in citrate pH 6 (n = 390), SP1 in Tris pH 9 (n = 390) and PharmDx in citrate pH 6 (n = 361). Results. At cut-offs of 1% and 10%, respectively, the prevalence of ER-positivity was higher with SP1 (75% and 72%) compared with 1D5 (68% and 66%) and PharmDx (66% and 62%). At these cut-offs, patients in the discordant groups (SP1-positive and 1D5-negative) seem to have a prognosis intermediate between those of the double-positive and double-negative groups. Comparison with the ER status determined by the cytosol-based methods in the discordant group also showed an intermediate pattern. The repeatability was good for all antibodies and cut-offs, with overall agreement andgt;= 93%. Conclusion. The present study shows that the choice of antibody and HIER method influences the prevalence of ER-positivity. We suggest that this be taken into consideration when choosing a cut-off for clinical decision making.

  • 44.
    Aamodt, Ina Thon
    et al.
    Oslo Univ Hosp, Norway; Lovisenberg Diaconal Univ Coll, Norway.
    Lie, Irene
    Oslo Univ Hosp, Norway; Norwegian Univ Sci & Technol, Norway.
    Lycholip, Edita
    Vilnius Univ, Lithuania; Vilnius Univ, Lithuania.
    Strömberg, Anna
    Linköpings universitet, Institutionen för hälsa, medicin och vård, Avdelningen för omvårdnad och reproduktiv hälsa. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Hjärtcentrum, Kardiologiska kliniken US.
    Jaarsma, Tiny
    Linköpings universitet, Institutionen för hälsa, medicin och vård, Avdelningen för omvårdnad och reproduktiv hälsa. Linköpings universitet, Medicinska fakulteten.
    Celutkiene, Jelena
    Vilnius Univ, Lithuania.
    Helleso, Ragnhild
    Univ Oslo, Norway.
    Informal Caregivers Experiences with Performing Telemonitoring in Heart Failure Care at Home-A Qualitative Study2022Inngår i: Healthcare, E-ISSN 2227-9032, Vol. 10, nr 7, artikkel-id 1237Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Informal caregivers have an important role in caring for family members at home. Supporting persons with a chronic illness such as heart failure (HF) in managing their self-care is reported to be a challenge and telemonitoring has been suggested to be of support. Aim: to explore informal caregivers experiences with performing non-invasive telemonitoring to support persons with HF at home for 30 days following hospital discharge in Norway and Lithuania. Methods: A qualitative explorative study of informal caregivers performing non-invasive telemonitoring using lung-impedance measurements and short message service (SMS). Data was collected using semi-structured interviews with informal caregivers of persons with HF in NYHA class III-IV in Norway and Lithuania. Results: Nine interviews were conducted with informal caregivers of persons with HF who performed non-invasive telemonitoring at home. A sequential process of three categories emerged from the data: access to support, towards routinizing, and mastering non-invasive telemonitoring. Conclusion: Informal caregivers performed non-invasive telemonitoring for the first time in this study. Their experiences were of a sequential process that included access to support from health care professionals, establishing a routine together, and access to nurses or physicians in HF care as part of mastering. This study highlights involving informal caregivers and persons with HF together in the implementation and future research of telemonitoring in HF care.

    Fulltekst (pdf)
    fulltext
  • 45.
    Aamodt, Ina Thon
    et al.
    Oslo Univ Hosp Ulleval, Norway; Univ Oslo, Norway.
    Lycholip, Edita
    Vilnius Univ, Lithuania.
    Celutkiene, Jelena
    Vilnius Univ, Lithuania.
    Strömberg, Anna
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Hjärt- och Medicincentrum, Kardiologiska kliniken US.
    Atar, Dan
    Oslo Univ Hosp, Norway; Univ Oslo, Norway.
    Falk, Ragnhild Sorum
    Oslo Univ Hosp, Norway.
    von Lueder, Thomas
    Oslo Univ Hosp, Norway.
    Helleso, Ragnhild
    Univ Oslo, Norway.
    Jaarsma, Tiny
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten.
    Lie, Irene
    Oslo Univ Hosp Ulleval, Norway.
    Health Care Professionals Perceptions of Home Telemonitoring in Heart Failure Care: Cross-Sectional Survey2019Inngår i: Journal of Medical Internet Research, E-ISSN 1438-8871, Vol. 21, nr 2, artikkel-id e10362Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Noninvasive telemonitoring (TM) can be used in heart failure (HF) patients to perform early detection of decompensation at home, prevent unnecessary health care utilization, and decrease health care costs. However, the evidence is not sufficient to be part of HF guidelines for follow-up care, and we have no knowledge of how TM is used in the Nordic Baltic region. Objective: The aim of this study was to describe health care professionals (HCPs) perception of and presumed experience with noninvasive TM in daily HF patient care, perspectives of the relevance of and reasons for applying noninvasive TM, and barriers to the use of noninvasive TM. Methods: A cross-sectional survey was performed between September and December 2016 in Norway and Lithuania with physicians and nurses treating HF patients at either a hospital ward or an outpatient clinic. A total of 784 questionnaires were sent nationwide by postal mail to 107 hospitals. The questionnaire consisted of 43 items with close- and open-ended questions. In Norway, the response rate was 68.7% (226/329), with 57 of 60 hospitals participating, whereas the response rate was 68.1% (310/455) in Lithuania, with 41 of 47 hospitals participating. Responses to the closed questions were analyzed using descriptive statistics, and the open-ended questions were analyzed using summative content analysis. Results: This study showed that noninvasive TM is not part of the current daily clinical practice in Norway or Lithuania. A minority of HCPs responded to be familiar with noninvasive TM in HF care in Norway (48/226, 21.2%) and Lithuania (64/310, 20.6%). Approximately half of the HCPs in both countries perceived noninvasive TM to be relevant in follow-up of HF patients in Norway (131/226, 58.0%) and Lithuania (172/310, 55.5%). For physicians in both countries and nurses in Norway, the 3 most mentioned reasons for introducing noninvasive TM were to improve self-care, to reduce hospitalizations, and to provide high-quality care, whereas the Lithuanian nurses described ability to treat more patients and to reduce their workload as reasons for introducing noninvasive TM. The main barriers to implement noninvasive TM were lack of funding from health care authorities or the Territorial Patient Fund. Moreover, HCPs perceive that HF patients themselves could represent barriers because of their physical or mental condition in addition to a lack of internet access. Conclusions: HCPs in Norway and Lithuania are currently nonusers of TM in daily HF care. However, they perceive a future with TM to improve the quality of care for HF patients. Financial barriers and HF patients condition may have an impact on the use of TM, whereas sufficient funding from health care authorities and improved knowledge may encourage the more widespread use of TM in the Nordic Baltic region and beyond.

    Fulltekst (pdf)
    fulltext
  • 46.
    Aamodt, Ina Thon
    et al.
    Oslo Univ Hosp, Norway; Univ Oslo, Norway.
    Lycholip, Edita
    Vilnius Univ, Lithuania.
    Celutkiene, Jelena
    Vilnius Univ, Lithuania.
    von Lueder, Thomas
    Oslo Univ Hosp, Norway.
    Atar, Dan
    Oslo Univ Hosp, Norway; Univ Oslo, Norway.
    Falk, Ragnhild Sorum
    Oslo Univ Hosp, Norway.
    Helleso, Ragnhild
    Univ Oslo, Norway.
    Jaarsma, Tiny
    Linköpings universitet, Institutionen för hälsa, medicin och vård, Avdelningen för omvårdnad och reproduktiv hälsa. Linköpings universitet, Medicinska fakulteten.
    Strömberg, Anna
    Linköpings universitet, Institutionen för hälsa, medicin och vård, Avdelningen för omvårdnad och reproduktiv hälsa. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Hjärtcentrum, Kardiologiska kliniken US.
    Lie, Irene
    Oslo Univ Hosp, Norway.
    Self-Care Monitoring of Heart Failure Symptoms and Lung Impedance at Home Following Hospital Discharge: Longitudinal Study2020Inngår i: Journal of Medical Internet Research, E-ISSN 1438-8871, Vol. 22, nr 1, artikkel-id e15445Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Self-care is key to the daily management of chronic heart failure (HF). After discharge from hospital, patients may struggle to recognize and respond to worsening HF symptoms. Failure to monitor and respond to HF symptoms may lead to unnecessary hospitalizations. Objective: This study aimed to (1) determine the feasibility of lung impedance measurements and a symptom diary to monitor HF symptoms daily at home for 30 days following hospital discharge and (2) determine daily changes in HF symptoms of pulmonary edema, lung impedance measurements, and if self-care behavior improves over time when patients use these self-care monitoring tools. Methods: This study used a prospective longitudinal design including patients from cardiology wards in 2 university hospitals-one in Norway and one in Lithuania. Data on HF symptoms and pulmonary edema were collected from 10 participants (mean age 64.5 years; 90% (9/10) male) with severe HF (New York Heart Association classes III and IV) who were discharged home after being hospitalized for an HF condition. HF symptoms were self-reported using the Memorial Symptom Assessment Scale for Heart Failure. Pulmonary edema was measured by participants using a noninvasive lung impedance monitor, the Cardio Set Edema Guard Monitor. Informal caregivers aided the participants with the noninvasive measurements. Results: The prevalence and burden of shortness of breath varied from participants experiencing them daily to never, whereas lung impedance measurements varied for individual participants and the group participants, as a whole. Self-care behavior score improved significantly (P=.007) from a median of 56 (IQR range 22-75) at discharge to a median of 81 (IQR range 72-98) 30 days later. Conclusions: Noninvasive measurement of lung impedance daily and the use of a symptom diary were feasible at home for 30 days in HF patients. Self-care behavior significantly improved after 30 days of using a symptom diary and measuring lung impedance at home. Further research is needed to determine if daily self-care monitoring of HF signs and symptoms, combined with daily lung impedance measurements, may reduce hospital readmissions.

    Fulltekst (pdf)
    fulltext
  • 47.
    Aamodt, Ina Thon
    et al.
    Oslo Univ Hosp, Norway; Univ Oslo, Norway; Lovisenberg Diaconal Univ Coll, Norway.
    Strömberg, Anna
    Linköpings universitet, Institutionen för hälsa, medicin och vård, Avdelningen för omvårdnad och reproduktiv hälsa. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Hjärtcentrum, Kardiologiska kliniken US.
    Helleso, Ragnhild
    Univ Oslo, Norway.
    Jaarsma, Tiny
    Linköpings universitet, Institutionen för hälsa, medicin och vård, Avdelningen för omvårdnad och reproduktiv hälsa. Linköpings universitet, Medicinska fakulteten.
    Lie, Irene
    Oslo Univ Hosp, Norway.
    Tools to Support Self-Care Monitoring at Home: Perspectives of Patients with Heart Failure2020Inngår i: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 17, nr 23, artikkel-id 8916Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Self-care monitoring at home can be a challenge for patients with heart failure (HF). Tools that leverage information and communication technology (ICT), comprise medical devices, or have written material may support their efforts at home. The aim of this study was to describe HF patients experiences and their prioritization of tools that support, or could support, self-care monitoring at home. A descriptive qualitative design employing semi-structured interviews was used with HF patients living at home and attending an HF outpatient clinic in Norway. We used a deductive analysis approach, using the concept of self-care monitoring with ICT tools, paper-based tools, medical devices, and tools to consult with healthcare professionals (HCPs) as the categorization matrix. Nineteen HF patients with a mean age of 64 years participated. ICT tools are used by individual participants to identify changes in their HF symptoms, but are not available by healthcare services. Paper-based tools, medical devices, and face-to-face consultation with healthcare professionals are traditional tools that are available and used by individual participants. HF patients use traditional and ICT tools to support recognizing, identifying, and responding to HF symptoms at home, suggesting that they could be used if they are available and supplemented by in-person consultation with HCPs.

    Fulltekst (pdf)
    fulltext
  • 48.
    Aanaes, K
    et al.
    Rigshosp, Denmark .
    Rasmussen, N
    Rigshosp, Denmark Statens Serum Institute, Denmark .
    Pressler, T
    Rigshosp, Denmark Rigshosp, Denmark .
    Segelmark, Mårten
    Linköpings universitet, Institutionen för medicin och hälsa, Farmakologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Njurmedicinska kliniken US.
    Johansen, H K
    Rigshosp, Denmark .
    Lindberg, U
    Lund University, Sweden .
    Hoiby, N
    Rigshosp, Denmark .
    Carlsson, M
    Lund University, Sweden .
    Wieslander, J
    EuroDiagnostica AB, Sweden .
    Buchwald, C
    Rigshosp, Denmark .
    Extensive Endoscopic Image-Guided Sinus Surgery Decreases BPI-ANCA in Patients with Cystic Fibrosis2012Inngår i: Scandinavian Journal of Immunology, ISSN 0300-9475, E-ISSN 1365-3083, Vol. 76, nr 6, s. 573-579Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Antineutrophil cytoplasm autoantibodies (ANCA) directed against bactericidal/permeability-increasing protein (BPI) are common in patients with cystic fibrosis (CF), and serum levels are correlated with lung colonization by Pseudomonas aeruginosa and the severity of lung damage. The production of BPI-ANCA may be due to the costimulation of BPI when mounting an immune response against P. aeruginosa. The effect of surgery aiming to eradicate bacteria and infected tissue on BPI-ANCA levels is sparsely described. A cohort of patients with CF were included: 53 patients having extensive image-guided sinus surgery (EIGSS) with topical postoperative antibiotic treatment, 131 non-operated controls and 36 who had double lung transplantation (LTX). In all 219 patients, serum samples before and after surgery or at similar intervals were analysed for IgG and IgA BPI-ANCA. The EIGSS group showed a highly significant decrease in both IgA and IgG BPI-ANCA levels compared with their own preoperative values and control group values (P andlt; 0.0010.02). The LTX patients also showed a highly significant decrease in both IgA and IgG BPI-ANCA levels (P andlt; 0.001). EIGSS and LTX decrease IgA and IgG BPI-ANCA levels in patients with CF, indicating that extensive removal of infected tissue influences the pathogenic process of autoantibody production. The results shown herein are in favour of applying EIGSS in selected patients with CF and for using BPI-ANCA as a surrogate marker for guiding further therapeutic interventions.

    Fulltekst (pdf)
    fulltext
  • 49. Aanesen, Arthur
    et al.
    Westerbotn, Margareta
    Sophiahemmet Högskola.
    Prospective study of a Swedish infertile cohort 2005-08: population characteristics, treatments and pregnancy rates2014Inngår i: Family Practice, ISSN 0263-2136, E-ISSN 1460-2229, Vol. 31, nr 3, s. 290-7Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND: We here report on results from a prospective study comprising 380 infertile couples undergoing infertility work-up and various treatments for infertility in our clinic. The aim was to investigate the overall birth rate as a result of different treatments, as well as spontaneous pregnancies.

    METHODS: Three hundred and eighty couples were consecutively included between December 2005 and May 2008. All couples underwent a fertility work-up, including hysterosalpingogram, hormonal characterization, clinical examination, screening for infectious diseases and semen analysis. The mean age of the women at the time of inclusion was 33.2 years. The mean duration of infertility prior to inclusion was 1.8 years. And 46.6% (n = 177) of the women had been pregnant prior to their first visit to the clinic and 30.0% (n = 114) had been pregnant earlier in their present relationship.

    RESULTS: As of November 2010, 57.3% (n = 218) of the women had given birth to a child when they were lost to follow up by the study. Spontaneous conception was observed in 11.3% (n = 43) of the women, 14.5% (n = 64) conceived after intrauterine insemination (IUI), 4.2% (n = 16) conceived after ovarian hyperstimulation and ovulation induction (OH/OI) and 28.4% (n = 113) after in vitro fertilization. There were 280 pregnancies and 58 spontaneous abortions (22.3%) in the group. Mean anti-mullerian hormone significantly correlated with antral follicle count and age and was significantly higher in the subgroup that became pregnant after IUI.

    CONCLUSIONS: Spontaneous pregnancies and IUI + OH/OI contributed significantly to the pregnancies observed in the total population. Predictive factors for pregnancy were anti-mullerian hormone in the group undergoing IUI treatment and in the age group ≥38-duration of infertility. Previous pregnancies, body mass index, estradiol, follicle stimulating hormone or having given birth prior to the infertility period were not predictive of pregnancy for the infertile couples in this study.

  • 50.
    Aanestad, Øystein
    Uppsala universitet, Medicinska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper.
    Quantitative electromyographic studies of the perineal muscles in normal subjects and patients suffering from anal or urinary incontinence1998Doktoravhandling, med artikler (Annet vitenskapelig)
    Abstract [en]

    The aims of the study were to characterize the interference pattern in perineal muscles in healthy subjects with the use of quantitative EMG techniques, to evaluate if prostatic surgery had any effect on the interference pattern and furthermore to examine the interference pattern in the perineal muscles in patients suffering from urinary or anal incontinence.

    The interference pattern in the perineal muscles was examined with a computerized analysis, the Turns and Amplitude (T/A) analysis, and the innervation pattern of the muscles was examined with single fiber electromyography measuring the fiber density. Reference values were collected from 30 normal subjects. The patient material consisted of 20 males subjected to transurethral prostatectomy (TUR-P), 10 males who underwent radical retropubic prostatectomy (RRP), 20 patients suffering from anal incontinence and 24 women withurinary incontinence.

    T/A analysis of the interference pattern in the perineal muscles in normal subjects showed a significant increase in number of turns/sec and mean amplitude correlating to increasing force but no age-related changes.

    TUR-P and RRP did effect the innervation of the distal urethral sphincter muscle as shown by increased fiber density indicating a peripheral nerve lesion. T/A analysis did not shown any increased activation of the distal urethral sphincter as a compensation for the loss in bladder neck sphincter function but rather signs of decreasedcentral activation.

    Patients with idiopathic faecal incontinence showed signs of impaired innervation of the external anal sphincter muscle. A decreased interference pattern at maximal contraction indicated a reduced central activation of perineal muscles, in particular for patients with partial rupture of the external anal sphincter muscle. The reduced central activation could play a role for the aetiology of faecal incontinence.

    Patients with urinary stress incontinence also showed signs of impaired innervation of the external anal sphincter muscle as well as reduced interference pattern at maximal contraction and during continuous recording of the EMG activity during cystometry. A reduced central activation of the motor units was predicted as one factor involved in the aetiology.

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