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  • 301.
    Appelros, Sara
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Samvetsstress och utbrändhet hos sjuksköterskor i kommunal hemsjukvård2018Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Stress in healthcare has been described as a specific form of stress that arises when immoral acts and ethically difficult situations lead to troubled conscience and stress of conscience. Previous studies have shown an association between stress of conscience and burnout.

    Aim: The aim was to examine the prevalence of and the stress of conscience and the association between stress of conscience and burnout among nurses working in municipal home care.

    Methods: A cross-sectional study was preformed using a questionnaire. The study was completed by 84 nurses working in municipal home care in southern Sweden, and the response rate was 79 percent.

    Results: The result showed that stress of conscience and burnout exists among nurses. The result showed a significant correlation between stress of conscience and exhaustion (r = 0.69, p <0.001). Of the participants, 27.4 percent (n = 23) were found to be at risk of exhaustion. Stress of conscience arose when work in health care felt so demanding that there was no energy to spend on their family. Feelings of troubled conscience occurred among 60.7 percent (n = 51) of the participants when they couldn’t give the care that the patient needed. But the participants testify that they rarely ever see patients being insulted or injured. Of the nurses, 22.6 percent (n = 19) reported that they were often exposed to incompatible work requirements. The result showed an increased sense of exhaustion among the participants, where 47.7 percent (n = 40) often feel tired after work and 40.4 percent (n = 34) answered that there were tired before work.

    Conclusion: Nurses working in municipal home care experience stress of conscience and exhaustion. Nurses experience troubled conscience when they cannot provide the care that the patient needs and when they are being exposed to incompatible demands at work. More than half of the participants experience an increased need for relaxation after work, while most of them felt that they tolerate the pressure of work well.

  • 302.
    Appelros, Sofia
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Psychology.
    Rosander, Jennifer
    Linnaeus University, Faculty of Health and Life Sciences, Department of Psychology.
    Kvinnors upplevelser av vänskapsrelationer: En kvalitativ studie2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Syftet med studien var att undersöka kvinnors upplevelser av vänskapsrelationer. Detta undersöktes genom semi-strukturerade intervjuer med sju kvinnor i åldrarna 22-33 år. Data analyserades med Burnards (1991) 14-stegs process då kategorier och teman utformades. Resultatet gav tre teman som döptes till: fristad, utbyte och vänskapsförbindelse. Dessa teman utgjordes av åtta kategorier och 22 underkategorier. Upplevelserna av vänskapsrelationer inkluderade bland annat förståelse, stöd, ärlighet, acceptans och likhet. Resultatet belyser både positiva och negativa aspekter då vänskapsrelationer å ena sidan kunde upplevas som gynnsamma och ömsesidiga men å andra sidan även krävande och ensidiga. En vän var en källa till stöd i svårare tider men även någon att dela glädje och skratt med. Vänskapsrelationer fyllde olika behov såsom gemenskap och tilhörighet, och ansågs vara en frivillig förbindelse mellan parterna där känslan av att kunna vara sig själv, att få bekräftelse, och att vara öppna mot varandra anses önskvärda.

  • 303.
    Arahal, David R.
    et al.
    Univ Valencia, Spain.
    Lucena, Teresa
    Univ Valencia, Spain.
    Carmen Macian, M.
    Univ Valencia, Spain.
    Ruvira, Maria A.
    Univ Valencia, Spain.
    Gonzalez, Jose M.
    Univ La Laguna, Spain.
    Lekumberri, Itziar
    Univ Girona, Spain.
    Pinhassi, Jarone
    Linnaeus University, Faculty of Health and Life Sciences, Department of Biology and Environmental Science.
    Pujalte, Maria J.
    Univ Valencia, Spain.
    Marinomonas blandensis sp nova, a novel marine gammaproteobacterium2016In: International Journal of Systematic and Evolutionary Microbiology, ISSN 1466-5026, E-ISSN 1466-5034, Vol. 66, p. 5544-5549Article in journal (Refereed)
    Abstract [en]

    A novel Gram-staining-negative, chemoorganotrophic, moderately halophilic, strictly aerobic bacterium, strain MED121(T), was isolated from a seawater sample collected at the Blanes Bay Microbial Observatory in the north-western Mediterranean Sea. Analysis of its 16S rRNA gene sequence, retrieved from the whole-genome sequence, showed that this bacterium was most closely related to Marinomonas dokdonensis and other Marinomonas species (96.3 and 93.3-95.7% sequence similarities, respectively), within the family Oceanospirillaceae. Strain MED121(T) was included into a whole-genome sequencing study and, subsequently, it was characterized using a polyphasic taxonomic approach. It was found to be oxidase and catalase positive, its cells are cocci to short rods, it does not ferment carbohydrates and does not reduce nitrate to nitrite or gas and it requires at least 2.5% (w/v) marine salts and tolerates up to 7% (w/v) salts. Its major cellular fatty acids in order of abundance are C-16:1 omega 7c/C-16:1 omega 6c,C-18:1 omega 7c(1), C-16:0 and C-10:0 3-OH. Its genome had an approximate length of 5.1 million bases and a DNA G+C content equal to 40.9 mol%. Analysis of the annotated genes reveals the capacity for the synthesis of ubiquinone 8 (O8) and the polar lipids phosphatidylglycerol and phosphatidylethanolannine, in agreement with other members of the genus. All the data collected supported the creation of a novel species to accommodate this bacterium, for which the name Marinomonas blandensis sp. nov. is proposed. The type strain is MED121(T) (=CECT 7076(T)=LMG 29722(T)).

  • 304.
    Archer, Trevor
    et al.
    University of Gothenburg.
    Lindahl, Mats
    Linnaeus University, Faculty of Health and Life Sciences, Department of Chemistry and Biomedical Sciences.
    Physical exercise to determine resilience: Hormesic processes arising from physiologic perturbation2019In: Journal of Public Health and General Medicine, Vol. 1, no 1, p. 1-10Article in journal (Refereed)
    Abstract [en]

    The propensity for regular and repeated physical exercise to induce and maintain ahormesic effect upon health parameters over a broad range of disorder conditions through the progression of resilience to neurodegenerative disorders, diabetes, stroke, sarcopenia, osteopenia, immunosenescence, and metabolic syndrome has been examined. Beyond the alleviation fragility, fatigue, stress-distress and selective vulnerability perturbations induced by different forms of physical exercise may induce hormesis and/or autophagy, through the disruption of homeostasis and manifestation of adaptive responses, to instigate multi-layered resilience. The hormesis challenges, accomplished through daily exercise, the promotion of resilience at molecular, cellular, tissue, e.g. muscle, and organ, e.g. brain, immune-functioning, bone material, physiological and behaviour-expressive levels, have been observed both from pathophysiological and etiogenetic dimensions. Regular exercise over extended periods (optimally years and decades, preferably lifelong) is expected to shift the inverted-U shaped hormesis curve to the right thereby conferred resistance to disease and ill-being and ensuring strength and health advantages. It seems likely that chronic, regular exercise, consisting of suitable proportions of endurance and resistance type, performed daily over months, years or decades ought to instigate some manner of ‘behavioural sensitization’ whereby the health benefits of equivalent levels of exercise escalate incrementally.

  • 305.
    Arczykowska, Edyta
    Linnaeus University, Faculty of Health and Life Sciences, Department of Chemistry and Biomedical Sciences.
    Effekter av probiotika vid hypolaktasi och laktosintolerans2019Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Laktos maldigestion är ett vanligt förekommande tillstånd hos mer än 75 procent av den vuxna befolkningen runt om i världen. Hypolaktasi innebär en minskad laktosnedbrytning på grund av en otillräcklig mängd av enzymet laktas. Laktosintolerans känneteckas av gastrointestinala symtom efter intag av laktosinnehållande produkt. Probiotika definieras som levande bakteriekultur och andra mikroorganismer, som i adekvata mängder har en hälsosam effekt hos en värd. Probiotika utgör en del av människans bakterieflora och har i flera studier uppvisat positiva egenskaper på människans mag-tarmhälsa och immunsystem. Syfte: Föreliggande litteraturstudie utvärderar effekten av probiotika vid hypolaktasi och laktosintolerans. Metod: Arbetet inkluderar sju vetenskapliga artiklar som utvärderar effekten av probiotika hos laktosintoleranta individer. Artiklarna erhölls från databasen Pubmed och sökningarna gjordes mellan september 2018 och februari 2019. Resultat: En sammanställning av studiernas resultat har visat på varierande grader av probiotikas effektivitet. I samtliga studier användes probiotika som ett enda behandlingsalternativ av laktos maldigestion. Metoden som användes vid bestämning av graden av intolerans i studierna, var ett laktosbelastningstest följt av utandningstest som är de vanligaste metoderna vid diagnostisering av hypolaktasi  och laktosintolerans. Probiotiska stammar som användes i försöken var olika stammar från Lactobacillus- (L. acidophilus, L. reuteri) och Bifidobakteriefamiljen (B. longum, B. animalis). I fyra av sju studier uppvisade probiotika en statistiskt säkerställd skillnad hos någon eller några av variabler som studerades. En minskning av vätekoncentrationen i utandningsluften efter probiotika tillskott kunde påvisas i tre granskade studierna. En minskning av gastrointestinala symtom så som diarré och flatulens registrerades i fyra av sju studier. Slutsats: En positiv relation har kunnat påvisas mellan probiotiska stammar och hypolaktasi. Regelbundet intag av produkter berikade med probiotika, kan minska symtom så som diarré och flatulens hos laktosintoleranta patienter. Det finns dock fortfarande för lite kunskap kring ämnet för att kunna rekommendera probiotika som ett enda behandlingsalternativ vid hypolaktasi. Det krävs mer forskning med fokus på de specifika probiotiska stammarna, dess ursprung och den adekvata dosen. Probiotika bör dock utan tvekan rekommenderas som ett komplement till behandlingen med enzymet laktas.

  • 306.
    Areda, Martha
    Linnaeus University, Faculty of Health and Life Sciences, Department of Chemistry and Biomedical Sciences.
    The role of omega-3 fatty acids in the treatment of schizophrenia through modification of membrane phospholipids2016Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Ever since the emergence of the hypothesis that linked the aetiology of schizophrenia with abnormal membrane phospholipids composition, an increasing number of evidences have suggested reduced membrane polyunsaturated fatty acids in patients with schizophrenia. This has led to a conduct of several studies to evaluate the efficacy of omega-3 fatty acid supplement in the modification of membrane phospholipids and treatment of schizophrenia. The two main omega-3 fatty acid classes, EPA and DHA, play a vital role in membranes. This project work reviews omega-3 fatty acid studies and summarizes their outcomes. Eight original articles (nine studies) were reviewed. Six out of nine studies measured RBC membrane fatty acids levels and all six studies reported a significant increase in EPA after EPA supplement. Two studies reported increased DHA post omega-3 fatty acid and DHA supplement, respectively. One study observed a dose-dependent increment in DHA after EPA supplement. Improved symptoms were observed in seven studies, while one study found a worsening of symptoms in patients with low baseline PUFA. Moreover, out of the six studies that evaluated the correlation between symptom change and membrane fatty acids change, three studies observed a correlation between increased EPA and symptom improvement. One study reported an increased AA associated with improved symptoms, in contrast to another study, which found a correlation between increased AA and worsened symptoms. The conclusion from this project work is that EPA supplement can increase the EPA levels in membranes; however, its therapeutic effect in schizophrenia requires further investigation using larger studies.

  • 307.
    Areskoug, Henrik
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Psychology.
    Olofsson, Lina
    Linnaeus University, Faculty of Health and Life Sciences, Department of Psychology.
    Sociala Mediers skeva bild av verkligheten och dess konsekvenser.: En korrelationsstudie mellan gymnasieelevers användande av Sociala Medier, Social jämförelse och Självkänsla2016Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    The purpose of this study was to investigate the association between Social Media use, Self-esteem and Social Comparison. Questionnaires were distributed to 127 pupils at a school in southern Sweden. Students were asked to answer questions about the use of social media and assess their self-esteem based on Rosenberg self-esteem scale and their perceived level of social comparison that was based on a shortened version (Schneider & Schupp, 2013) of the Iowa-Netherlands Comparison Orientation Measure (Buunk & Gibbons, 1999 ). The results showed significant relationships, and also gender differences in the use of social media, social comparison and self-esteem. The study showed that students who spent more time on social media and had greater social comparison tended to have lower self-esteem. Women also tended to spend more time on social media, have greater social comparison and lower levels of self-esteem than men. The study confirmed Findahl och Davidsson (2015), showing that social media is increasing, but that the activity decreases. Students tended to only post positive events or images on Selfies and friends as well as images edited. This could contribute to a serious distortion that can lead to negative effects (such as lower self-esteem). Given the results, we propose that future studies focus on in-depth research about social media impact on our wellbeing and how modern social comparison works.

  • 308.
    Arildsson, Mathilda
    Linnaeus University, Faculty of Health and Life Sciences, Department of Chemistry and Biomedical Sciences.
    Har ketamin effekt mot terapiresistent depression?2019Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Depression is a syndrome characterized by depressed mood, loss of interest and energy, feelings of guilt or worthlessness and thoughts of death and suicide. Over 300 million people suffer from depression and it is one of the leading causes of disability in the world.

    Today’s treatment for depression includes psychological treatment as well as pharmacological treatment. While there are many antidepressant drugs, it can take up to weeks or even months before a clinical effect in the severity of the depression can be noticed. In addition, one third of the patients do not achieve remission. These patients, after treatment with two antidepressant medications given at adequate doses for an adequate duration, are considered to have treatment-resistant depression (TRD).

    Ketamine is a drug long used for its anesthetic and analgesic effects, but it is also known as a party-drug that can cause out-of-body experience. However, it has also been found that a single-dose ketamine may give people with TRD a rapid antidepressant effect, within 24 hours. In contrast to current antidepressant medications which primarily acts on the monoaminergic system, ketamine instead acts on the glutamatergic system.

    The aim of this study was to evaluate if ketamine has an effect on people suffering from TRD.

    This study is a literature review where five randomized controlled trials on the effect of ketamine in patients with TRD have been analyzed. Four studies evaluated the effect of intravenous ketamine where one of them used a varied dose frequency and one of them used esketamine in various doses. The fifth study evaluated the effect of intranasal administration of ketamine. All studies were found in the database PubMed.

    The overall result shows that ketamine has an effect on TRD. After 24 hours all the studies showed a significant improvement in the severity of the depression with ketamine treatment compared to placebo (p <0.05). Ketamine treatment resulted in a 7-16 points larger reduction in depressive symptoms on the scales used compared to placebo. This represents on average a change from severe/moderately severe depression to mild depression. There was also a significant difference in response (at least 50 % reduction in points from baseline on the scale used) after 24 hours with ketamine treatment compared to placebo (p <0.05). The proportion of ketamine treated patients with response varied between 44-71 % compared to 0-6 % for placebo and 28 % for active placebo (midazolam).

    Even though ketamine seems to have an effect on patients with TRD there is still limited knowledge of how the antidepressant effect shall be maintained and the safety of long-term use. Further studies are needed to determine if ketamine will be an option in future antidepressant treatment against TRD.

  • 309.
    Arndt, Corinna
    Linnaeus University, Faculty of Health and Life Sciences, Department of Chemistry and Biomedical Sciences.
    Försäljning och förskrivning av antidepressiva läkemedel ur genusperspektiv.2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    In Sweden as well as in other countries women are consuming more health care and medicinal drugs than men. Partly, this difference can be explained by disease panorama and prescription of contraceptive pills. Biological and sociological factors may have an influence in cases of depression and GAD. Also, gender bias, a twisted view and prejudice concerning gender or sex, is thought to play a part. Among adults the depression prevalence rate ranges from 5% to 8%, and it increases to around 13% among elderly people. The lifetime risk of being effected by GAD is around 8% and the one-year prevalence rate ranges from 1.6% to 3.1%.

    The purpose of this study is to examine the sale/prescription of antidepressants from a gender perspective. Who prescribes the drugs? Are some drugs preferred to others, and are there geographical, age-related or economical differences between the sexes regarding prescriptions of antidepressants?

    Information about the type and the extent of the sale of antidepressants has been obtained from The National Board of Health and Welfare and The Medicine Unit (Läkemedelsenheten) in Kronoberg County.

    In 2015 more then 900.000 people bought antidepressants in Sweden. In Kronoberg (G County) 18.700 people bought antidepressants, 12.9% of them were women and 6.8% men. The sale in G County is slightly higher than in the rest of the country. The purchase among women increases relatively more than among men until menopause, after which the difference in purchase is stabilized. Almost 40% of the women and one of every four men purchase antidepressants in the highest ages. Counting in terms of DDD, women in G County are buying 1.87 times bigger volumes of antidepressants than men, of which 70% are prescribed at health centers, 14% in the mental health care area and the rest mainly by doctors working at hospitals. A small geographical difference can be seen between the counties in Sweden (+/- 5%). Within each county the prescription difference between men and women is small. Two drugs, sertraline (29%) and citalopram (19%), make up about half the volume. In the mental health care area slightly larger volumes of venlafaxine and duloxetine are prescribed to women compared to men. Men are prescribed somewhat more of fluoxetin. Relatively more women (65%) are treated for depression in primary care than in psychiatric care (59%). In primary care, women are prescribed relatively more Duloxetine. No difference in cost (pharmacy sales price (PSP)) per DDD can be observed between the sexes.

    Conclusion: Approx. 10% of the Swedish population bought antidepressants in 2015. Two times more women than men are purchase antidepressants. There is no definite answer to what is causing this difference. Can it be caused by overconsumption among women, or inadequate treatment among men? The greater part of antidepressants is prescribed in out-patient care, which indicates that antidepressants are used mainly in cases of less noticeable anxiety symptoms and mild to moderate depression. According to The Swedish Board of Health and Welfare these cases should foremost be treated with CBT.

  • 310.
    Arneson, Sofia
    Linnaeus University, Faculty of Health and Life Sciences, Department of Biology and Environmental Science.
    Att motverka dehydrering hos äldre i teori och praktik2015Independent thesis Basic level (degree of Bachelor), 180 HE creditsStudent thesis
    Abstract [en]

    Objective: To identify similarities and differences in methods and aids used to prevent dehydraton in the elderly as identified from the scientific literature and from interviews with caretakers.

    Method: Literature studies was performed through the University Library search service ”OneSearch” and further from references in key papers. Three interviews were conducted on nursing assistants in two retirement homes and home care services, to offer some insight into the practical activities.

    Results : The following factors were identified as important in both literature and interviews: (1) knowledge of the elderly through documentation, (2) adapted approach when serving drinks after the elderly person's preferences and condition, (3) a homely environment with social interactions, (4) assessments of fluid intake, fluid balance and risk factors through attention, fluid registration and with the help of several other professional groups, and given the history of the elderly, (5) reminders for dementia and a accessibility of large amount of easily absorbed beverages consumed gradually during diarrhea and vomiting, (6) easy-to-use and specially designed drinking aids. For the following factors differences were obeserved between literature survey and interviews: (1) education for caregivers; limited to the investigated sites, (2) technical aids and swallowing therapy (dietary modifications, adapted head positions, swallowing training) in dysphagia; diet modification is used at the investigated sites (3) the importance of cup and jug colours; blue cups used in practice, no support in literature.

    Conclusions: Differences were found in terms of education and the use of swallowing therapy, assistive technology and infusions. Education, more frequent fluid registration and a complete swallowing therapy are improvement opportunites, some of them requires extra resources and/or clear guidelines. Acceptance of technical aids is not self-evident. Investigation of the effect of cup color and design that can encourage the elderly to drink could potentially be a way forward. The results of the interviews are not generalizable because they only aimed to give an insight into the practical activities. Most of the strategies that have been identified are "soft" in nature. It is difficult to get a clear picture of the efficiency of different methods. Methods that have been evaluated with good results in dysphagia and therefore offer potential to improve liquid intake, are swallowing therapy and stimulation of swallowing musculature.

  • 311.
    Arnesson, Kerstin
    et al.
    Linnaeus University, Faculty of Social Sciences, Department of Social Work.
    Albinsson, Gunilla
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Mentorship – a pedagogical method for integration of theory and practice in higher education2017In: Nordic Journal of Studies in Educational Policy, ISSN 2002-0317, Vol. 3, no 3, p. 202-217Article in journal (Refereed)
    Abstract [en]

    Mentorship is a method that is used in both professional education and training and inworking life to introduce new employees. Previous research has shown that there is limitedexperience of mentorship in the parts of higher education that are outside of professionaleducation and training. The purpose of this article is to deepen knowledge of how mentorshipcan be used as a pedagogic tool to integrate theory and practice in a social scienceprogramme at a Swedish university. The empirical material is obtained from a case study thatincludes students/mentees and contact persons/mentors. The results show that mentorship isan important contribution to the learning process for the integration of theory and practice inhigher education to develop both practically applied and theoretically anchored knowledge.Besides cooperation forms and workplace-related studies in the programme, mentorship thusbecomes the third component of the learning process.

  • 312.
    Arnesson, Kerstin
    et al.
    Linnaeus University, Faculty of Social Sciences, Department of Social Work.
    Albinsson, Gunilla
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Reflecting talks: a pedagogical model in the learning organization2019In: Reflective Practice, ISSN 1462-3943, E-ISSN 1470-1103, Vol. 20, no 2, p. 234-249Article in journal (Refereed)
    Abstract [en]

    The aim of the article is to deepen the understanding of how a pedagogical model for reflecting talks can be used in order to make sustainable learning part of the daily work in the learning organization. From an interactive research approach, we have together with a project management group in a European Social Fund project worked with sustainable learning and knowledge development. Empirical data has been collected at the implementation of ten reflecting talks about sustainable equality. The results of the study lead to a strategy for how sustainable learning can become part of the daily work at a workplace. The strategy is constituted by a pedagogical model for reflecting talks, which clearly shows how sustainable learning in an organization can be structured. The core of the pedagogical model for the reflecting talks where both practically applied and theoretically anchored knowledge are important components. The learning process is based on observation, reflection, analysis and discussion of concrete situations/events. The models rests on four basic conditions; pedagogical competence, a delimited problem area, the learning group and timeframes. The model can be used in the daily work at short dialogues or at more penetrating discussions.

  • 313.
    Arnesson, Thomas
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Rundberg, Tobias
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    När det inte blev som det var tänkt: Svenska föräldrars upplevelse av att leva med ett barn med autism.2016Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Autism är en gammal diagnos som de senaste hundra åren genomgått flera förändringar. Även på senare år förändras diagnosen men grundproblematiken för individens och dess omgivning är den samma. Ett barn med autism påverkar hela familjen.

    Syfte: Syftet var att undersöka hur svenska föräldrar till barn med autism upplever familjens livssituation och hur den påverkas av barnets problematik.

    Metod: Studien genomfördes med en kvalitativ ansats baserad på fem självbiografier skrivna av föräldrar till barn med autism. Innehållet i självbiografierna analyserades med hjälp av en kvalitativ manifest innehållsanalys.

    Resultat: Två huvudkategorier framkom efter analysprocessen, Föräldrarnas känslor och Påverkan på vardagen, samt 14 underkategorier. Omgivningen kring barnet berörs i stor utsträckning. Föräldrarna påverkas både när det gäller deras känsloliv och de får se sin vardag förändras. Syskon till barn med autism får inte lika mycket uppmärksamhet som sitt syskon utan får i stor utsträckning klara sig själva.  

    Slutsats: Ett barn med autism påverkar hela familjen på ett eller annat sätt. En annan viktig del som kommit fram i föreliggande studie var behovet av ytterligare insatser och stöd från samhället. Föräldrarna känner ofta att de får klara sig själva och inte får den hjälp de behöver.

  • 314.
    Arnholm, Petra
    Linnaeus University, Faculty of Health and Life Sciences, Department of Psychology.
    Stress hos föräldrar till barn med särskilda behov: En enkätstudie av upplevd stress2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 315.
    Aronsson, Edvin
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Broman, Robin
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    UPPLEVELSER AV INTRODUKTIONSTIDEN FÖR NYUTEXAMINERADE SJUKSKÖTERSKOR: En studie baserad på förbättringsarbeten2015Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 316.
    Aronsson, Josefina
    Linnaeus University, Faculty of Health and Life Sciences, Department of Biology and Environmental Science.
    Den småskaliga vattenkraftens framtid: En övergripande studie för Sverige samt en fallstudie i Lyckebyån2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    The objective of this bachelor's thesis was to get knowledge concerning the trend of small scale hydropower plants and the possibility according the present legislation to use small scale hydropower as energy source in Sweden. The result aims also to conclude if it is possible to get permission for small scale hydropower stations at the river Lyckebyån.

     

    To achieve this, ten legal cases where five of them have been permitted and five of them has been denied license have been examined. These cases were dated between 2010-2016. These have been analyzed from given questions. They may describe the trend of small scale hydropower in Sweden. To examine the cases at Lyckebyån different sources were used, such as literature studies, interviews and by using information from different databases.

     

    The results shows that it is possible to get permission for small scale hydropower production in Sweden today, but it is a complicated process and the result of the probation depends on many factors. The legislation sets high standards and there exist conflicting interests which are against small scale hydropower stations due to their effects on biodiversity. There are both positive and negative environmental consequences of hydropower production at Lyckebyån. However, there are no evident obstacles for permission in Lyckebyån.  

  • 317.
    Aronsson, Sofie
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Hultgren, Kaisa
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Gestationsdiabetes: en journalgranskningsstudie2013Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
  • 318.
    Arosenius, Lisa
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Vad föräldrar anser om bildstöd som preoperativ information till barn: En enkätstudie2019Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Using the right preoperative information for the right patient is of the utmost importance for the patient to feel involved in their own care. In the operation of children, it is also important that the information is reached and understood by both the child and its parents. Purpose: The purpose of this study was to investigate how parents of the children who are operated under anesthesia find that the preoperative information in the form of an picture sheet works and if there is a difference between younger and older children. Method: The study has a quantitative approach where a questionnaire was distributed to parents whose children have undergone anesthesia for a period of six weeks. The selection was all parents (one per child) to children aged 1-10 years. The families in need of an interpreter were excluded from the study. The questionnaires responses have been analyzed in the statistics program SPSS and are reported both as tables and text. The open question has been analyzed through content analysis. Result: The parents felt that their children understood and were helped by the picture sheet. Even they themselves felt that they had benefited from it. It created security and participation. The older children understood the information better than the younger children. Conclusion: Using a picture sheet, which where sent both home and then used during the day, creates security and participation among parents and children.

  • 319.
    Arslanovic, Medina
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Seppälä, Caiyun
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Livet efter ett hjärtstopp: En litteraturstudie om patienters upplevelser efter att ha överlevt ett hjärtstopp2019Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Varje år drabbas cirka 10 000 personer av ett hjärtstopp i Sverige. Allt fler överlever ett hjärtstopp idag eftersom allt fler personer utbildar sig inom hjärt-lungräddning (HLR). Patientens livsvärld och den levda kroppen förändras efter ett hjärtstopp. Teoretisk referensram: KASAM-känsla av sammanhang. Antonovsky (1991) beskrev tre viktiga komponenter: begriplighet, hanterbarhet och meningsfullhet. Tillsammans beskriver det hur patienten upplever känsla av sammanhang. Problemformulering: Det är viktigt att sjuksköterskan har förståelse om patientens situation. Bristande förståelse kan leda till negativa konsekvenser vilket kan resultera till att återhämtningen för patienten blir försämrad. Syfte: Syftet med litteraturstudien var att beskriva patienters upplevelser efter att ha överlevt ett hjärtstopp. Metod: Den valda metoden till studien innefattar både kvalitativ och kvantitativ forskning. Resultatet: Patienterna upplevde livsstilsförändringar efter hjärtstoppet. Behovet av stöd och information från vårdpersonal och anhöriga var viktigt för patienten för återhämtningen efter hjärtstoppet. Emotionella känslor uppkom som inte fanns innan och patienterna såg livet ur ett nytt perspektiv. Psykiska förändringar uppstod samt kognitiva vilket resulterade till ett förändrat liv. Slutsats: Kunskapen om hjärtstopp ökar idag allt mer eftersom fler drabbas vilket medför till att upplivning sker på ett säkrare sätt. Sjuksköterskan behöver lägga en stor vikt vid att förstå hur en patient livsvärld är för att kunna ge det stöd och information som just den patienten behöver. Genom det kommer patienten uppleva känsla av sammanhang.

  • 320.
    Arthur, Edmund
    et al.
    Indiana University, USA.
    Young, Stuart B.
    Baskaran, Karthikeyan
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Elsner, Ann E.
    Muller, Matthew S.
    Gast, Thomas J.
    Haggerty, Bryan P.
    Clark, Christopher A.
    Brahm, Shane
    Litvin, Taras V.
    Ozawa, Glen Y.
    Cuadros, Jorge
    Individual Retinal Layer Thickness in Diabetic Patients with Clinically Significant Macular Edema: A Gender Based Analysis2016Conference paper (Refereed)
    Abstract [en]

    Purpose: To compare segmented retinal layer thicknesses between male and female diabetics with clinically significant macular edema (CSME). This study expands our earlier analysis of central macular thickness (CMT) measurements in diabetic males vs. females. Methods: Diabetic retinopathy screening of 2080 diabetics from Alameda County, CA, indicated 142 patients with CSME, as judged by EyePACS certified graders using color fundus images (Canon CR6-45NM). Of the 2080 diabetics, 1784 were imaged with SD-OCT (Optovue iVue). From the 142 patients, we selected 11 males with good fixation, CMT > 300 µm, and no other ocular complications, along with 11 females with the greatest values of CMT while controlling for age, HbA1c and diabetes duration. Manual segmentation of retinal layers using custom software (Mathworks Matlab) of the SD-OCT images of these subjects was done. We analyzed thicknesses for regions 1 deg - 2 deg for nasal and temporal retina in a B-scan centered on the fovea. A 2 X 2 ANOVA probed the differences in thickness for gender, meridian, and their interaction. We also analyzed the central 1 mm of the outer retinal layers, and performed t-tests. Results: Males had significantly thicker nerve fiber layer (NFL) (13.30 ± 2.85 µm) than females (10.13 ± 6.13 µm) and ganglion cell layer-inner plexiform layer (GCL-IPL) (62.54 ± 21.18 µm) than females (48.07 ± 25.91 µm), p < 0.05. There was no effect of meridian and no interaction (p > 0.05). All other layers except the retinal pigment epithelium (RPE) were thicker for males than females even though these were not significant (p > 0.05). There were no significant differences for the layers of the outer retina, which were highly variable and distorted by cysts. Conclusion: Outside the fovea, NFL and GCL-IPL thicknesses were significantly higher in males than females.

  • 321.
    Arthur, Edmund
    et al.
    Indiana University, USA.
    Young, Stuart B.
    Bowersox Vision Center, Shelbyville, USA.
    Elsner, Ann E.
    Indiana University, USA.
    Baskaran, Karthikeyan
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Papay, Joel A.
    Indiana University, USA.
    Muller, Matthew S.
    Aeon Imaging, LLC, Bloomington, USA.
    Gast, Thomas J.
    Indiana University, USA;Aeon Imaging, LLC, Bloomington, USA.
    Haggerty, Bryan P.
    Indiana University, USA.
    Clark, Christopher A.
    Indiana University, USA.
    Malinovsky, Victor E.
    Indiana University, USA.
    Brahm, Shane G.
    Peter Christensen Health Center, Lac Du Flambeau, USA.
    Litvin, Taras V.
    University of California, USA.
    Ozawa, Glen Y.
    University of California Berkeley, USA.
    Cuadros, Jorge A.
    University of California Berkeley, USA.
    Central Macular Thickness in Diabetic Patients: A Sex-based Analysis2019In: Optometry and Vision Science, ISSN 1040-5488, E-ISSN 1538-9235, Vol. 96, no 4, p. 266-275Article in journal (Refereed)
    Abstract [en]

    SIGNIFICANCE The pathological changes in clinically significant diabetic macular edema lead to greater retinal thickening in men than in women. Therefore, male sex should be considered a potential risk factor for identifying individuals with the most severe pathological changes. Understanding this excessive retinal thickening in men may help preserve vision. PURPOSE The purpose of this study was to investigate the sex differences in retinal thickness in diabetic patients. We tested whether men with clinically significant macular edema had even greater central macular thickness than expected from sex differences without significant pathological changes. This study also aimed to determine which retinal layers contribute to abnormal retinal thickness. METHODS From 2047 underserved adult diabetic patients from Alameda County, CA, 142 patients with clinically significant macular edema were identified by EyePACS-certified graders using color fundus images (Canon CR6-45NM). First, central macular thickness from spectral domain optical coherence tomography (iVue; Optovue Inc.) was compared in 21 men versus 21 women without clinically significant macular edema. Then, a planned comparison contrasted the greater values of central macular thickness in men versus women with clinically significant macular edema as compared with those without. Mean retinal thickness and variability of central macular layers were compared in men versus women. RESULTS Men without clinically significant macular edema had a 12-μm greater central macular thickness than did women (245 ± 21.3 and 233 ± 13.4 μm, respectively; t40 = −2.18, P = .04). Men with clinically significant macular edema had a 67-μm greater central macular thickness than did women (383 ± 48.7 and 316 ± 60.4 μm, P < .001); that is, men had 55 μm or more than five times more (t20 = 2.35, P = .02). In men, the outer-nuclear-layer thickness was more variable, F10,10 = 9.34. CONCLUSIONS Underserved diabetic men had thicker retinas than did women, exacerbated by clinically significant macular edema.

  • 322.
    Arvidson Svensson, Annie
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Johansson, Emma
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Självständighet förutsätter delaktighet: Perioperativa sjuksköterskors upplevelser av hur förståelse påverkar teamarbetet2017Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: In an operating theatre teamwork is important, partly to get the job done, but also to ensure patient safety. An important aspect of teamwork is that perioperative nurses feel that the other members of the team understand their work assignments. Aim: The aim of this study was to highlight perioperative nurses' experiences of teamwork based on an understanding of their work assignments. Method: A qualitative inductive interview study was conducted with 16 perioperative nurses from three small to medium-sized hospitals in southern Sweden. The data were analyzed based on a qualitative latent content analysis. Results: The study shows that there are several aspects that affect teamwork and nurses feel that although understanding of their work assignments from other team members usually are good, there are possibilities for improvement. The overall theme independence requires participation emerged from the result, as well as the categories profession, collaboration, work environment and patient safety with related subcategories. Conclusion: To give perioperative personnel an insight into what might facilitate teamwork can be beneficial.  Further research on the topic is required, but it is also important that schools and workplaces practice teamwork to increase knowledge and understanding between different professions.

  • 323.
    Arvidsson & Färm, Hanna, Jennifer
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Upplevelsen av att leva med depression: En litteraturstudie2014Independent thesis Basic level (degree of Bachelor), 15 credits / 22,5 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Depression kan drabba alla ålderskategorier vilket gör den till en av de mer vanligt förekommande och kostsamma sjukdomarna i världen. Deprimerade personer vänder sig i allmänhet till primärvården vilket ställer krav på sjuksköterskans kunskap och bemötande. Tidigare forskning lyfter fram behandlingsalternativ framför hur det upplevs att leva med depression. Därför behövs mer kunskap om upplevelsen.

    Syfte: Syftet för studien var att undersöka upplevelsen av att leva med depression.

    Metod: En litteraturstudie baserad på tio vetenskapliga artiklar med en kvalitativ ansats och ett induktivt tänkande som utgångspunkt. Studien analyserades utifrån en kvalitativ manifest innehållsanalys.

    Resultat: Ett övergripande tema och fyra subteman identifierades i studien. I resultatet framkom att personer oavsett ålder och kön upplevde depression i samma utsträckning. Det övergripande temat beskrev att personer upplevde en vilsenhet i samband med depressionen. Vilsenheten delades in i subteman där personer upplevde sig inte förstå vad som hade hänt, upplevde social isolering, upplevde en förändrad identitet och att befinna sig i ett djup.

    Slutsats: Resultatets variation av upplevelser tyder på att sjuksköterskan behöver ha ett patientperspektiv i fokus där den unika personens upplevelser av livsvärlden sätts i centrum för att främja hälsoprocessen.

  • 324.
    Arvidsson, Emma
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Skiljer sig blinkfrekvensen vid läsning på olika medier?2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Purpose: The purpose of this study was to evaluate whether Spontaneous Eye Blink Rate (SEBR) differ when reading on hard copy, tablet or smartphone. Complete and incomplete blinks were also evaluated to see if there were any differences regarding the hard copy, tablet and smartphone. 

    Methods: The participants read three different texts on hard copy, tablet and smartphone while they were being filmed. Afterwards, each video was analysed twice in order to count complete blinks, incomplete blinks and total blink rate (SEBR).

    Results: This study showed that there is a significant difference in total blink rate between reading on hard copy and tablet (p=0.03), where blinks/minute decreased by 14.9% for the hard copy condition. There was also a significant difference in incomplete blinks regarding the two devices (p=0.02), where incomplete blinks increased by 30.0% when reading on tablet. Tablet and smartphone reading also resulted in a significant difference, where incomplete blinks increased  by 42% when reading on tablet (p=0.01).

    Conclusion: Spontaneous Eye Blink Rate differ when reading on hard copy and tablet. Incomplete blinks increase when reading on tablet. No significant differences are found between hard copy and smartphone.

  • 325.
    Arvidsson, Jesper
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Psychology.
    Bergs, Anna
    Linnaeus University, Faculty of Health and Life Sciences, Department of Psychology.
    Utmattningssyndrom - En livslång resa?: En kvalitativ studie om kvinnors upplevelser av att (försöka)bli friska från utmattningssyndrom2020Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    This study aimed to gain a better understanding of how women suffering from burnout syndrome may experience trying to recover and what they consider significant for recovery. A qualitative method was applied, where seven women participated in semi-structured interviews, after which thematic content analysis was conducted. The analysis resulted in two overarching themes; Lifelong adaptation and Understanding and support. To get well after burnout is a long and complex process where recovery started with insight and acceptance and it was questioned whether someone with burnout would  ever completely recover. The informants stated that they would never be the same as they were before, and that they will have to work with adaptations and strategies for the rest of their lives. The responsibility to recover and stay well lied in their own hands although understanding, support and help at the right time from healthcare, therapists, work, family and friends were also needed.

  • 326.
    Arvidsson, Johanna
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Einar, Emma
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Sjuksköterskors erfarenheter av att vårda patienter med depression inom psykiatrisk slutenvård2017Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Depression är en av de vanligaste orsakerna till ohälsa världen över. Sjuksköterskor inom psykiatrisk vård har en viktig roll i arbetet för att främja patientens hälsa. Forskning visar att sjuksköterskan upplever svårigheter i sitt arbete med patienter med depression. Dessa svårigheter är bland annat att öppna upp och möta patientens lidande, då kontakten med den deprimerade patienten kan upplevas tung och svår att hantera.

    Syfte: Studiens syfte var att belysa sjuksköterskors erfarenheter av att vårda patienter med depression inom psykiatrisk slutenvård.

    Metod: Studien genomfördes utifrån en kvalitativ metod med induktiv ansats. Urvalet till studien skedde ändamålsenligt hos sjuksköterskor inom sluten psykiatrisk specialistvård och data samlades in genom kvalitativa intervjuer. Dataanalys genomfördes i enlighet med en kvalitativ innehållsanalys.

    Resultat: Resultatet presenteras i två huvudkategorier; Ljuset i vården av deprimerade patienter samt Mörkret i vården av deprimerade patienter. Ljuset i vården bildade underkategorierna; En patientgrupp som ofta tillfrisknar, Att medverka till tillfrisknande, Att ge god omvårdnad och Att arbeta i team. Mörkret i vården bildade underkategorierna; Tillkortakommanden i vården av deprimerade patienter och Möten med meningslöshet.

    Slutsats: Sjuksköterskor ansåg att deprimerade patienter är en patientgrupp som är intressant och hoppfull att vårda. Däremot möter sjuksköterskorna flera utmaningar i sitt arbete med deprimerade patienter inom psykiatisk slutenvård. Centrala verktyg för att kunna hantera sina egna känslor som uppkommer i arbetet samt att kunna medverka till tillfrisknande hos patienterna är utbildning, handledning och kollegialt stöd. 

  • 327.
    Arvidsson, My
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Alfson, Elin
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Att leva med en långvarig psykossjukdom: En kvalitativ litteraturstudie baserad på självbiografier2019Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Varje år insjuknar ca 1000 personer i en långvarig psykossjukdom. Sjukdomen kan ge symtom som vanföreställningar, hörsel- och synhallucinationer, apati och viljelöshet. Sjuksköterskan är en stor del av livet för en person med långvarig psykossjukdom och måste därför vara medveten om sin vårdande hållning.

    Syfte: Syftet var att öka förståelsen om hur det är att leva med en långvarig psykossjukdom utifrån ett livsvärldsperspektiv.

    Metod: Studien är en kvalitativ litteraturstudie baserad på fem självbiografier. Datainsamlingen utgick från studiens syfte samt exklusion- och inklusionskriterierna för att finna självbiografierna. Analysprocessen genomfördes med en manifest innehållsanalys som resulterade i femton underkategorier och tre kategorier: Sjukdomen styr livet, En trygg men frustrerande plats att bli vårdad och Framtiden skräms.

    Resultat: Sjukdomen styr personens liv på ett ofta skrämmande och befallande sätt. Vården kan vara en trygg men också en frustrerande plats att vistas på i långa perioder. Vägen mot att bli “frisk” kan ses som avlägsen och skrämmande då rollen som patient med en långvarig psykossjukdom är bekant och invand. 

    Slutsats: Stigmatisering påverkar tillfrisknandet negativt och kan ge ett lägre självförtroende hos patienterna. En individuell vårdplan tros kunna öka patienternas välbefinnande och stärka tillfrisknandet då patienterna upplever sig mer sedda och hörda av vården.

  • 328.
    Arvidsson, Sanna
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Eriksson, Ann
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Distriktssköterskans erfarenhet av stress i sitt arbete: - med fokus på moralisk stress2013Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Nurses think themselves to be stressed by time constraints and lack of resources. Moral distress arise out of dilemmas and these dilemmas emerge when there are limitations in the organization and conflicts between previous assessments and, contradicting thoughts about what can be done instead arise.

     

    Purpose: To examine the district nurse's experience of stress in their work on health center, focusing on moral distress.

     

    Method: A qualitative study with semi-structured interviews was conducted with eight district nurses and to analyze, manifest content analysis was used.

     

    Results: The district nurse´s experience stress in many different situations, lack of time and struggles with telephone counseling was the most prominent. The need for care is greater than there are doctor’s appointments and the district nurses cannot provide the care they desire. When meeting with patients, rules and procedures can be more obstructive than helpful, this often led to feelings of frustration and second guessing the right thing to do.

     

    Conclusion: District nurses experience stress, concern and frustration when there is too much workload, staff shortages, when times for doctors’ appointments are few and the communication between colleagues and patients is insufficient. The district nurses are facing these dilemmas because the rules and procedures in the organization prevent them from performing the care they desire. In other words, they are experiencing moral distress.

  • 329.
    Aschenbrenner, Andreas
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Gyllerfelt, Viktor
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Mäns upplevelser av att överleva en hjärtinfarkt: En litteraturstudie om hur män upplever sitt liv efter en hjärtinfarkt2015Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Hjärtinfarkt är en av vår tids vanligaste sjukdomar och står för 30 % av dödsfallen i Sverige. Av de som drabbas är 60 % män som efter en hjärtinfarkt står inför en stor omställning och kan uppleva det svårt att lita på sin kropp. Detta kan begränsa möjligheten till ett gott välbefinnande och återgång till ett normalt liv.

    Syfte: Syftet var att undersöka vilka faktorer som påverkar hur män upplever sitt liv efter en hjärtinfarkt.

    Metod: Kvalitativ litteraturstudie baserad på 10 vetenskapliga originalartiklar som analyserades med en manifest innehållsanalys.

    Resultat: Vid analysen framkom fyra huvudkategorier som beskrev mäns upplevelse efter en hjärtinfarkt; En omskakande händelse, Livet förändrades, Vägen tillbaka och Upplevelsen av vården.

    Slutsatser: Män kan erfara hjärtinfarkten på individuellt olika vis. För att återanpassa män till ett drägligt liv efter en hjärtinfarkt behövs mer resurser och kunskap då männen kan uppleva en nytillkommen rädsla för döden, förändrad identitet samt svårigheter att acceptera och anpassa sitt liv. Genom professionell hållning och omvårdnad med ett patientfokuserat möte kan den unika livsvärlden uppmärksammas, vårdlidandet minskas och välbefinnandet ökas.

  • 330.
    Asif, Sana
    et al.
    Uppsala University, Sweden.
    Asawa, Kenta
    Univ Tokyo, Japan.
    Inoue, Yuuki
    Univ Tokyo, Japan.
    Ishihara, Kazuhiko
    Univ Tokyo, Japan.
    Lindell, Björn
    Uppsala University, Sweden.
    Holmgren, Robin
    Uppsala University, Sweden.
    Nilsson, Bo
    Uppsala University, Sweden.
    Ryden, Anneli
    Swedish University of Agricultural Sciences, Sweden.
    Jensen-Waern, Marianne
    Swedish University of Agricultural Sciences, Sweden.
    Teramura, Yuji
    Uppsala University, Sweden;Univ Tokyo, Japan.
    Nilsson Ekdahl, Kristina
    Linnaeus University, Faculty of Health and Life Sciences, Department of Chemistry and Biomedical Sciences. Uppsala University, Sweden.
    Validation of an MPC Polymer Coating to Attenuate Surface-Induced Crosstalk between the Complement and Coagulation Systems in Whole Blood in In Vitro and In Vivo Models2019In: Macromolecular Bioscience, ISSN 1616-5187, E-ISSN 1616-5195, Vol. 19, no 5, article id 1800485Article in journal (Refereed)
    Abstract [en]

    Artificial surfaces that come into contact with blood induce an immediate activation of the cascade systems of the blood, leading to a thrombotic and/or inflammatory response that can eventually cause damage to the biomaterial or the patient, or to both. Heparin coating has been used to improve hemocompatibility, and another approach is 2-methacryloyloxyethyl phosphorylcholine (MPC)-based polymer coatings. Here, the aim is to evaluate the hemocompatibility of MPC polymer coating by studying the interactions with coagulation and complement systems using human blood in vitro model and pig in vivo model. The stability of the coatings is investigated in vitro and MPC polymer-coated catheters are tested in vivo by insertion into the external jugular vein of pigs to monitor the catheters' antithrombotic properties. There is no significant activation of platelets or of the coagulation and complement systems in the MPC polymer-coated one, which was superior in hemocompatibility to non-coated matrix surfaces. The protective effect of the MPC polymer coat does not decline after incubation in human plasma for up to 2 weeks. With MPC polymer-coated catheters, it is possible to easily draw blood from pig for 4 days in contrast to the case for non-coated catheters, in which substantial clotting is seen.

  • 331.
    Asif, Sana
    et al.
    Uppsala University.
    Jonsson, Nina
    Linnaeus University, Faculty of Health and Life Sciences, Department of Chemistry and Biomedical Sciences. Uppsala University.
    Teramura, Yuji
    Univ Tokyo, Japan.
    Gustafson, Elisabet
    Univ Uppsala Hosp.
    Nilsson Ekdahl, Kristina
    Linnaeus University, Faculty of Health and Life Sciences, Department of Chemistry and Biomedical Sciences. Uppsala University.
    Nilsson, Bo
    Uppsala University.
    Conjugation of human recombinant CD39 to primary human hepatocytes protects against thromboinflammation2015In: Xenotransplantation, ISSN 0908-665X, E-ISSN 1399-3089, Vol. 22, p. S87-S87Article in journal (Other academic)
  • 332.
    Asif, Sana
    et al.
    Uppsala University.
    Nilsson Ekdahl, Kristina
    Linnaeus University, Faculty of Health and Life Sciences, Department of Chemistry and Biomedical Sciences. Uppsala University.
    Fromell, Karin
    Uppsala University.
    Gustafson, Elisabet
    Uppsala University Hospital.
    Barbu, Andreea
    Uppsala University.
    Le Blanc, Katarina
    Karolinska Institutet;Karolinska University Hospital.
    Nilsson, Bo
    Uppsala University.
    Teramura, Yuji
    Uppsala University;The University of Tokyo, Japan.
    Heparinization of cell surfaces with short peptide-conjugated PEG-lipid regulates thromboinflammation in transplantation of human MSCs and hepatocytes2016In: Acta Biomaterialia, ISSN 1742-7061, E-ISSN 1878-7568, Vol. 35, p. 194-205Article in journal (Refereed)
    Abstract [en]

    Infusion of therapeutic cells into humans is associated with immune responses, including thromboinflammation, which result in a large loss of transplanted cells\ To address these problems, heparinization of the cell surfaces was achieved by a cell-surface modification technique using polyethylene glycol conjugated phospholipid (PEG-lipid) derivatives. A short heparin-binding peptide was conjugated to the PEG-lipid for immobilization of heparin conjugates on the surface of human mesenchymal stem cells (hMSCs) and human hepatocytes. Here three kinds of heparin-binding peptides were used for immobilizing heparin conjugates and examined for the antithrombogenic effects on the cell surface. The heparinized cells were incubated in human whole blood to evaluate their hemocompatibility by measuring blood parameters such as platelet count, coagulation markers, complement markers, and Factor Xa activity. We found that one of the heparin-binding peptides did not show cytotoxicity after the immobilization with heparin conjugates. The degree of binding of the heparin conjugates on the cell surface (analyzed by flow cytometer) depended on the ratio of the active peptide to control peptide. For both human MSCs and hepatocytes in whole-blood experiments, no platelet aggregation was seen in the heparin conjugate-immobilized cell group vs. the controls (non-coated cells or control peptide). Also, the levels of thrombin-antithrombin complex (TAT), C3a, and sC5b-9 were significantly lower than those of the controls, indicating a lower activation of coagulation and complement. Factor Xa analysis indicated that the heparin conjugate was still active on the cell surface at 24 h post-coating. It is possible to immobilize heparin conjugates onto hMSC and human hepatocyte surfaces and thereby protect the cell surfaces from damaging thromboinflammation. Statement of Signigficance We present a promising approach to enhance the biocompatibility of therapeutic cells. Here we used short peptide-conjugated PEG-lipid for cell surface modification and heparin conjugates for the coating of human hepatocytes and MSCs. We screened the short peptides to find higher affinity for heparinization of cell surface and performed hemocompatibility assay of heparinized human hepatocytes and human MSCs in human whole blood. Using heparin-binding peptide with higher affinity, not only coagulation activation but also complement activation was significantly suppressed. Thus, it was possible to protect human hepatocytes and human MSCs from the attack of thromboinflammatory activation, which can contribute to the improvement graft survival. (C) 2016 Acta Materialia Inc. Published by Elsevier Ltd. All rights reserved.

  • 333.
    Ask, Paulin
    Linnaeus University, Faculty of Health and Life Sciences, Department of Biology and Environmental Science.
    Regnvatten från hustak som resurs: Användning av takavrinningsvatten som resurs och kvalitetskriterier2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Flooding from rainwater in megacities around the world is a major problem which is growing even bigger with the scenarios that has been predicted by IPCC. The problem has to be taken care of somehow and one possible solution could be to use the water once it just hit the ground area. This study will show some of the opportunities we have to use runoff water from roofs with local solutions in Gothenburg and analyse quality differences of run off-water with raw water from the river Göta Älv, which today is used as drinking water in Gothenburg. Among some of the existing solutions for rainwater today, for example stone filter and trees, the result will show specifically one solution which is used at Stadsbyggnadskontoret in Gothenburg city center. The results of the run off-water show higher values of metals, nitrogen and phosphorus than Göta Älv and comparison between run off from green roof and run off from other roof materials shows lower values of the same chemical parameters. Since the values are taken from a report which contains schablon values, the results are just symbolic. A hypothetical calculation which shows that one year of estimated volume rainwater on a building example could provide for either 31 people/year total consumption or 100 people/year only for laundry and flushing toilets.

  • 334.
    Ask Persson, Louise
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Sandberg, Caroline
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Anhörigas erfarenheter av att närvara vid ett prehospitalt hjärtstopp hos en närstående2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: I Sverige påbörjades hjärt-lungräddning (HLR) på 5785 personer när ett prehospitalt hjärtstopp inträffade under 2017. Överlevnadschansen för dessa personer har ökat med ungefär 160% sedan år 2000 men ändå överlever endast cirka 600. Ett hjärtstopp bevittnas oftast av en anhörig. Det behövs kunskapsöversikter som belyser anhörigas erfarenheter, en kunskap som kan användas för att förbättra omhändertagandet av anhöriga.

    Syfte: Syftet var att beskriva anhörigas erfarenheter av att närvara vid ett prehospitalt hjärtstopp hos en närstående.

    Metod: En allmän litteraturöversikt har genomförts där åtta vetenskapliga artiklar identifierats och inkluderats. Av dessa var en kvantitativ, en både kvalitativ och kvantitativ och sex kvalitativa. Analysprocessen innebar att gå från helheten till delarna för att sedan skapa en ny helhet. Analysen är en sammanställning av åtta vetenskapliga artiklar.

    Resultat: Tre teman identifierades: Överväldigad av ansvaret att hantera situationen, Lättnad att lämna över ansvaret till ambulanspersonalen och Att närvara under HLR. Temana mynnade ut i sju undergrupper. Resultatet visade att de flesta anhöriga önskar att vara närvarande under HLR, att stöd från sjukvårdspersonalen var viktigt och att förmågan att starta HLR skiljde sig åt mellan de anhöriga.

    Slutsats: När ett prehospitalt hjärtstopp inträffar är det oftast de anhöriga som bevittnar händelsen. Att starta HLR i väntan på ambulansen kan oavsett om man har genomgått HLR-utbildning eller inte innebära kunskapsmässiga, fysiska och etiska utmaningar. Stöd och uppmuntran, information och svar på frågor underlättar för den anhörige såväl under pågående HLR som efteråt. Alla individer har olika behov av bekräftelse och det är därför viktigt att sjukvårdspersonalen ser till den enskilde individens behov.  De flesta anhöriga vill vara närvarande under HLR-behandlingen.

  • 335.
    Ask, Samuel
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. 9008250814.
    Olsson, Tobias
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Postoperativ smärtbehandling på sjukhus: Sjuksköterskor erfarenheter2015Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund

    Postoperativ smärta är ett återkommande fenomen trots mängden av tillgängliga behandlingsmetoder. Otillräcklig eller utebliven postoperativ smärtbehandling orsakar ett lindande för patienten och kan leda till komplikationer som gör vårdtiden längre än nödvändigt för patienten. Den förlängda vårdtiden orsakar ytterligare lidande för patienten.

    Syfte

    Att belysa sjuksköterskors erfarenheter av postoperativ smärtbehandling av patienter som vårdas på sjukhus.

    Metod

    En systematisk litteraturöversikt där 11 artiklar om sjuksköterskors erfarenheter om postoperativ smärtbehandling sammanställts. Sökningen utfördes i databaserna Cinahl, PubMed och PsycInfo.

    Resultat

    Två teman med två kategorier vardera framkom om sjuksköterskors erfarenheter av postoperativ smärtbehandling: Hindrande faktorer med kategorier Tidsperspektivets betydelse samt Hierarki i organisationen. Underlättande faktorer med kategorier Vårdrelation och Kunskap och Kompetens.

    Slutsats

    Tidsaspekten upplevdes som den mest övergripande hindrande faktorn för sjuksköterskor i den postoperativa smärtbehandlingen då det fanns flera orsaker som gjorde att tid försvann från själva behandlingen. En god mellanmänskligrelation mellan sjuksköterskor och patient upplevdes som den mest övergripande underlättande faktorn för sjuksköterskor arbete. 

  • 336.
    Asp, Malin
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Bengtsson, Emma
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Ambulanssjuksköterskors upplevelser av hjärt- och lungräddningsituationer med och utan LUCAS2016Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Varje år drabbas cirka 10 000 personer av hjärtstopp utanför sjukhus i Sverige, ungefär 4000 får behandling och cirka 300 överlever. Ett snabbt agerande och start av hjärt-och lungräddning (HLR) med en god kvalité kan öka patientens överlevnadschanser. Ambulanssjuksköterskorna utsätts för stora påfrestningar när de behöver fatta snabba beslut och behandla patienten på olika platser som kan brista i säkerhet i arbetsmiljön. Som ett hjälpmedel vid HLR har de Lund University Cardiac Assist System (LUCAS) som utför bröstkompressioner på patienten. Syfte: Att beskriva ambulanssjuksköterskors upplevelser av hjärt-och lungräddningsituationer med och utan LUCAS. Metod: En kvalitativ ansats med semistrukturerade intervjuer. Analysen gjordes utifrån Graneheim och Lundmans tolkning av innehållsanalys. Resultat: Vid HLR skapas många tankar och känslor hos ambulanssjuksköterskorna och för dem är det av vikt för att arbetet ska fungera att kunna skapa goda arbetsförhållanden och upprätthålla ett professionellt förhållningssätt i den stressade situationen, både för dem själva, patienten och de anhöriga. Hjärt- och lungräddning kan ge emotionell påverkan och en känsla av otillräcklighet inför patient och anhöriga. Den egna arbetsmiljöns säkerhet och fysiska belastning påverkar ambulanssjuksköterskornas arbetssituation. Fokus ska läggas på att göra det bästa, och det finns verktyg och hjälpmedel för att känna sig säker i sin yrkesroll, ett av dessa hjälpmedel är LUCAS. Slutsats: För att minska den psykiska stressen vid HLR krävs möjlighet till stöd och verktyg i olika former och därefter kontinuerlig utbildning och övning samt arbetslivserfarenhet från ambulansen. För att kunna ge alla samma förutsättningar till bra vård behöver LUCAS utvecklas för att passa alla individer.

  • 337.
    Asp, Margareta
    et al.
    Mälardalen University, Sweden.
    Wiklund Gustin, Lena
    Mälardalen University, Sweden.
    Almerud Österberg, Sofia
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Hörberg, Ulrica
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Lindberg, Elisabeth
    University of Borås, Sweden.
    Palmér, Lina
    University of Borås, Sweden.
    ”Samvetsstress och dåliga villkor bakom sjuksköterskeflykten”2017In: Dagens nyheter, ISSN 1101-2447, no 2017-05-04Article in journal (Other (popular science, discussion, etc.))
  • 338.
    Aspegren, Erini
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Lundin, Anna
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Upplevelser av att ha växt upp med en psykiskt sjuk förälder: En kvalitativ litteraturstudie baserad på självbiografier2019Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Psykiska sjukdomar av olika slag är vanligt förekommande i vårt samhälle och i hela världen. Trots detta föreligger ett tabu och ett stigma kring psykisk sjukdom, vilket påverkar såväl den sjuke som de anhöriga negativt. Att växa upp med en psykiskt sjuk förälder kan leda till att barnen inte mår väl och kommer i skymundan.

    Syfte: Syftet var att beskriva vuxna personers upplevelser av att ha växt upp tillsammans med en psykiskt sjuk förälder.

    Metod: Studien är en kvalitativ litteraturstudie med en induktiv ansats, som har utgångspunkt i självbiografier. Data utifrån fem självbiografier har analyserats genom en manifest innehållsanalys.

    Resultat: Barnens upplevelser sammanställdes i tre kategorier och åtta underkategorier. Kategorierna som framkom var Otrygghet, En betungande vardag och Saknad.

    Slutsats: Att som barn ha en förälder som är psykiskt sjuk leder till känslor av ansvarstagande, otrygghet och längtan efter ett vanligt liv. Det är viktigt att sjuksköterskan lyssnar till barnet för att skapa tillit, samt upplyser barnet angående förälderns sjukdom och dess påverkan på familjeförhållandena, för att verka för en bättre hälsa för barnet.

  • 339.
    Asplund, Elin
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Prevalens av horisontella avståndsforier och avståndstropier bland hjälpsökande i Ghana2016Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    The aim of this study was to investigate the prevalence of distance heterophoria and heterotropia in a sample population of Ghana who attended vision screening camps from the Swedish non-profit organization called Vision For All.

    Vision For All collects, cleans and measures old spectacles in Sweden. During organized trips to less privileged countries in the world they perform eye examinations and donate spectacles.

    At first a simple eye examination was performed to find the patients’ best binocular spherical equivalent. Then to determine if a distance phoria or tropia was present, the unilateral and alternating cover test were used. If a heterophoria or heterotropia was found the prism cover test was performed using a prism bar to determine the size.

    153 people were included in the study, with an average age of 47±19 years and ranging between 5-85 years. The study found that 87,6 % were orthophoric at distance. 7,8 % were exophoric and 0,7 % were esophoric. Exo- and esotropia were 2,0 % respectively. The average deviation size for the whole group was 0,27±1,21 Δ exophoria, where 2 Δ exophoria was the most common. Only two of the six found tropias could be measured, they were 6 Δ esotropia and 10 Δ esotropia.

    Earlier studies confirm that the most common condition is no deviation at distance and that an exophoric state is the second most common condition. The presence of tropia in this study was more frequent than the mean of other studies presented in this paper.

    This study only shows a hint of how the prevalence of distance heterophoria and heterotropia is in Ghana. Desirably further prevalence studies should be conducted with more stable conditions, better spectacle correction and a bigger sample size to accomplish higher reliability.

  • 340.
    Asplund, Sofia
    Linnaeus University, Faculty of Health and Life Sciences, Department of Biology and Environmental Science.
    Frihet under ansvar kräver mycket kunskap: Privata skogsägares kompetens att bedöma naturvärden och deras förståelse för biologisk mångfald2016Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    The Environmental Objectives for the Swedish forests are not being achieved and the biodiversity is declining despite the fact that both production targets and environmental goals should be considered equally by the industry. The swedish forestry act is based on Freedom with responsibility, where the law specifies the minimum requirements and the forest owners are expected to take a greater responsibility than the law requires. In reality, the production targets tend to dominate and the definition of good environmental practicestends to vary, which could be the basis of the difficulties and conflicts that arise in the Swedish forestry. The purpose of this research is to investigate the knowledge of environmental consideration and biodiversity among forest owners, since they are the ones responsible for their forest. To examine this, questionnaires were sent out to private forest owners in southern Sweden. The results showed an overconfidence among the land owners to assess the natural values of their forest and poor understanding of the importance of biodiversity. With the lack of knowledge of their expected responsibility and poor understanding of the importance of the environmental goals, the difficulties in achieving the environmental goals will remain. This study shows the need to improve the knowledge among forest owners.

  • 341.
    Asplund-Samuelsson, Johannes
    et al.
    Stockholm University.
    Sundh, John
    Linnaeus University, Faculty of Health and Life Sciences, Department of Biology and Environmental Science.
    Dupont, Chris L.
    Craig Venter Institute, USA.
    Allen, Andrew E.
    Craig Venter Institute, USA.
    McCrow, John P.
    Craig Venter Institute, USA.
    Celepli, Narin A.
    Stockholm University.
    Bergman, Birgitta
    Stockholm University.
    Ininbergs, Karolina
    Stockholm University.
    Ekman, Martin
    Stockholm University.
    Diversity and expression of bacterial metacaspases in an aquatic ecosystem2016In: Frontiers in Microbiology, ISSN 1664-302X, E-ISSN 1664-302X, Vol. 7, p. 1-18, article id 1043Article in journal (Refereed)
    Abstract [en]

    Metacaspases are distant homologs of metazoan caspase proteases, implicated in stress response, and programmed cell death (PCD) in bacteria and phytoplankton. While the few previous studies on metacaspases have relied on cultured organisms and sequenced genomes, no studies have focused on metacaspases in a natural setting. We here present data from the first microbial community-wide metacaspase survey; performed by querying metagenomic and metatranscriptomic datasets from the brackish Baltic Sea, a water body characterized by pronounced environmental gradients and periods of massive cyanobacterial blooms. Metacaspase genes were restricted to ~4% of the bacteria, taxonomically affiliated mainly to Bacteroidetes, Alpha- and Betaproteobacteria and Cyanobacteria. The gene abundance was significantly higher in larger or particle-associated bacteria (<0.8 μm), and filamentous Cyanobacteria dominated metacaspase gene expression throughout the bloom season. Distinct seasonal expression patterns were detected for the three metacaspase genes in Nodularia spumigena, one of the main bloom-formers. Clustering of normalized gene expression in combination with analyses of genomic and assembly data suggest functional diversification of these genes, and possible roles of the metacaspase genes related to stress responses, i.e., sulfur metabolism in connection to oxidative stress, and nutrient stress induced cellular differentiation. Co-expression of genes encoding metacaspases and nodularin toxin synthesis enzymes was also observed in Nodularia spumigena. The study shows that metacaspases represent an adaptation of potentially high importance for several key organisms in the Baltic Sea, most prominently Cyanobacteria, and open up for further exploration of their physiological roles in microbes and assessment of their ecological impact in aquatic habitats.

  • 342.
    Ataei, Shakila
    Linnaeus University, Faculty of Health and Life Sciences, Department of Chemistry and Biomedical Sciences.
    Optimering av analysmetoden hos koldioxid-isotop-analysatorn, Picarro-G2131-i2015Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Marine bacteria are microscopically visible organisms that can survive in most of the marine environments. Their function is to decompose dead organic matter, and thus contribute to the carbon cycle in the oceans. They utilizes dissolved organic matter in the oceans and produce carbon dioxide through respiration. This carbon dioxide can be measured with modern instruments to determine the primary production of the ecosystem and determine what carbon sources are responsible for the energy flow in the ecosystem. During this study, the possibility, advisability and the sensitivity of measuring bacterial respiration with the carbon dioxide isotope analyzer Picarro-G2131-i was examined. Further, the method was developed. For the experiment, two species of proteorhodopsin containing marine bacteria Polaribacter sp. strain MED152 and Dokdonia sp. strain MED134 were used. Growth and respiration of the bacteria were studied in nutrient rich medium. To test the Picarro-instrument is sensitivity, the respiration of both bacterial species was performed in respectively dilution series. In addition, the growth and respiration of MED134 in nutrient-poor conditions in light and darkness condition was compared. To study the impact of light on the growth of bacteria. No significant difference was found between MED134´s growth and respiration in light and dark. The method could be improved by modification such as changing pump, shorten tubes, remove a safety bottle and use a refefence bottle.

     

    Conclusion

    The carbon dioxide isotope analyzer Picarro-G2131-i is a sensitive instrument and can detect both the 12CO2 and 13CO2. According to the growth experiment, the bacteria grow very rapidly in nutrient rich medium. For comparing bacterial growth in light and dark, the correct light intensity and sufficient nutrient must be used.

  • 343.
    Ataei, Tahereh
    Linnaeus University, Faculty of Health and Life Sciences, Department of Chemistry and Biomedical Sciences.
    Förekomst av penicillinkänslighet hos blododlingsisolat av Staphylococcus aureus2014Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Staphylococcus aureus is the most clinically important Staphylococcus species and is associated with high mortality in patients with positive blood cultures. S. aureus bacteria may cause a variety of disease manifestations ranging from minor skin infections to life-threatening conditions such as pneumonia, meningitis, osteomyelitis, endocarditis, toxic shock syndrome (TSS) and sepsis. This microorganism belonging to the gram positive cocci may also be part of the normal flora. In Sweden, penicillinase-stable penicillins are the primary alternatives to treat S. aureus infection. Mutations in genes encoding the penicillin binding proteins (PBP2) in the bacteria which lead to a lower affinity for the  beta-lactam antibiotics define  methicillin resistant S. aureus (MRSA) which is a significant global health problem. Other resistance mechanisms of S. aureus are present, and one of these is penicillinase production which is associated with resistance to penicillin G. In order to detect penicillinase production in S. aureus, there are several methods but the European guidelines recommend disc diffusion and the clover-leaf test for follow-up if the zone diameter for benzylpenicillin (PcG) is 26 mm or more. There are no modern Swedish studies on the prevalence of S. aureus susceptible to PcG and this has recently attained interest from infectious disease physicans. Thus, the purpose of this study was to investigate the frequency of S. aureus susceptible to PcG from blood cultures isolated during 2012 from the Kalmar county.    Disc diffusion testing showed that 32% of 90 unique isolates tested had an inhibition zone diameter of PcG that was ≥ 26 mm in diameter. All of these isolates were confirmed as PcG sensitive with clover-leaf test. Internal controls showed little variation and external control isolates showed full agreement with the results obtained from a Danish study, suggesting that PcG zone diameter of ≥ 26 mm in combination with cloverleaf test can be used to detect penicillin susceptibility of S. aureus.    In conclusion, this study shows that nearly 1 /3 of the blood culture isolates of S. aureus from Kalmar are sensitive to benzylpenicillin.

  • 344.
    Athley, Ellen
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Rokka, Michaela
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Rummets betydelse vid vård av ungdomars sexuella hälsa.: En kvalitativ intervjustudie baserad på sjuksköterskors upplevelse.2016Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 345.
    Atterby, Clara
    et al.
    Uppsala University.
    Börjesson, Stefan
    National Veterinary Institute.
    Ny, Sofia
    Public Health Agency of Sweden;Karolinska Institutet.
    Järhult, Josef D.
    Uppsala University.
    Byfors, Sara
    Public Health Agency of Sweden.
    Bonnedahl, Jonas
    Linnaeus University, Faculty of Health and Life Sciences, Department of Biology and Environmental Science. Kalmar County Council;Linköping University.
    ESBL-producing Escherichia coli in Swedish gulls: A case of environmental pollution from humans?2017In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 12, no 12, article id e0190380Article in journal (Refereed)
    Abstract [en]

    ESBL-producing bacteria are present in wildlife and the environment might serve as a resistance reservoir. Wild gulls have been described as frequent carriers of ESBL-producing E. coli strains with genotypic characteristics similar to strains found in humans. Therefore, potential dissemination of antibiotic resistance genes and bacteria between the human population and wildlife need to be further investigated. Occurrence and characterization of ESBL-producing E. coli in Swedish wild gulls were assessed and compared to isolates from humans, livestock and surface water collected in the same country and similar time-period. Occurrence of ESBL-producing E. coli in Swedish gulls is about three times higher in gulls compared to Swedish community carriers (17% versus 5%) and the genetic characteristics of the ESBL-producing E. coli population in Swedish wild gulls and Swedish human are similar. ESBL-plasmids IncF-and IncI1-type carrying ESBL-genes blaCTX-M-15 or blaCTX-M-14 were most common in isolates from both gulls and humans, but there was limited evidence of clonal transmission. Isolates from Swedish surface water harbored similar genetic characteristics, which highlights surface waters as potential dissemination routes between wildlife and the human population. Even in a low-prevalence country such as Sweden, the occurrence of ESBL producing E. coli in wild gulls and the human population appears to be connected and the occurrence of ESBL-producing E. coli in Swedish gulls is likely a case of environmental pollution.

  • 346.
    Atterby, Clara
    et al.
    Uppsala University.
    Mourkas, Evangelos
    Uppsala University;Univ Bath, UK.
    Meric, Guillaume
    Univ Bath, UK.
    Pascoe, Ben
    Univ Bath, UK;MRC CLIMB Consortium, UK.
    Wang, Helen
    Uppsala University.
    Waldenström, Jonas
    Linnaeus University, Faculty of Health and Life Sciences, Department of Biology and Environmental Science.
    Sheppard, Samuel K.
    Univ Bath, UK;MRC CLIMB Consortium, UK.
    Olsen, Björn
    Uppsala University.
    Jarhult, Josef D.
    Uppsala University.
    Ellström, Patrik
    Uppsala University.
    The Potential of Isolation Source to Predict Colonization in Avian Hosts: A Case Study in Campylobacter jejuni Strains From Three Bird Species2018In: Frontiers in Microbiology, ISSN 1664-302X, E-ISSN 1664-302X, Vol. 9, article id 591Article in journal (Refereed)
    Abstract [en]

    Campylobacter jejuni is the primary cause of bacterial gastroenteritis worldwide, infecting humans mostly through consumption of contaminated poultry. C. jejuni is common in the gut of wild birds, and shows distinct strain-specific association to particular bird species. This contrasts with farm animals, in which several genotypes co-exist. It is unclear if the barriers restricting transmission between host species of such specialist strains are related to environmental factors such as contact between host species, bacterial survival in the environment, etc., or rather to strain specific adaptation to the intestinal environment of specific hosts. We compared colonization dynamics in vivo between two host-specific C. jejuni from a song thrush (ST-1304 complex) and a mallard (ST-995), and a generalist strain from chicken (ST-21 complex) in a wild host, the mallard (Anas platyrhynchos). In 18-days infection experiments, the song thrush strain showed only weak colonization and was cleared from all birds after 10 days, whereas both mallard and chicken strains remained stable. When the chicken strain was given 4 days prior to co-infection of the same birds with a mallard strain, it was rapidly outcompeted by the latter. In contrast, when the mallard strain was given 4 days prior to co-infection with the chicken strain, the mallard strain remained and expansion of the chicken strain was delayed. Our results suggest strain-specific differences in the ability of C. jejuni to colonize mallards, likely associated with host origin. This difference might explain observed host association patterns in C. jejuni from wild birds.

  • 347.
    Atterby, Clara
    et al.
    Uppsala University, Sweden.
    Osbjer, Kristina
    Swedish University of Agricultural Sciences, Sweden;Food & Agr Org United Nations, Cambodia.
    Tepper, Viktoria
    Swiss Fed Inst Technol, Switzerland.
    Rajala, Elisabeth
    Swedish University of Agricultural Sciences, Sweden.
    Hernandez, Jorge
    Linnaeus University, Faculty of Health and Life Sciences, Department of Biology and Environmental Science. Linköping University, Sweden;Kalmar County Council, Sweden;Kalmar County Hospital, Sweden.
    Seng, Sokerya
    Food & Agr Org United Nations, Cambodia.
    Holl, Davun
    Minist Agr Forestry & Fisheries, Cambodia.
    Bonnedahl, Jonas
    Linköping University, Sweden;Kalmar County Council, Sweden.
    Börjesson, Stefan
    National Veterinary Institute, Sweden;Linköping University, Sweden.
    Magnusson, Ulf
    Swedish University of Agricultural Sciences, Sweden.
    Jarhult, Josef D.
    Uppsala University, Sweden.
    Carriage of carbapenemase- and extended-spectrum cephalosporinase-producing Escherichia coli and Klebsiella pneumoniae in humans and livestock in rural Cambodia; gender and age differences and detection of bla(OXA-48 )in humans2019In: Zoonoses and Public Health, ISSN 1863-1959, E-ISSN 1863-2378, Vol. 66, no 6, p. 603-617Article in journal (Refereed)
    Abstract [en]

    Objectives This study investigates the frequency and characteristics of carbapenemase-producing Escherichia coli/Klebsiella pneumoniae (CPE/K) and extended-spectrum cephalosporinase-producing E. coli/K. pneumoniae (ESCE/K) in healthy humans and livestock in rural Cambodia. Additionally, household practices as risk factors for faecal carriage of ESCE/K are identified. Methods Faecal samples were obtained from 307 humans and 285 livestock including large ruminants, pigs and poultry living in 100 households in rural Cambodia in 2011. Each household was interviewed, and multilevel logistic model determined associations between household practices/meat consumption and faecal carriage of ESCE/K. CPE and ESCE/K were detected and further screened for colistin resistance genes. Results CPE/K isolates harbouring bla(OXA-48 )were identified in two humans. The community carriage of ESCE/K was 20% in humans and 23% in livestock. The same ESBL genes: bla(CTX-M-15), bla(CTX-M-14), bla(CTX-M-27), bla(CTX-M-55), bla(SHV-2), bla(SHV-12), bla(SHV-28); AmpC genes: bla(CMY-2), bla(CMY-42,) bla(DHA-1); and colistin resistance genes: mcr-1-like and mcr-3-like were detected in humans and livestock. ESCE/K was frequently detected in women, young children, pigs and poultry, which are groups in close contact. The practice of burning or burying meat waste and not collecting animal manure indoors and outdoors daily were identified as risk factors for faecal carriage of ESCE/K. Conclusions Faecal carriage of E. coli and K. pneumoniae harbouring extended-spectrum cephalosporinase genes are common in the Cambodian community, especially in women and young children. Exposure to animal manure and slaughter products are risk factors for intestinal colonization of ESCE/K in humans.

  • 348.
    Atterby, Clara
    et al.
    Uppsala University.
    Ramey, Andrew M.
    US Geological Survey, USA.
    Hall, Gabriel Gustafsson
    Uppsala University.
    Järhult, Josef
    Uppsala University.
    Börjesson, Stefan
    National Veterinary Institute.
    Bonnedahl, Jonas
    Linnaeus University, Faculty of Health and Life Sciences, Department of Biology and Environmental Science. Kalmar County Hospital.
    Increased prevalence of antibiotic-resistant E. coli in gulls sampled in Southcentral Alaska is associated with urban environments2016In: Infection Ecology & Epidemiology, ISSN 2000-8686, E-ISSN 2000-8686, Vol. 6, no 1, p. 1-7, article id 32334Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Antibiotic-resistant bacteria pose challenges to healthcare delivery systems globally; however, limited information is available regarding the prevalence and spread of such bacteria in the environment. The aim of this study was to compare the prevalence of antibiotic-resistant bacteria in large-bodied gulls (Larus spp.) at urban and remote locations in Southcentral Alaska to gain inference into the association between antibiotic resistance in wildlife and anthropogenically influenced habitats.

    METHODS: Escherichia coli was cultured (n=115 isolates) from fecal samples of gulls (n=160) collected from a remote location, Middleton Island, and a more urban setting on the Kenai Peninsula.

    RESULTS: Screening of E. coli from fecal samples collected from glaucous-winged gulls (Larus glaucescens) at Middleton Island revealed 8% of isolates were resistant to one or more antibiotics and 2% of the isolates were resistant to three or more antibiotics. In contrast, 55% of E. coli isolates derived from fecal samples collected from large-bodied gulls (i.e. glaucous, herring [Larus argentatus], and potentially hybrid gulls) on the Kenai Peninsula were resistant to one or more antibiotics and 22% were resistant to three or more antibiotics. In addition, total of 16% of the gull samples from locations on the Kenai Peninsula harbored extended-spectrum cephalosporin-resistant E. coli isolates (extended-spectrum beta-lactamases [ESBL] and plasmid-encoded AmpC [pAmpC]), in contrast to Middleton Island where no ESBL- or pAmpC-producing isolates were detected.

    CONCLUSION: Our findings indicate that increased prevalence of antibiotic resistance is associated with urban environments in Southcentral Alaska and presumably influenced by anthropogenic impacts. Further investigation is warranted to assess how migratory birds may maintain and spread antimicrobial-resistant bacteria of relevance to human and animal health.

  • 349.
    Atwine, Fortunate
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. MUST, Uganda.
    Hjelm, Katarina
    Linköping University.
    Health professionals' knowledge and attitudes to healthcare-seeking practices and complementary alternative medicine usage in Ugandans with diabetes: a cross-sectional survey2017In: Pan African Medical Journal, ISSN 1937-8688, E-ISSN 1937-8688, Vol. 28, article id 256Article in journal (Refereed)
    Abstract [en]

    Introduction: Healthcare-seeking behaviour among persons with diabetes has been investigated to a limited extent, and not from professionals' perspective. The aim of the study was to describe healthcare professionals' knowledge, attitudes and practice concerning healthcare-seeking behaviour and the use of complementary and alternative medicine among persons with diabetes. Methods: A cross-sectional, self-administered questionnaire was conducted in western Uganda. Nurses, midwives or nurse assistants 72.2%, physicians 12% and clinical officers 10% volunteered to participate in the study with a total 108 (93% response rate) response rate. Descriptive statistics were used to analyse data with frequencies, percentages and summarized in tables. Results: Most of the healthcare providers perceived more uneducated people to be at risk of developing complications related to diabetes (66.7%) and that most of the patients with diabetes were not knowledgeable about signs and symptoms of diabetes before being diagnosed (75.9%). The main reasons inducing persons with diabetes to seek care outside the health care sector were reported to be seeking a cure for the condition, influence from the popular sector, the accessibility of the place and signs of complications of diabetes related to poor glycaemic control. Healthcare providers had relatively positive attitudes towards using complementary and alternative medicine. Conclusion: Insufficient knowledge about diabetes, compromised healthcare-seeking practices including drug procurement for diabetes seem to be barriers to diabetes management. Patients were thus reported to be burdened with co-morbidities of complications of diabetes related to poor glycaemic control.

  • 350.
    Atwine, Fortunate
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Mbarara University of Science and Technology, Uganda.
    Hultsjö, Sally
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Albin, Björn
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Hjelm, Katarina
    Linköping University.
    Health-care seeking behaviour and the use of traditional medicine among persons with type 2 diabetes in south-western Uganda: a study of focus group interviews2015In: Pan African Medical Journal, ISSN 1937-8688, E-ISSN 1937-8688, Vol. 20, p. 1-13, article id 76Article in journal (Refereed)
    Abstract [en]

    Introduction: Health-care seeking behaviour is important as it determines acceptance of health care and outcomes of chronic conditions but it has been investigated to a limited extent among persons with diabetes in developing countries. The aim of the study was to explore health-care seeking behaviour among persons with type 2 diabetes to understand reasons for using therapies offered by traditional healers.

    Methods: Descriptive study using focus-group interviews. Three purposive focus-groups were conducted in 2011 of 10 women and 7 men aged 39–72 years in Uganda. Data were collected through semi-structured interviews and qualitatively analysed according to a method described for focus-groups.

    Results: Reasons for seeking help from traditional healers were symptoms related to diabetes such as polydipsia, fatigue and decreased sensitivity in lower limbs. Failure of effect from western medicine was also reported. Treatment was described to be unknown extracts, of locally made products taken as herbs or food, and participants had sought help from different health facilities with the help of relatives and friends.

    Conclusion: The pattern of seeking care was inconsistent, with a switch between different health care providers under the influence of the popular and folk sectors. Despite beliefs in using different healthcare providers seeking complementary and alternative medicine, participants still experienced many physical health problems related to diabetes complications. Health professionals need to be aware of the risk of switches between different health care providers, and develop strategies to initiate health promotion interventions to include in the care actors of significance to the patient from the popular, folk and professional sectors, to maintain continuity of effective diabetes care. © Katarina Hjelm et al.

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