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  • 101. Tang, Ping Fen
    et al.
    Johansson, Camilla
    Wadensten, Barbro
    Wenneberg, Stig
    Örebro universitet, Institutionen för vårdvetenskap och omsorg.
    Ahlström, Gerd
    Chinese nurses' ethical concerns in a neurological ward2007Inngår i: Nursing Ethics, ISSN 0969-7330, E-ISSN 1477-0989, Vol. 14, nr 6, s. 810-824Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Our aim was to describe Chinese nurses' experiences of workplace distress and ethical dilemmas on a neurological ward. Qualitative interviews were performed with 20 nurses. On using latent content analysis, themes emerged in four content areas: ethical dilemmas, workplace distress, quality of nursing and managing distress. The ethical dilemmas were: ( 1) conflicting views on optimal treatment and nursing; ( 2) treatment choice meeting with financial constraints; and ( 3) misalignment of nursing responsibilities, competence and available resources. The patients' relatives lacked respect for the nurses' skills. Other dilemmas could be traced to the transition from a planned to a market economy, resulting in an excessive workload and treatment withdrawal for financial reasons. Lack of resources was perceived as an obstacle to proper patient care in addition to hospital organization, decreasing the quality of nursing, and increasing moral and workplace distress. The nurses managed mainly by striving for competence, which gave them hope for the future.

  • 102.
    Udén, Giggi
    et al.
    Centre of Caring Sciences, Lund University, Lund.
    Ehnfors, Margareta
    Örebro universitet, Institutionen för vårdvetenskap och omsorg.
    Sjöström, Kerstin
    Department of Internal Medicine, Malmö University Hospital, Malmö.
    Use of initial risk assessment and recording as the main nursing intervention in identifying risk of falls1999Inngår i: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 29, nr 1, s. 145-52Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The consequences of falls among hospital patients are a great problem, for the patient, the family and society, and cost billions of dollars. In Sweden, almost one-third of all hip fractures occur in the hospital population. Despite this, very few prevention strategies have been developed and tested. In this study, a risk assessment and recording programme in relation to the risk of falling among patients in a geriatric department at a Swedish hospital was implemented. The records of all patients admitted to a geriatric unit during one year, and a stratified random sample of patient records, constituting the control group from the year before, were reviewed. No recording of assessments regarding the patients' risk of falling, and no preventive nursing interventions, were found in the records of the control group. The study group, however, increased the recording of risk assessment to 96%. Only implemented nursing interventions were found in the patients' records, despite the fact that Swedish law makes it obligatory for the registered nurse to record both the planning and implementation of nursing care. In the study group there were explicit descriptions of problems of concern for nursing regarding the patients' risk of falling in less than one-third of the records, the nursing care plans were rare, and the evaluations were not satisfactory. Nursing interventions consisted mostly of information or education, promotion of patient participation, and structuring of the environment. There was no agreement on any standard-care plan. Recording of falls was found more often in the study group than in the control group (probably due to more careful recording), but the proportion of injuries in relation to falls was higher in the control group. The results of this study may be used as a baseline for developing a nursing strategy and documentation relating to falls.

  • 103.
    Uggla, Bertil
    et al.
    Department of Medicine, Örebro University Hospital, Örebro; Karolinska Institute, Stockholm.
    Ståhl, Elisabet
    Clinical Research Centre, Örebro University Hospital, Örebro.
    Wågsäter, Dick
    Örebro universitet, Institutionen för vårdvetenskap och omsorg.
    Paul, Christer
    Department of Haematology, Huddinge University Hospital, Stockholm; Karolinska Institute, Stockholm.
    Karlsson, Mats G.
    Department of Pathology, Örebro University Hospital, Örebro.
    Sirsjö, Allan
    Örebro universitet, Institutionen för vårdvetenskap och omsorg.
    Tidefelt, Ulf
    Örebro universitet, Institutionen för klinisk medicin. Department of Medicine, Örebro University Hospital, Örebro.
    BCRP mRNA expression v. clinical outcome in 40 adult AML patients2005Inngår i: Leukemia research: a Forum for Studies on Leukemia and Normal Hemopoiesis, ISSN 0145-2126, E-ISSN 1873-5835, Vol. 29, nr 2, s. 141-146Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Efflux pumps are considered being mechanisms behind drug resistance in acute myeloid leukaemia (AML). A recently described efflux pump, breast cancer resistance protein (BCRP), can be expressed in AML, but its clinical importance is uncertain. In this study BCRP mRNA expression was determined in samples from 40 AML patients by real-time RT-PCR. The expression varied from negative to 76 times that of control cells. There was no difference in BCRP mRNA expression between patients responding to induction treatment and non-responders. However, in the group of responders, the 14 patients with the highest expression had significantly shorter overall survival (mean 38 months, SEM 15 months) than the 14 patients with the lowest (74 months, SEM 16 months) (P = 0.047). This suggests a possible role of BCRP in drug resistance in AML.

  • 104.
    Widar, Marita
    et al.
    Örebro universitet, Institutionen för vårdvetenskap och omsorg.
    Ahlström, Gerd
    Pain in persons with post-polio: the Swedish version of the Multidimensional Pain Inventory (MPI)1999Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 13, nr 1, s. 33-40Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Increasing muscular atrophy and joint instability in the post-polio syndrome (PPS) leads to muscle and joint pain. The aim of this study was to describe how persons with post-polio syndrome (PPS) perceive their pain and how the pain affects their everyday lives. The Multidimensional Pain Inventory (MPI-S) was used together with supplementary questions concerning location and verbal description of the pain. The study group comprised 37 persons with PPS who had had pain for an average of 19 years. Most commonly reported was pain from the joints of the extremities, followed by pain from the lower back. The verbal description suggests that pain is a palpable health problem for this study group. The results of the MPI-S show that women had the most pain and that the younger the persons are, the more the pain involves negative stress experiences. Activities such as outdoor work, social and other activities away from home involve difficulties, according to the results. The study group could manage their pain, experienced social support, and especially women managed to carry out household chores despite their pain. The MPI-S demonstrates acceptable reliability for this study group.

  • 105.
    Widar, Marita
    et al.
    Örebro universitet, Institutionen för vårdvetenskap och omsorg.
    Ahlström, Gerd
    Ek, Anna-Christina
    Health-related quality of life in persons with long-term pain after a stroke2004Inngår i: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 13, nr 4, s. 497-505Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND:

    No study has, to our knowledge, previously been published on health-related quality of life (HRQoL) in a group suffering from long-term pain after a stroke.

    AIM:

    The aim of the present study was to describe HRQoL in persons with long-term pain after a stroke, and to compare this with different types of pain conditions, age, gender and household status.

    DESIGN:

    This study has a design combining qualitative and quantitative methods.

    METHODS:

    Forty three participants suffering from long-term pain after a stroke were included. A qualitative interview was performed and then analysed by means of latent content analysis. In addition, two self-report questionnaires, SF-36 and the Hospital Anxiety and Depression Scale (HAD Scale), were used.

    RESULTS:

    The qualitative data revealed that physical and cognitive functioning, economic security and good relationships, support and having the ability to be together with family and friends were important factors with regard to experienced HRQoL. No significant differences were found in SF-36 and the HAD Scale with regard to the different types of pain. The older age group had decreased physical functioning in SF-36. The men had more decreased vitality than the women.

    CONCLUSION:

    The results show, that the participants in this study have a lower HRQoL due to their long-term pain than those in previous studies on stroke survivors. It is evident that further research is needed with longitudinal studies and larger populations to gain more knowledge and thereby provide better supportive care.

    RELEVANCE TO CLINICAL PRACTICE:

    Awareness and understanding of the patients' perceptions and transitions with regard to their life situation and suffering from long-term pain after a stroke is important in order to support a maintained or increased HRQoL. This is also important after the acute stage and rehabilitation, including quality of life of the relatives, especially to older and dependent persons.

  • 106.
    Widar, Marita
    et al.
    Örebro universitet, Institutionen för vårdvetenskap och omsorg.
    Ek, Anna-Christina
    Ahlström, Gerd
    Coping with long-term pain after a stroke2004Inngår i: Journal of Pain and Symptom Management, ISSN 0885-3924, Vol. 27, nr 3, s. 215-225Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The aim of this qualitative study was to describe pain, coping strategies, and experienced outcome of coping with long-term pain conditions after a stroke. Forty-three participants were interviewed: 15 with central post-stroke pain (CPSP), 18 with nociceptive pain, and 10 with tension-type headache. Analysis of the data was by content analysis. Pain-related problems described were incomprehensibility regarding the pain, disturbed sleep, fatigue, diminished capacity, mood changes, and stress in relationships. Different coping strategies were used; the most common were making the pain comprehensible, planning of activities, taking medications, communicating, and distractions. Changing body position, making comparison, and enduring the pain were common in central or nociceptive pain, rest and relaxation in tension-type headache. Communicating their pain gave a feeling of perplexity and resignation. Satisfaction was reported in the cases of consideration shown by others. Pain after a stroke requires specialized knowledge in order to understand the patient's experiences and to enhance coping.

  • 107. Wuttge, Dirk M.
    et al.
    Zhou, Xinghua
    Sheikine, Yuri
    Wågsäter, Dick
    Örebro universitet, Institutionen för vårdvetenskap och omsorg.
    Stemme, Veronika
    Hedin, Ulf
    Stemme, Sten
    Hansson, Göran K.
    Sirsjö, Allan
    Örebro universitet, Institutionen för vårdvetenskap och omsorg.
    CXCL16/SR-PSOX is an interferon-gamma-regulated chemokine and scavenger receptor expressed in atherosclerotic lesions2004Inngår i: Arteriosclerosis, Thrombosis and Vascular Biology, ISSN 1079-5642, E-ISSN 1524-4636, Vol. 24, nr 4, s. 750-755Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVE: Atherosclerosis is an inflammatory disease. Several chemokines are important for monocyte/macrophage and T-cell recruitment to the lesion. CXCL16 is a recently discovered chemokine that is expressed in soluble and transmembrane forms, ligates CXCR6 chemokine receptor, and guides migration of activated Th1 and Tc1 cells. It is identical to scavenger receptor SR-PSOX, which mediates uptake of oxidized low-density lipoprotein. We investigated whether CXCL16 expression is controlled by interferon-gamma (IFN-gamma)-cytokine abundant in atherosclerotic lesions. METHODS AND RESULTS: CXCL16 and CXCR6 expression was identified by polymerase chain reaction and histochemistry in atherosclerotic lesions from humans and apolipoprotein-E-deficient mice. In vitro IFN-gamma induced CXCL16 in human monocytic THP-1 cells and primary human monocytes, which led to increased uptake of oxidized low-density lipoprotein in THP-1 cells, which could be blocked by peptide antibodies against CXCL16. In vivo IFN-gamma induced CXCL16 expression in murine atherosclerotic lesions. CONCLUSIONS: We demonstrate a novel role of IFN-gamma in foam cell formation through upregulation of CXCL16/SR-PSOX. CXCR6 expression in the plaque confirms the presence of cells able to respond to CXCL16. Therefore, this chemokine/scavenger receptor could serve as a molecular link between lipid metabolism and immune activity in the atherosclerotic lesion.

  • 108.
    Wågsäter, Dick
    Örebro universitet, Institutionen för vårdvetenskap och omsorg.
    CXCL16 and CD137 in atherosclerosis2005Doktoravhandling, med artikler (Annet vitenskapelig)
    Abstract [en]

    Atherosclerosis is a progressive inflammatory disease that is characterized by the accumulation of lipids, infiltrated cells and fibrous elements in large arteries.

    This thesis focuses on the molecular mechanisms behind foam cell formation and inflammation, two central processes in the development of atherosclerosis. More specific, we studied the effects of proinflammatory cytokines on CXCL16 expression and its role as scavenger receptor on macrophages and smooth muscle cells in atherogenesis. CXCL16 is defined as a chemokine and a scavenger receptor, regulating adhesion and chemoattraction of CXCR6 expressing cells and uptake of oxLDL. We show that the expression of CXCL16 and its receptor CXCR6 are more pronounced in human atherosclerotic lesions compared with non-atherosclerotic vessels. Increased expression of CXCL16 was also seen in atherosclerotic aortas of apoE-/- mice compared with aortas of non-atherosclerotic, age-matched C57BL/6 mice. In vitro, IFN gamma induced CXCL16 expression in primary human monocytes and smooth muscle cells which resulted in an increased uptake of oxLDL. Treatment of mice with IFN gamma also induced CXCL16 expression in atherosclerotic lesions. Thus, we have demonstrated a role for IFN gamma in foam cell formation through upregulation of CXCL16. The expression of CXCR6 was defined to the same regions as for CXCL16 in the lesion, indicating the presence of cells able to respond to CXCL16. Consequently, CXCL16 could serve as a molecular link between lipid metabolism and immune activity in atherosclerotic lesion.

    CD137 belongs to the TNF family and mediates several important processes in inflammation. CD137 is involved in the activation of T cells, NK cells, B cells and monocytes and regulate cytokine production, proliferation and apoptosis in these cells. A limited number of studies have demonstrated CD137 expression on smooth muscle cells and endothelial cells. Our results show that CD137 mRNA is higher expressed in human atherosclerotic lesions compared with unaffected vessels. We found that endothelial cells express CD137 in atherosclerotic lesions and that cultured endothelial cells and smooth muscle cells express CD137 and CD137 ligand in vitro. CD137 was regulated differentially by proinflammatory cytokines (i.e. IFN gamma, TNF alpha, IL-1 beta) and bacterial lipopolysaccharide depending on cell type. Furthermore, we investigated the effects of CD137 signalling, demonstrating that binding of the CD137 ligand to its receptor increases proliferation and migration of smooth muscle cells.

    In summary, this thesis has focused on the expression, regulation and role of CXCL16 and CD137, two genes that have not been described earlier in the concept of atherosclerosis. The findings demonstrate some of the molecular mechanisms involved in vascular inflammation and may increase our knowledge about the development of atherosclerosis.

    Delarbeid
    1. CXCL16/SR-PSOX is an interferon-gamma-regulated chemokine and scavenger receptor expressed in atherosclerotic lesions
    Åpne denne publikasjonen i ny fane eller vindu >>CXCL16/SR-PSOX is an interferon-gamma-regulated chemokine and scavenger receptor expressed in atherosclerotic lesions
    Vise andre…
    2004 (engelsk)Inngår i: Arteriosclerosis, Thrombosis and Vascular Biology, ISSN 1079-5642, E-ISSN 1524-4636, Vol. 24, nr 4, s. 750-755Artikkel i tidsskrift (Fagfellevurdert) Published
    Abstract [en]

    OBJECTIVE: Atherosclerosis is an inflammatory disease. Several chemokines are important for monocyte/macrophage and T-cell recruitment to the lesion. CXCL16 is a recently discovered chemokine that is expressed in soluble and transmembrane forms, ligates CXCR6 chemokine receptor, and guides migration of activated Th1 and Tc1 cells. It is identical to scavenger receptor SR-PSOX, which mediates uptake of oxidized low-density lipoprotein. We investigated whether CXCL16 expression is controlled by interferon-gamma (IFN-gamma)-cytokine abundant in atherosclerotic lesions. METHODS AND RESULTS: CXCL16 and CXCR6 expression was identified by polymerase chain reaction and histochemistry in atherosclerotic lesions from humans and apolipoprotein-E-deficient mice. In vitro IFN-gamma induced CXCL16 in human monocytic THP-1 cells and primary human monocytes, which led to increased uptake of oxidized low-density lipoprotein in THP-1 cells, which could be blocked by peptide antibodies against CXCL16. In vivo IFN-gamma induced CXCL16 expression in murine atherosclerotic lesions. CONCLUSIONS: We demonstrate a novel role of IFN-gamma in foam cell formation through upregulation of CXCL16/SR-PSOX. CXCR6 expression in the plaque confirms the presence of cells able to respond to CXCL16. Therefore, this chemokine/scavenger receptor could serve as a molecular link between lipid metabolism and immune activity in the atherosclerotic lesion.

    HSV kategori
    Forskningsprogram
    Biomedicin
    Identifikatorer
    urn:nbn:se:oru:diva-2823 (URN)10.1161/01.ATV.0000124102.11472.36 (DOI)
    Tilgjengelig fra: 2005-05-04 Laget: 2005-05-04 Sist oppdatert: 2017-12-14bibliografisk kontrollert
    2. The chemokine and scavenger receptor CXCL16/SR-PSOX is expressed in human vascular smooth muscle cells and is induced by interferon gamma
    Åpne denne publikasjonen i ny fane eller vindu >>The chemokine and scavenger receptor CXCL16/SR-PSOX is expressed in human vascular smooth muscle cells and is induced by interferon gamma
    Vise andre…
    2004 (engelsk)Inngår i: Biochemical and Biophysical Research Communications - BBRC, ISSN 0006-291X, E-ISSN 1090-2104, Vol. 325, nr 4, s. 1187-1193Artikkel i tidsskrift (Fagfellevurdert) Published
    Abstract [en]

    Atherosclerosis is an inflammatory disease that is characterised by the involvement of chemokines that are important for the recruitment of leukocytes and scavenger receptors that mediate foam cell formation. Several cytokines are involved in the regulation of chemokines and scavenger receptors in atherosclerosis. CXCL16 is a chemokine and scavenger receptor and found in macrophages in human atherosclerotic lesions. Using double-labelled immunohistochemistry, we identified that smooth muscle cells in human lesions express CXCL16. We then analysed the effects of IFN-gamma, TNF-alpha, IL-12, IL-15, IL-18, and LPS on CXCL16 expression in cultured aortic smooth muscle cells. IFN-gamma was the most potent CXCL16 inducer and increased mRNA, soluble form, membrane form, and total cellular levels of CXCL16. The IFN-gamma induction of CXCL16 was also associated with increased uptake of oxLDL into these cells. Taken together, smooth muscle cells express CXCL16 in atherosclerotic lesions, which may play a role in the attraction of T cells to atherosclerotic lesions and contribute to the cellular internalisation of modified LDL.

    HSV kategori
    Forskningsprogram
    Biomedicin
    Identifikatorer
    urn:nbn:se:oru:diva-2824 (URN)10.1016/j.bbrc.2004.10.160 (DOI)
    Tilgjengelig fra: 2005-05-04 Laget: 2005-05-04 Sist oppdatert: 2017-12-14bibliografisk kontrollert
    3. CD137 is expressed on endothelial cells in human atherosclerotic lesions and induced by proinflammatory cytokines and bacterial lipopolysaccharides
    Åpne denne publikasjonen i ny fane eller vindu >>CD137 is expressed on endothelial cells in human atherosclerotic lesions and induced by proinflammatory cytokines and bacterial lipopolysaccharides
    Vise andre…
    (engelsk)Manuskript (Annet vitenskapelig)
    HSV kategori
    Forskningsprogram
    Biomedicin
    Identifikatorer
    urn:nbn:se:oru:diva-2825 (URN)
    Tilgjengelig fra: 2005-05-04 Laget: 2005-05-04 Sist oppdatert: 2017-10-18bibliografisk kontrollert
    4. CD137 mediates migration of human aortic smooth muscle cells and is regulated by proinflammatory cytokines
    Åpne denne publikasjonen i ny fane eller vindu >>CD137 mediates migration of human aortic smooth muscle cells and is regulated by proinflammatory cytokines
    Vise andre…
    (engelsk)Manuskript (Annet vitenskapelig)
    HSV kategori
    Forskningsprogram
    Biomedicin
    Identifikatorer
    urn:nbn:se:oru:diva-2826 (URN)
    Tilgjengelig fra: 2005-05-04 Laget: 2005-05-04 Sist oppdatert: 2017-10-18bibliografisk kontrollert
  • 109.
    Wågsäter, Dick
    et al.
    Örebro universitet, Institutionen för vårdvetenskap och omsorg.
    Olofsson, Peder S.
    Norgren, Lars
    Stenberg, Björn
    Sirsjö, Allan
    The chemokine and scavenger receptor CXCL16/SR-PSOX is expressed in human vascular smooth muscle cells and is induced by interferon gamma2004Inngår i: Biochemical and Biophysical Research Communications - BBRC, ISSN 0006-291X, E-ISSN 1090-2104, Vol. 325, nr 4, s. 1187-1193Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Atherosclerosis is an inflammatory disease that is characterised by the involvement of chemokines that are important for the recruitment of leukocytes and scavenger receptors that mediate foam cell formation. Several cytokines are involved in the regulation of chemokines and scavenger receptors in atherosclerosis. CXCL16 is a chemokine and scavenger receptor and found in macrophages in human atherosclerotic lesions. Using double-labelled immunohistochemistry, we identified that smooth muscle cells in human lesions express CXCL16. We then analysed the effects of IFN-gamma, TNF-alpha, IL-12, IL-15, IL-18, and LPS on CXCL16 expression in cultured aortic smooth muscle cells. IFN-gamma was the most potent CXCL16 inducer and increased mRNA, soluble form, membrane form, and total cellular levels of CXCL16. The IFN-gamma induction of CXCL16 was also associated with increased uptake of oxLDL into these cells. Taken together, smooth muscle cells express CXCL16 in atherosclerotic lesions, which may play a role in the attraction of T cells to atherosclerotic lesions and contribute to the cellular internalisation of modified LDL.

  • 110.
    Wågsäter, Dick
    et al.
    Örebro universitet, Institutionen för vårdvetenskap och omsorg.
    Olofsson, Peder S.
    Sheikine, Yuri
    Hansson, Göran K.
    Sirsjö, Allan
    Örebro universitet, Institutionen för vårdvetenskap och omsorg.
    CD137 mediates migration of human aortic smooth muscle cells and is regulated by proinflammatory cytokinesManuskript (Annet vitenskapelig)
123 101 - 110 of 110
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