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  • 201.
    Andersson, Åsa
    et al.
    Örebro University Hospital, Örebro, Sweden; Department of NVS, Karolinska Institutet, Stockholm, Sweden.
    Kamwendo, Kitty
    Örebro University, School of Health and Medical Sciences.
    Appelros, Peter
    Örebro University Hospital, Örebro, Sweden; Department of NVS, Karolinska Institutet, Stockholm, Sweden.
    Fear of falling in stroke patients: relationship with previous falls and functional characteristics2008In: International Journal of Rehabilitation Research, ISSN 0342-5282, E-ISSN 1473-5660, Vol. 31, no 3, p. 261-264Article in journal (Refereed)
    Abstract [en]

    The objectives of this study were to determine the relationship between fear of falling and functional characteristics of patients after stroke as well as to determine what characterizes fallers who score high fall-related self-efficacy, and nonfallers who score low fall-related self-efficacy. Patients (n=140) treated in a stroke unit during a 12-month period were included. On follow-up, fallers were identified and patients answered the questions in the Falls Efficacy Scale, Swedish version (FES-S). Assessments of motor capacity, functional mobility and balance were also made. In univariate analysis, low fall-related self-efficacy was significantly associated with increased age, female sex, earlier falls, visual and cognitive impairment, low mood and impaired physical function. In multivariate analysis, only earlier falls and physical function remained significant. Twenty percent of the patients scored low fall-related self-efficacy without having experienced a fall, and 11% who experienced a fall scored high fall-related self-efficacy. Impaired physical function was significantly associated with scoring low fall-related self-efficacy, for both fallers and nonfallers. Fear of falling is significantly associated with poor physical function and earlier falls. Falls Efficacy Scale, Swedish version could add useful information to a fall risk analysis. Patients scoring low fall-related self-efficacy should be offered fall prevention measures whether they have fallen or not.

  • 202.
    Andervik, Johanna
    et al.
    Örebro University, School of Health and Medical Sciences.
    Toftling, Marita
    Örebro University, School of Health and Medical Sciences.
    Anhörigas upplevelser av omsorg vid livets slut2009Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
  • 203.
    Anderzén-Carlsson, Agneta
    Örebro University, School of Health and Medical Sciences.
    Aktuell forskare om barn med cancer, deras rädsla och sättet den hanteras på2008In: Barnbladet, ISSN 0349-1994, Vol. 33, no 2, p. 45-46Article in journal (Other (popular science, discussion, etc.))
  • 204.
    Anderzén-Carlsson, Agneta
    Örebro University, School of Health and Medical Sciences.
    Att hantera rädsla hos barn med cancer2008In: Onkologi i Sverige, ISSN 1653-1582, Vol. 4, no 6, p. 14-20Article in journal (Other (popular science, discussion, etc.))
  • 205.
    Anderzén-Carlsson, Agneta
    et al.
    Örebro University, School of Health and Medical Sciences.
    Kihlgren, Annica
    Örebro University, School of Health and Medical Sciences.
    Sörlie, Venke
    Högskolan i Bodö.
    Embodied suffering: experiences of fear in adolescent girls with cancer2008In: Journal of Child Health Care, ISSN 1367-4935, E-ISSN 1741-2889, Vol. 12, no 2, p. 129-143Article in journal (Refereed)
    Abstract [en]

    Previously, fear in adolescents with cancer has been sparsely described from an emic perspective. The aim of this study was to illuminate fear in adolescents with personal experience of cancer. The participants were six adolescent girls between the age of 14 and 16 years who were no longer under active treatment for cancer but still went for regular check-ups. Open interviews were conducted. Data were analysed according to the phenomenological hermeneutic method. In the result one main theme was identified: `an embodied fear — a threat to the personal self'. This theme was built up by three separate but intertwined themes: `experiencing fear related to the physical body', `experiencing existential fear' and `experiencing fear related to the social self'. In the comprehensive understanding the fear was interpreted from youth cultural aspects as well as a holistic perspective. The importance of professionals taking the whole person and their situation into account when meeting the fear is underlined.

  • 206.
    Anderzén-Carlsson, Agneta
    et al.
    Örebro University, School of Health and Medical Sciences.
    Sørlie, Venke
    Högskolan i Bodö.
    Gustafsson, Karin
    Olsson, Maria
    Kihlgren, Mona
    Fear in children with cancer: observations at an outpatient visit2008In: Journal of Child Health Care, ISSN 1367-4935, E-ISSN 1741-2889, Vol. 12, no 3, p. 191-208Article in journal (Refereed)
    Abstract [en]

    The aim of the study was to describe interactions within the family and between them and professionals on a routine visit at a paediatric oncology outpatient clinic where the visiting child was likely to be fearful. Observations were performed. Data were analysed by qualitative content analysis. The behaviours most frequently observed as expressing fear were being quiet, withdrawn or providing detailed descriptions of experiences. Within the theme `Recognition of the fear', an attentive attitude to the fear was traced; fear was confirmed and cooperation was seen. Although many efforts were made to meet the fear, this was not always successful. Within the theme `Lack of attention to the fear', the fear was not in focus due to parental worries and concerns about the child's health, and organizational disturbances. The results can serve as a basis for collegial reflections of how to handle fear in children with cancer.

  • 207.
    Andreychenko, Sergiy
    Örebro University, School of Health and Medical Sciences.
    Analysis of radioation induced structural changes in rat spermatozoa2010Independent thesis Advanced level (degree of Master (Two Years)), 30 credits / 45 HE creditsStudent thesis
  • 208.
    André, Annika
    et al.
    Örebro University, School of Health and Medical Sciences.
    Bryndahl, Linnéa
    Föräldrars upplevelser av att få ett prematurt barn2011Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 209.
    Andrén, Ove
    Örebro University, School of Health and Medical Sciences.
    Natural history and prognostic factors in localized prostate cancer2008Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The natural history of localized prostate cancer is not fully understood. In most patients the tumor will never progress to a lethal disease, while a subset of patients will ultimately die of the disease. Efficient tools to separate indolent from lethal disease is currently lacking which means that many patients will be offered treatment without any benefit, but still be at risk of experiencing treatment related side effects.

    The aims of these studies were to get more insight into the natural history of untreated localized prostate cancer, to assess the prognostic value of established clinical parameters such as Gleason score, nuclear grade and tumor volume and, moreover, some new prognostic markers Ki-67, AMACR and MUC-1. We also aimed to study time trends in the detection of incidental tumors in Sweden.

    Patients with localized disease (n=223) and no initial treatment were followed for 21 years. Most patients had a favorable outcome. However, a subset of patients developed lethal disease even beyond 15 years of follow-up and these patients define the group that may benefit most from treatment with curative intent. Patients with poorly differentiated tumors experienced a 9 time higher risk of dying in prostate cancer.

    The studies on prognostic markers are based on a cohort of patients (n=253) with incidental prostate cancer detected by transurethral resection for presumed benign hyperplasia. All patients were left without initial treatment. Gleason grade, nuclear grade and tumor volume turned all out to be independent prognostic factors. MUC-1, AMACR and Ki-67 also carried prognostic information. However, after adjustment for Gleason grade, nuclear grade and tumor volume only MUC-1 and AMACR remained as statistically significant prognostic factors. When tested for sensitivity and specificity they all failed and, consequently, they seem to be of less value in daily practice for cancelling an individual patient regarding the choice of treatment.

    Time trends in incidental prostate tumors in Sweden were analyzed in a cohort of patients with prostate tumors detected by transurethral resection (TUR-P). Through linkage of the national registration number (NRN) with several registers, e.g. the Swedish Cancer Registry, the National Inpatient registry and the Cause of Death Registry we identified, during the period 1970 through 2003, in total 23288 patients with incidental prostate cancer, who constituted the study group. As comparison group we choose all patients diagnosed with prostate cancer between 1970-2003 excluding those with incidental cancer, in total 112204 patients. Our result confirms earlier findings that there has been a dramatic change over time in incidence of incidental prostate cancers in Sweden, which parallels the introduction of prostate specific antigen. We also found that the cumulative incidence of prostate cancer death is high in the incidental group, opposing earlier findings that incidental tumours are a non-lethal disease.

    List of papers
    1. Natural history of early, localized prostate cancer
    Open this publication in new window or tab >>Natural history of early, localized prostate cancer
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    2004 (English)In: Journal of the American Medical Association (JAMA), ISSN 0098-7484, E-ISSN 1538-3598, Vol. 291, no 22, p. 2713-2719Article in journal (Refereed) Published
    Abstract [en]

    Context Among men with early prostate cancer, the natural history without initial therapy determines the potential for survival benefit following radical local treatment. However, little is known about disease progression and mortality beyond 10 to 15 years of watchful waiting. Objective To examine the long-term natural history of untreated, early stage prostatic cancer. Design Population-based, cohort study with a mean observation period of 21 years. Setting Regionally well-defined catchment area in central Sweden (recruitment March 1977 through February 1984). Patients A consecutive sample of 223 patients (98% of all eligible) with early-stage (T0-T2 NX MO classification), initially untreated prostatic cancer. Patients with tumor progression were hormonally treated (either by orchiectomy or estrogens) if they had symptoms. Main Outcome Measures Progression-free, cause-specific, and overall survival. Results After complete follow-up, 39 (17%) of all patients experienced generalized disease. Most cancers had an indolent course during the first 10 to 15 years. However, further follow-up from 15 (when 49 patients were still alive) to 20 years, revealed a substantial decrease in cumulative progression-free survival (from 45.0% to 36.0%), survival without metastases (from 76.9% to 51.2%), and prostate cancer-specific survival (from 78.7% to 54.4%). The prostate cancer mortality rate increased from 15 per 1000 person-years (95% confidence interval, 10-21) during the first 15 years to 44 per 1000 person-years (95% confidence interval, 22-88) beyond 15 years of follow-up (P=.01). Conclusion Although most prostate cancers diagnosed at an early stage have an indolent course, local tumor progression and aggressive metastatic disease may develop in the long term. These findings would support early radical treatment, notably among patients with an estimated life expectancy exceeding 15 years.

    National Category
    Surgery
    Research subject
    Surgery esp. Urology Specific
    Identifiers
    urn:nbn:se:oru:diva-15599 (URN)10.1001/jama.291.22.2713 (DOI)000221862300025 ()2-s2.0-2642548279 (Scopus ID)
    Available from: 2011-05-18 Created: 2011-05-18 Last updated: 2023-12-08Bibliographically approved
    2. How well does the Gleason score predict prostate cancer death?: A 20-year followup of a population based cohort in Sweden
    Open this publication in new window or tab >>How well does the Gleason score predict prostate cancer death?: A 20-year followup of a population based cohort in Sweden
    Show others...
    2006 (English)In: Journal of Urology, ISSN 0022-5347, E-ISSN 1527-3792, Vol. 175, no 4, p. 1337-1340Article in journal (Refereed) Published
    Abstract [en]

    Purpose

    Adenocarcinoma of the prostate is the most common cancer among men in Western countries. Although the prognostic heterogeneity of prostate cancer is enormous, clinically insignificant aggressive prostate cancers cannot be reliably distinguished. Therefore, identifying prognostic factors is increasingly important, notably among men diagnosed with localized prostate cancer, because many of them may not require aggressive treatment.

    Materials and Methods

    We analyzed a population based cohort of 253 men with early stage (T1a-b, Nx, M0) initially untreated prostate cancer diagnosed between 1977 and 1991, before PSA screening was available. Tissue samples were available for 240 patients diagnosed with transurethral resection. During complete followup through September 2003, standardized criteria were used to classify histopathological characteristics, progression and causes of death.

    Results

    Higher Gleason grade, higher nuclear grade and larger tumor volume were independent predictors of death in prostate cancer with monotonous and statistically significant trends (p <0.05). In contrast, the level of Ki-67 – strongly correlated to Gleason score – was not an independent predictor of prostate cancer death. Given a Gleason score of 7 or greater, the probability of dying of prostate cancer was 29%. The corresponding predictive value for Gleason score 8 or greater was 48%.

    Conclusions

    Although a high Gleason score is a determinant of prostate cancer death, its PPV is relatively low. Thus, further efforts in finding other or complementary indicators of prostate cancer outcome are needed.

    Place, publisher, year, edition, pages
    Baltimore: Williams and Wilkins Co., 2006
    National Category
    Medical and Health Sciences Surgery Urology and Nephrology
    Research subject
    Surgery esp. Urology Specific
    Identifiers
    urn:nbn:se:oru:diva-5067 (URN)10.1016/S0022-5347(05)00734-2 (DOI)
    Available from: 2009-01-26 Created: 2009-01-26 Last updated: 2017-12-14Bibliographically approved
    3. Decreased alpha-methylacyl CoA racemase expression in localized prostate cancer is associated with an increased rate of biochemical recurrence and cancer-specific death
    Open this publication in new window or tab >>Decreased alpha-methylacyl CoA racemase expression in localized prostate cancer is associated with an increased rate of biochemical recurrence and cancer-specific death
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    2005 (English)In: Cancer Epidemiology, Biomarkers and Prevention, ISSN 1055-9965, E-ISSN 1538-7755, Vol. 14, no 6, p. 1424-1432Article in journal (Refereed) Published
    Abstract [en]

    alpha-Methylacyl CoA racemase (AMACR) is overexpressed in prostate cancer relative to benign prostatic tissue. AMACR expression is highest in localized prostate cancer and decreases in metastatic prostate cancer. Herein, we explored the use of AMACR as a biomarker for aggressive prostate cancer. AMACR protein expression was determined by immunohistochemistry using an image analysis system on two localized prostate cancer cohorts consisting of 204 men treated by radical prostatectomy and 188 men followed expectantly. The end points for the cohorts were time to prostate-specific antigen (PSA) failure (i.e., elevation > 0.2 ng/mL) and time to prostate cancer death in the watchful waiting cohort. Using a regression tree method, optimal AMACR protein expression cutpoints were determined to best differentiate prostate cancer outcome in each of the cohorts separately. Cox proportional hazard models were then employed to examine the effect of the AMACR cutpoint on prostate cancer outcome, and adjusted for clinical variables. Lower AMACR tissue expression was associated with worse prostate cancer outcome, independent of clinical variables (hazard ratio, 3.7 for PSA failure; P = 0.018; hazard ratio, 4.1 for prostate cancer death, P = 0.0006). Among those with both low AMACR expression and high Gleason score, the risk of prostate cancer death was 18-fold higher (P = 0.006). The AMACR cutpoint developed using prostate cancer-specific death as the end point predicted PSA failures independent of Gleason score, PSA, and margin status. This is the first study to show that AMACR expression is significantly associated with prostate cancer progression and suggests that not all surrogate end points may be optimal to define biomarkers of aggressive prostate cancer.

    National Category
    Surgery
    Research subject
    Surgery esp. Urology Specific
    Identifiers
    urn:nbn:se:oru:diva-15600 (URN)10.1158/1055-9965.EPI-04-0801 (DOI)000229766600017 ()
    Available from: 2011-05-18 Created: 2011-05-18 Last updated: 2017-12-11Bibliographically approved
    4. MUC-1 gene is associated with prostate cancer death: a 20-year follow-up of a population-based study in Sweden
    Open this publication in new window or tab >>MUC-1 gene is associated with prostate cancer death: a 20-year follow-up of a population-based study in Sweden
    Show others...
    2007 (English)In: British Journal of Cancer, ISSN 0007-0920, E-ISSN 1532-1827, Vol. 97, no 6, p. 730-734Article in journal (Refereed) Published
    Abstract [en]

    Anti-adhesion mucins have proven to play an important part in the biology of several types of cancer. Therefore, we test the hypothesis that altered expression of MUC-1 is associated with prostate cancer progression. We retrieved archival tumour tissue from a population-based cohort of 195 men with localised prostate cancer (T1a-b, Nx, M0) that has been followed for up to 20 years with watchful waiting. Semi-automated, quantitative immunohistochemistry was undertaken to evaluate MUC-1 expression. We modelled prostate cancer-specific death as a function of MUC-1 levels accounting for age, Gleason grade and tumour extent, and calculated age-adjusted and multivariate adjusted hazard ratios (HR). Men that had tumours with an MUC-intensity lower or higher than normal tissue had a higher risk of dying in prostate cancer, independent of tumour extent and Gleason score (HR 5.1 and 4.5, respectively). Adjustment for Gleason grade and tumour stage did not alter the results. Men with a Gleason score >=7 and MUC-1 deviating from the normal had a 17 (RR=17.1 95% confidence interval=2.3–128) times higher risk to die in prostate cancer compared with men with Gleason score <7 and normal MUC-1 intensity. In summary, our data show that MUC-1 is an independent prognostic marker for prostate cancer death.

    Place, publisher, year, edition, pages
    London: Harcourt Publishers, 2007
    National Category
    Medical and Health Sciences Surgery Cancer and Oncology
    Research subject
    Oncology; Surgery esp. Urology Specific
    Identifiers
    urn:nbn:se:oru:diva-5063 (URN)10.1038/sj.bjc.6603944 (DOI)000249392100005 ()2-s2.0-34548565758 (Scopus ID)
    Available from: 2009-01-26 Created: 2009-01-26 Last updated: 2023-12-08Bibliographically approved
    5. Time trends and survival among men diagnosed with incidental prostate cancer in Sweden: a register-based study between 1970 and 2003
    Open this publication in new window or tab >>Time trends and survival among men diagnosed with incidental prostate cancer in Sweden: a register-based study between 1970 and 2003
    Show others...
    (English)Manuscript (preprint) (Other academic)
    National Category
    Surgery
    Research subject
    Surgery esp. Urology Specific
    Identifiers
    urn:nbn:se:oru:diva-15601 (URN)
    Available from: 2011-05-18 Created: 2011-05-18 Last updated: 2017-10-17Bibliographically approved
    Download full text (pdf)
    FULLTEXT01
    Download full text (pdf)
    FULLTEXT02
    Download (pdf)
    COVER01
  • 210.
    Andrén, Ove
    et al.
    Örebro University, School of Health and Medical Sciences.
    Fall, Katja
    Andersson, Swen-Olof
    Rubin, Mark A.
    Bismar, Tarek A.
    Karlsson, M.
    Johansson, Jan-Erik
    Örebro University, School of Health and Medical Sciences.
    Mucci, Lorelei A.
    MUC-1 gene is associated with prostate cancer death: a 20-year follow-up of a population-based study in Sweden2007In: British Journal of Cancer, ISSN 0007-0920, E-ISSN 1532-1827, Vol. 97, no 6, p. 730-734Article in journal (Refereed)
    Abstract [en]

    Anti-adhesion mucins have proven to play an important part in the biology of several types of cancer. Therefore, we test the hypothesis that altered expression of MUC-1 is associated with prostate cancer progression. We retrieved archival tumour tissue from a population-based cohort of 195 men with localised prostate cancer (T1a-b, Nx, M0) that has been followed for up to 20 years with watchful waiting. Semi-automated, quantitative immunohistochemistry was undertaken to evaluate MUC-1 expression. We modelled prostate cancer-specific death as a function of MUC-1 levels accounting for age, Gleason grade and tumour extent, and calculated age-adjusted and multivariate adjusted hazard ratios (HR). Men that had tumours with an MUC-intensity lower or higher than normal tissue had a higher risk of dying in prostate cancer, independent of tumour extent and Gleason score (HR 5.1 and 4.5, respectively). Adjustment for Gleason grade and tumour stage did not alter the results. Men with a Gleason score >=7 and MUC-1 deviating from the normal had a 17 (RR=17.1 95% confidence interval=2.3–128) times higher risk to die in prostate cancer compared with men with Gleason score <7 and normal MUC-1 intensity. In summary, our data show that MUC-1 is an independent prognostic marker for prostate cancer death.

  • 211. Andrén, Ove
    et al.
    Garmo, H.
    Mucci, L.
    Andersson, Swen-Olof
    Johansson, Jan-Erik
    Örebro University, School of Health and Medical Sciences.
    Fall, Katja
    Incidence and mortality of incidental prostate cancer: a Swedish register-based study2009In: British Journal of Cancer, ISSN 0007-0920, E-ISSN 1532-1827, Vol. 100, no 1, p. 170-173Article in journal (Refereed)
    Abstract [en]

    In a national register-based study of incidence trends and mortality of incidental prostate cancer in Sweden, we found that a significant proportion (26.6%) of affected men diagnosed died of their disease, which challenges earlier descriptions of incidental prostate cancer as a non-lethal disease.

  • 212.
    Andrén, Ove
    et al.
    Örebro University, School of Health and Medical Sciences.
    Garmo, Hans
    Mucci, Lorelei
    Andersson, Swen-Olof
    Johansson, Jan-Erik
    Fall, Katja
    Time trends and survival among men diagnosed with incidental prostate cancer in Sweden: a register-based study between 1970 and 2003Manuscript (preprint) (Other academic)
  • 213. Anedda, Francesca
    et al.
    Zucchelli, Marco
    Schepis, Danika
    Hellquist, Anna
    Corrado, Lucia
    D'Alfonso, Sandra
    Achour, Adnane
    McInerney, Gerald
    Bertorello, Alejandro
    Lordal, Mikael
    Befrits, Ragnar
    Bjork, Jan
    Bresso, Francesca
    Torkvist, Leif
    Halfvarson, Jonas
    Örebro University, School of Health and Medical Sciences.
    Kere, Juha
    D'Amato, Mauro
    Multiple polymorphisms affect expression and function of the neuropeptide S receptor (NPSR1)2011In: PLOS ONE, E-ISSN 1932-6203, Vol. 6, no 12, p. e29523-Article in journal (Refereed)
    Abstract [en]

    Background: neuropeptide S (NPS) and its receptor NPSR1 act along the hypothalamic-pituitary-adrenal axis to modulate anxiety, fear responses, nociception and inflammation. The importance of the NPS-NPSR1 signaling pathway is highlighted by the observation that, in humans, NPSR1 polymorphism associates with asthma, inflammatory bowel disease, rheumatoid arthritis, panic disorders, and intermediate phenotypes of functional gastrointestinal disorders. Because of the genetic complexity at the NPSR1 locus, however, true causative variations remain to be identified, together with their specific effects on receptor expression or function. To gain insight into the mechanisms leading to NPSR1 disease-predisposing effects, we performed a thorough functional characterization of all NPSR1 promoter and coding SNPs commonly occurring in Caucasians (minor allele frequency >0.02). Principal Findings: we identified one promoter SNP (rs2530547 [-103]) that significantly affects luciferase expression in gene reporter assays and NPSR1 mRNA levels in human leukocytes. We also detected quantitative differences in NPS-induced genome-wide transcriptional profiles and CRE-dependent luciferase activities associated with three NPSR1 non-synonymous SNPs (rs324981 [Ile107Asn], rs34705969 [Cys197Phe], rs727162 [Arg241Ser]), with a coding variant exhibiting a loss-of-function phenotype (197Phe). Potential mechanistic explanations were sought with molecular modelling and bioinformatics, and a pilot study of 2230 IBD cases and controls provided initial support to the hypothesis that different cis-combinations of these functional SNPs variably affect disease risk. Significance: these findings represent a first step to decipher NPSR1 locus complexity and its impact on several human conditions NPS antagonists have been recently described, and our results are of potential pharmacogenetic relevance.

  • 214.
    Anerös, Terese
    Örebro University, School of Health and Medical Sciences.
    En studie om sambandet mellan självskattad astmakontroll och en inflamationsmarkör hos barn med astma2009Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
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    En studie om sambandet mellan självskattad astmakontroll och en inflamationsmarkör hos barn med astma
  • 215.
    Angberg, Maria
    Örebro University, School of Health and Medical Sciences.
    Patienters upplevelser på akutmottagningen2010Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Till en akutmottagning söker sig människor med akut sjukdom eller skada. Det är på en akutmottagning som många människor får den första kontakten med sjukhus och sjukdom. Varje enskild patient bedöms och prioriteras efter sökorsak och det medicinska tillståndet. Patienterna placeras i ett turordningssystem, triage, som är behovsbaserat och innebär att de svårast sjuka eller skadade går först. Sjuksköterskans uppgift på akutmottagningen är att ansvara för ett korrekt omhändertagande av patienterna.

    Syftet med studien var att beskriva patienters upplevelser på en akutmottagning.

    Den systematiska litteraturstudien är uppbyggd på tretton vetenskapliga artiklar. Den genomförda litteratursökningen gjordes systematiskt i databaserna Cinahl och Medline.

    Resultatet visade att väntetiden på en akutmottagning var en kritisk faktor, oavsett om väntetiden var lång eller kort. Flera patienter upplevde att de inte blev bemötta på ett lämplig sätt eller att de inte fick tillräckligt med uppmärksamhet från vårdpersonalen. Det var viktigt för patienterna att känna sig trygga med vårdpersonalen för att få en positiv upplevelse på akutmottagningen, och många patienter litade på vårdpersonalens kompetens och expertis. Patienterna behövde känna sig delaktiga i vården samt få sina fysiska och psykiska behov tillfredsställda. Under väntetiden upplevde även patienterna att relevant och lättförståelig information om deras tillstånd, behandling och väntetidens längd och orsak var bristfällig. Miljön hade också en stor inverkan på hur upplevelsen skulle bli för patienterna på akutmottagningen.

    Genom denna litteraturstudie har det framkommit att det är viktigt att ge patienten ett personligt och bra bemötande och omhändertagande, och att den enskilda patienten får individuellt anpassad omvårdnad. Saklig information och verbal kommunikation från vårdpersonalen gör att väntan på en akutmottagning blir mer uthärdig för patienten. Att vårdpersonalen uppvisar professionalitet samt inger ett lugn betyder att patienterna känner trygghet.

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    FULLTEXT01
  • 216.
    Anorga Wirén, Andrea
    et al.
    Örebro University, School of Health and Medical Sciences.
    Tsegay, Neguse
    Örebro University, School of Health and Medical Sciences.
    Omvårdnadsåtgärder för att minska preoperativ oro2009Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
  • 217.
    Anselmius, Johan
    et al.
    Örebro University, School of Health and Medical Sciences.
    Milton, Ludvig
    Örebro University, School of Health and Medical Sciences.
    Expand A Lung: Ett träningsverktyg för andningsmuskulaturen?2011Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

     Abstrakt

     

    Syfte:

    Syftet var att undersöka om prestation och uthålligheten hade förbättrats vid användandet av Expand a lung.

     

    Metod:

    En intervention genomfördes på sju testpersoner (4 kvinnor & 3 män) som använde Expand a lung under fjorton dagar, som jämfördes mot en kontrollgrupp på fyra testpersoner (2 kvinnor & 2 män). Testpersonerna genomförde två tester, med en intervall på fjorton dagar. I undersökningen figurerade 4 kvinnor och 3 män (ålder: 22.7 ± 2, vikt: 68.5 ± 10, längd: 175.1 ± 8.5) i experimentgruppen. 2 kvinnor och 2 män (ålder: 22.5 ± 1.5, vikt: 69 ± 9, längd: 170.7 ± 5.5) ingick i kontrollgruppen. Hjärtfrekvens, respiratoriska kvoten och blodlaktat uppmättes med hjälp utav Jaeger Oxycon Pro och lungvolym (SVC & FEV1) uppmättes med hjälp av Spirare SPS 310.

     

    Resultat:

    Ingen signifikant skillnad existerade inom grupperna. Experimentgruppen: SVC före x 4.73, SVC efter x 4,77. FEV1 före x 4.31, FEV1 efter x 4.29, HF (vid OBLA) före x 156, HF efter 155, RQ (vid OBLA) före x 1.04, RQ efter 1.05. Kontrollgruppen: SVC före x 4.98, SVC efter x 4.95. FEV1 före 4.48, FEV1 efter x 4.49, HF (vid OBLA) före x 165, HF efter 163, RQ (vid OBLA) före x 0.99, RQ efter x 1.00. Det som gick att urskilja var att det fanns skillnader på individnivå.

     

    Diskussion:

    Vår undersökning visade ingen signifikant skillnad på gruppnivå efter 14 dagars användande av Expand a lung. Dock fanns det skillnader på individnivå. Detta resultat kan bland annat bero på för kort träningsperiod och för få deltagare. Om Expand a lung kan förbättra prestationen vid träning under längre tid kan vi inte uttala oss om utan krävs vidare forskning.

     

    Nyckelord:

    Expand a lung, andningsmuskulaturträning, laktat, lungvolym.

    Inledning:

    Det existerar träningsredskap som utlovar en ökning gällande prestation och uthållighet, i träningssammanhang, av människans andningsmuskulatur. Träningsredskapen isolerade träningen till att bara sätta andningsmuskulaturen i arbete. Expand a lung var en av dessa nya, mer obeprövade, träningsredskap som utlovade en förbättrad prestation och uthållighet vid ett frekvent användande. Samtidigt visade en befintlig del av forskning att det indirekt inte gick att träna andningsmuskulaturen. Vi påträffade aldrig granskade vetenskaplig forskning som kunde fastställa vad Expand a lung utlovade.

  • 218.
    Appelros, Peter
    et al.
    Örebro University, School of Health and Medical Sciences.
    Stegmayr, Birgita
    Terént, Andreas
    Riks-Stroke och hur fallgropar vid tolkning av resultaten undviks: [Riks-Stroke and how to prevent pitfalls interpreting the results]2008In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 105, no 8, p. 529-533Article in journal (Other academic)
    Abstract [en]

    Riks-Stroke, the Swedish quality register for stroke care, has been in service for twelve years. The register gives a unique opportunity to compare treatment, care, and rehabilitation of stroke patients. The protocol has now been launched in its eighth version. The most important changes include that the register now also includes cases that are treated as outpatients. Also, a more robust measure of stroke severity, the National Institutes of Health Stroke Scale (NIHSS) has been included. All quality registers are sensitive for selection bias. Therefore, it is important to aim at as complete case ascertainment as possible, both at baseline and at the 3-month follow-up. To analyze the comparability of quality parameters between different time points, or between different hospitals, we suggest the use of certain “base factors”, for example age, stroke severity, and number of patients included at baseline and at follow-up.From 2007, with a more robust measure of stroke severity, we are offered an instrument that facilitates comparisons. By registering outpatients, selection bias from this cause is avoided. We will also learn if outpatients have a worse long time outcome. A possible future direction is that the quality of medical follow-up is evaluated within the frames of Riks-Stroke, for example life style factors and treatment of hypertension.

  • 219.
    Ardeman Merten, Rebecka
    Örebro University, School of Health and Medical Sciences.
    Agressivitet mellan personer med demens inom kommunal hälso- och sjukvård: - sjuksköterskors erfarenheter2010Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
  • 220.
    Arenhall, Eva
    et al.
    Örebro University, School of Health and Medical Sciences. Department of Cardiology, Örebro University Hospital, Örebro, Sweden; Centre for Health Care Sciences, Örebro County Council, Örebro, Sweden.
    Kristofferzon, Marja-Leena
    Department of Health and Caring Sciences, University of Gävle, Gävle, Sweden; Department of Public Health and Caring Sciences, Section of Caring Sciences, Uppsala University, Uppsala, Sweden.
    Fridlund, Bengt
    School of Health and Caring Sciences, Linnéaus University, Växjö, Sweden; School of Health Sciences, Jönköping University, Jönköping, Sweden.
    Malm, Dan
    School of Health Sciences, Jönköping University, Jönköping, Sweden; Department of Internal Medicine, Division of Cardiology, County Hospital Ryhov, Jönkoping, Sweden.
    Nilsson, Ulrica
    Department of Anaesthesia and Intensive Care, Örebro University Hospital, Örebro, Sweden.
    The male partners' experiences of the intimate relationships after a first myocardial infarction2011In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 10, no 2, p. 108-114Article in journal (Refereed)
    Abstract [en]

    Background: Stress in the intimate relationship is found to worsen the prognosis in women suffering from myocardial infarction (MI). Little is known about how male spouses experience the intimate relationship.

    Aim: This study aimed to explore and describe the experience of men's intimate relationships in connection to and after their female partner's first MI.

    Methods: An explorative and qualitative design was used. Interviews were conducted with 16 men having a partner who the year before had suffered a first MI. The data were analysed with qualitative content analysis.

    Results: Three themes emerged: masculine image challenged; life takes another direction; and life remains unchanged. The men were forced to deal with an altered image of themselves as men, and as sexual beings. They were hesitant to approach their spouse in the same way as before the MI because they viewed her to be more fragile. The event also caused them to consider their own lifestyle, changing towards healthier dietary and exercise habits.

    Conclusions: After their spouse's MI, men experienced a challenge to their masculine image. They viewed their spouse as being more fragile, which led the men to be gentler in sexual intimacy and more hesitant to invite sexual activity. This knowledge about how male spouses experience the intimate relationship could be helpful for health personnel in hospitals and primary care when they interact with couples where the woman suffers from cardiac disease or other chronic disorders. (C) 2010 European Society of Cardiology. Published by Elsevier B.V. All rights reserved.

  • 221.
    Arenhall, Eva
    et al.
    Örebro University, School of Health and Medical Sciences. Centre for Health Care Sciences, Örebro County Council, Örebro, Sweden.
    Kristofferzon, Marja-Leena
    Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, University of Gävle, Gävle, Sweden; Department of Public Health and Caring Sciences, Section of Caring Sciences, Uppsala University, Uppsala, Sweden.
    Fridlund, Bengt
    School of Health Sciences, Jönköpings University, Jönköping, Sweden.
    Nilsson, Ulrica
    Örebro University, School of Health and Medical Sciences. Department of Anaesthesia and Intensive Care, Örebro University Hospital,Örebro, Sweden; Centre for Health Care Sciences, Örebro County Council, Örebro, Sweden.
    The female partners' experiences of intimate relationship after a first myocardial infarction2011In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 20, no 11-12, p. 1677-1684Article in journal (Refereed)
    Abstract [en]

    Aim. This study aimed to explore and describe women's experience of intimate relationships in connection to and after their partner's first myocardial infarction. Background. Support from partners is important for recovery, but little is known about partners' experience of intimate relationships after myocardial infarction. Design. The study used an explorative, qualitative design. Methods. The first author interviewed 20 women having a partner who had suffered a first myocardial infarction during the preceding year. Qualitative content analysis was used to analyse the data. Findings. Three themes emerged: 'limited life space', 'sense of life lost' and 'another dimension of life'. The women described how their self-assumed responsibility led to a more stifling and limited life. Their sense of life lost was described in terms of deficits and feeling the loss. The women also described experiencing another dimension of life characterised by three subthemes: 'uncertainty of life', 'certain of relationship' and 'share life more'. Conclusions. The partners' myocardial infarction had an impact on the interviewees' intimate relationships; they suffered a major loss and missed their 'former' partner, both emotionally and sexually. They struggled with the new asymmetry in their intimate relationship and felt compelled to adapt to their partners' lack of sexual desire or function. Also, their partner controlled them, which lead towards a stifling, more limited life space. Relevance to clinical practice. Caregivers in hospital and primary care settings could apply the findings in their efforts to help couples recover or maintain intimate relationships following myocardial infarction. 

  • 222. Armstrong, Neil
    et al.
    Tomkinson, Grant R.
    Ekelund, Ulf
    Örebro University, School of Health and Medical Sciences.
    Aerobic fitness and its relationship to sport, exercise training and habitual physical activity during youth2011In: British Journal of Sports Medicine, ISSN 0306-3674, E-ISSN 1473-0480, Vol. 45, no 11, p. 849-858Article, review/survey (Refereed)
    Abstract [en]

    Aim To analyse aerobic fitness and its relationship with sport participation, exercise training and habitual physical activity (HPA) during youth. Methods Studies were located through computer searches of Medline, SPORT Discus and personal databases. Systematic reviews of time trends in aerobic fitness/performance, and exercise training and peak oxygen uptake (peak VO(2)) are reported. Results Peak VO(2) increases with age and maturation. Boys' peak VO(2) is higher than girls'. Despite data showing a decrease in performance test estimates of aerobic fitness there is no compelling evidence to suggest that young people have low levels of peak VO(2) or that it is declining over time. The primary time constant of the VO(2) kinetics response to moderate and heavy intensity exercise slows with age and the VO(2) kinetics response to heavy intensity exercise is faster in boys. There is a negative correlation between lactate threshold as a percentage of peak VO(2) and age but differences related to maturation or sex remain to be proven. Young athletes have higher peak VO(2), a faster primary time constant and accumulate less blood lactate at the same relative exercise intensity than their untrained peers. Young people can increase their peak VO(2) through exercise training but a meaningful relationship between aerobic fitness and HPA has not been demonstrated. Conclusions During youth the responses of the components of aerobic fitness vary in relation to age, maturation and sex. Exercise training will enhance aerobic fitness but a relationship between young people's current HPA and aerobic fitness remains to be proven.

  • 223.
    Arnesson, Emma
    Örebro University, School of Health and Medical Sciences.
    Att leva med en make/maka som har en demenssjukdom2011Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 224.
    Arvidsson, Matilda
    Örebro University, School of Health and Medical Sciences.
    "Vi är ju killar och då måste vi ju idrotta mer":  en kvalitativ studie om maskulinitetskonstruktion i skolämnet idrott och hälsa2009Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 225.
    Arvidsson, Sandra
    et al.
    Örebro University, School of Health and Medical Sciences.
    Kljajevic, Nevena
    Örebro University, School of Health and Medical Sciences.
    Arbetsterapeuters upplevelse av sin roll i teamarbete - en intervjustudie2011Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Sammanfattning: Syftet med studien är att undersöka hur arbetsterapeuter upplever teamarbete och vad de upplever påverkar teamarbetet. Syftet är även att undersöka hur arbetsterapeuter upplever sin roll och betydelse av den i teamarbete samt hur de upplever att andra professioner i teamet uppfattar arbetsterapeutens roll. Det finns olika typer av team och det talas allt mer om det interprofessionella teamets värde och vinsterna med detta. Teamarbete är komplext och påverkas av flera olika faktorer. Tidigare forskning har visat att arbetsterapeuter har svårt att definiera sin roll och kan bli missförstådda av andra professioner i teamet.   

    Metod: Studien hade en kvalitativ ansats. Data insamlades genom semistrukturerade intervjuer och analyserades enligt kvalitativ innehållsanalys. Intervjuer genomfördes med 6 arbetsterapeuter verksamma inom kommun eller landsting.

    Resultat: Resultatet presenterades i två teman; olika dimensioner av att arbeta i team samt arbetsterapeutens paradoxala roll. Resultatet skildrar både likheter och skillnader i arbetsterapeuters uppfattningar om sin roll i teamarbete. Ledning, verksamhetstyp, nivå på kompetens och personlig inställning var faktorer som kunde påverka teamarbetet. Arbetsterapeutyrkets utveckling har påverkat tydligheten i arbetsterapeutens roll. Arbetsterapeuterna som intervjuades presenterade strategier för att marknadsföra sin roll.

    Slutsats: Arbetsterapeuter uppfattar att deras roll i team är tydlig men att det alltid krävs marknadsföring och tydliggörande av rollen. Arbetsterapeuters yrkesroll är mångfacetterad. Arbetsterapeuterna upplevde att de av andra professioner uppfattades vara tillgängliga och att de fungerade som ett stöd. Teamarbete upplevdes som något positivt av alla respondenter, men att arbeta i team är inte en självklarhet då det finns faktorer och omständigheter som påverkar möjligheten till att arbeta i team.

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    Arbetsterapeuters upplevelse av sin roll i teamarbete - en intervjustudie
  • 226.
    Arvidsson, Sofie
    et al.
    Örebro University, School of Health and Medical Sciences.
    Witwicki Carlsson, Matilda
    Örebro University, School of Health and Medical Sciences.
    Exoskelett som hjälpmedel inom rehabilitering för personer med fysiska funktionsnedsättningar2011Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Exoskeletten uppfanns för användning inom militären, men forskning och utveckling av den här robottekniken har öppnat en möjlighet även till användning i rehabiliteringssyfte. Syfte: Att beskriva exoskelett för övre extremitet, ändamålet till vilket dessa används inom rehabilitering för personer med fysiska funktionsnedsättningar, samt värdet av att använda dem. Metod: Systematisk litteraturstudie. De databaser som användes var Amed, Cinahl och Medline. Genom en kombination av olika sökord resulterade sökningen i 11 artiklar som inkluderades i studien. Resultat: Åtta olika exoskelett togs med i uppsatsen. Ändamålet med de flesta exoskeletten var i huvudsak att assistera terapeuten i träning av hand och arm medan ett exoskelett användes i studier som handlade om att underlätta för användaren vid dennes ADL-utförande. Användningen av exoskeletten visade en övergripande förbättrad förmåga i bland annat motorik, rörelseomfång, muskelstyrka, reducering av tremor och i utförandet av dagliga aktiviteter. De flesta studier som handlar om exoskelett är förstudier inför större, kliniska studier. Slutsats: Att använda sig av exoskelett är en potentiell och effektiv rehabiliteringsmetod som ger möjlighet till större självständighet hos individerna. Viss utveckling krävs för ökad bekvämlighet och alla exoskelett är under vidareutveckling. Kvaliteten på materialet är medelmåttligt, varvid resultatet bör läsas med viss förbehållsamhet.

     

    Download full text (pdf)
    Exoskeleton essay
  • 227.
    Arving, Cecilia
    et al.
    Department of Public Health and Caring Sciences, Uppsala University, Sweden.
    Holmström, Inger
    Örebro University, School of Health and Medical Sciences. Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Creating a new profession in cancer nursing?: Experiences of working as a psychosocial nurse in cancer care2011In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 20, no 19-20, p. 2939-2947Article in journal (Refereed)
    Abstract [en]

    AIMS: To describe the nature of being a psychosocial nurse in cancer care.

    BACKGROUND: Psychosocial nurses in cancer care are a new profession in cancer nursing in Sweden, with potential to offer unique support to patients regarding somatic and psychological needs. This new profession is hitherto unexplored.

    DESIGN: A qualitative inductive interview approach was used.

    METHODS: A strategic sample of five nurses working as psychosocial nurses in cancer care in Sweden was interviewed. A thematic stepwise analysis was performed.

    RESULTS: The analysis revealed the twofold experience of being a psychosocial nurse in cancer care. The nurses felt as if they had two professions: nurse and therapist. They used skills from both professions to help the person, who had cancer and a psychosocial problem. It was stimulating to be able to combine the knowledge and practices of two professions. It was also difficult because they felt an uncertainty about what their roles and responsibilities really were.

    CONCLUSIONS: This new profession seems to need role descriptions and formal education so that psychosocial nurses receive respect and appreciation in their new and relatively unknown work in cancer care. RELEVANCE TO CLINICAL PRACTICES: The adjustment to the cancer disease and treatment side effects can be difficult for the patients and their families, which has highlighted the need for psychosocial support. To meet this need the health care system has to provide such support. Nurses are available and can be successfully educated to handle psychosocial problems among cancer patients. A new profession among nurses is emerging, which the present study aimed at describing. The present findings have potential to make healthcare professionals grasp what the core of psychosocial cancer nursing is, as well as its potential and pitfalls.

  • 228.
    Ashtab, Susann
    et al.
    Örebro University, School of Health and Medical Sciences.
    Ringvall, Hanna
    Örebro University, School of Health and Medical Sciences.
    Fritidsaktiviteters betydelse och påverkan i ungdomars vardagsliv: en kvalitativ studie genomförd i Spånga-Tensta stadsdel2009Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Sammanfattning:

    Tidigare studier som gjorts om ungdomar och fritidsaktiviteter har ofta fokuserat på specifika aktiviteter som fysiska sporter. Inom arbetsterapi är aktivitet ett centralt begrepp som består av olika komponenter och vi ville därför göra en studie med ett bredare perspektiv på fritidsaktiviteter. Syftet med denna studie var att beskriva hur ungdomar i Spånga-Tensta stadsdel upplever betydelsen av fritidsaktiviteter och hur dessa påverkar deras vardagsliv. Fokusgruppsintervjuer är en form av kvalitativ datainsamlingsmetod som användes för att svara på syftet. Intervjuerna utfördes på två fritidsgårdar med ungdomar mellan 14-21 år. Resultatet visar att ungdomarna upplever betydelsen av att ha fritidsaktiviteter som positivt och konsekvenserna av att inte ha några som negativt. Aspekter som berörs av fritidsaktiviteter är enligt ungdomarna social betydelse, rutiner, kultur och framtid.

    Resultatet visar att fritidsaktiviteter inte bara har en påverkan på deras vardagsliv utan också på deras framtid.

    Sökord: Fritidsaktivitet, ungdomar, kvalitativ forskning, intervju

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    FULLTEXT01
  • 229. Asp, Nils-Georg
    et al.
    Akner, Gunnar
    Örebro University, School of Health and Medical Sciences.
    Forsum, Elisabet
    Hådell, Karin
    Laser Reutersvärd, Anita
    Wersäll, Jan
    Näringslära i svensk läkarutbildning1995In: Nordisk Medicin, ISSN 0029-1420, Vol. 110, no 11, p. 292-293Article in journal (Other academic)
  • 230.
    Asplund, Andréa
    et al.
    Örebro University, School of Health and Medical Sciences.
    Löwgren, Tina
    Omvårdnadsåtgärder vid sömnproblem2011Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 231.
    Asplund, Caroline
    et al.
    Örebro University, School of Health and Medical Sciences.
    Stenevang, Ida
    Örebro University, School of Health and Medical Sciences.
    Upplevelser av att leva med bloddialysbehandling vid kronisk njursjukdom - en litteraturstudie2009Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
  • 232. Astuto, L. M.
    et al.
    Bork, J. M.
    Weston, M. D.
    Askew, J. W.
    Fields, R. R.
    Orten, D. J.
    Ohlinger, S. J.
    Riazuddin, S.
    Morell, R. J.
    Khan, S.
    Kremer, H.
    van Hauwe, P.
    Möller, Claes
    Örebro University, School of Health and Medical Sciences.
    Cremers, C. W.
    Ayuso, C.
    Heckenlively, J. R.
    Rohrschneider, K.
    Spandau, U.
    Greenberg, J.
    Ramesar, R.
    Reardon, W.
    Bitoun, P.
    Millan, J.
    Legge, R.
    Friedman, T. B.
    Kimberling, W.
    CDH23 mutation and phenotype heterogeneity: a profile of 107 diverse families with Usher syndrome and nonsyndromic deafness2002In: American Journal of Human Genetics, ISSN 0002-9297, E-ISSN 1537-6605, Vol. 71, no 2, p. 262-275Article in journal (Refereed)
    Abstract [en]

    Usher syndrome type I is characterized by congenital hearing loss, retinitis pigmentosa (RP), and variable vestibular areflexia. Usher syndrome type ID, one of seven Usher syndrome type I genetic localizations, have been mapped to a chromosomal interval that overlaps with a nonsyndromic-deafness localization, DFNB12. Mutations in CDH23, a gene that encodes a putative cell-adhesion protein with multiple cadherin-like domains, are responsible for both Usher syndrome and DFNB12 nonsyndromic deafness. Specific CDH23 mutational defects have been identified that differentiate these two phenotypes. Only missense mutations of CDH23 have been observed in families with nonsyndromic deafness, whereas nonsense, frameshift, splice-site, and missense mutations have been identified in families with Usher syndrome. In the present study, a panel of 69 probands with Usher syndrome and 38 probands with recessive nonsyndromic deafness were screened for the presence of mutations in the entire coding region of CDH23, by heteroduplex, single-strand conformation polymorphism, and direct sequence analyses. A total of 36 different CDH23 mutations were detected in 45 families; 33 of these mutations were novel, including 18 missense, 3 nonsense, 5 splicing defects, 5 microdeletions, and 2 insertions. A total of seven mutations were common to more than one family. Numerous exonic and intronic polymorphisms also were detected. Results of ophthalmologic examinations of the patients with nonsyndromic deafness have found asymptomatic RP-like manifestations, indicating that missense mutations may have a subtle effect in the retina. Furthermore, patients with mutations in CDH23 display a wide range of hearing loss and RP phenotypes, differing in severity, age at onset, type, and the presence or absence of vestibular areflexia.

  • 233. Astuto, Lisa M.
    et al.
    Weston, Michael D.
    Carney, Carol A.
    Hoover, Denise M.
    Cremers, Cor W. R. J.
    Wagenaar, Mariette
    Möller, Claes
    Örebro University, School of Health and Medical Sciences.
    Smith, Richard J. H.
    Pieke-Dahl, Sandra
    Greenberg, Jacquie
    Ramesar, Raj
    Jacobson, Samuel G.
    Ayuso, Carmen
    Heckenlively, John R.
    Tamayo, Marta
    Gorin, Michael B.
    Reardon, Willie
    Kimberling, William J.
    Genetic heterogeneity of Usher syndrome: analysis of 151 families with Usher type 12000In: American Journal of Human Genetics, ISSN 0002-9297, E-ISSN 1537-6605, Vol. 67, no 6, p. 1569-1574Article in journal (Refereed)
    Abstract [en]

    Usher syndrome type I is an autosomal recessive disorder marked by hearing loss, vestibular areflexia, and retinitis pigmentosa. Six Usher I genetic subtypes at loci USH1A-USH1F have been reported. The MYO7A gene is responsible for USH1B, the most common subtype. In our analysis, 151 families with Usher I were screened by linkage and mutation analysis. MYO7A mutations were identified in 64 families with Usher I. Of the remaining 87 families, who were negative for MYO7A mutations, 54 were informative for linkage analysis and were screened with the remaining USH1 loci markers. Results of linkage and heterogeneity analyses showed no evidence of Usher types Ia or Ie. However, one maximum LOD score was observed lying within the USH1D region. Two lesser peak LOD scores were observed outside and between the putative regions for USH1D and USH1F, on chromosome 10. A HOMOG chi(2)((1)) plot shows evidence of heterogeneity across the USH1D, USH1F, and intervening regions. These results provide conclusive evidence that the second-most-common subtype of Usher I is due to genes on chromosome 10, and they confirm the existence of one Usher I gene in the previously defined USH1D region, as well as providing evidence for a second, and possibly a third, gene in the 10p/q region.

  • 234.
    Augustsson, Kristin
    et al.
    Örebro University, School of Health and Medical Sciences.
    Rydqvist, Amanda
    Sömn och tvättstugescheman: En studie kring vårdanställda skiftarbetares sömn och risk för trötthet, misstag samt olyckor2011Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 235.
    Austeng, Dordi
    et al.
    Dept Ophthalmol, Uppsala Univ, Uppsala, Sweden.
    Blennow, Mats
    Dept Pediat, Karolinska Univ Hosp Huddinge, Stockholm, Sweden .
    Ewald, Uwe
    Dept Pediat, Uppsala Univ, Uppsala, Sweden.
    Fellman, Vineta
    Dept Pediat, Lund Univ, Lund, Sweden.
    Fritz, Thomas
    Dept Obstet & Gynecol, Sahlgrens Univ Hosp, Gothenburg, Sweden.
    Hellstrom-Westas, Lena
    Dept Pediat, Uppsala Univ, Uppsala, Sweden .
    Hellstrom, Ann
    Dept Ophthalmol, Inst Neurosci & Physiol, Sahlgrenska Acad, Univ Gothenburg, Gothenburg, Sweden.
    Holmgren, Per Åke
    Dept Clin Sci Obstet & Gynecol, Umeå Univ Hosp, Umeå, Sweden.
    Holmstrom, Gerd
    Dept Ophthalmol, Uppsala Univ, Uppsala, Sweden.
    Jakobsson, Peter
    Dept, Ophthalmol, Linkoping Univ, Linkoping, Sweden.
    Jeppsson, Annika
    Dept Obstet & Gynecol, Linköping Univ, Linköping, Sweden.
    Johansson, Kent
    Dept Ophthalmol, Umeå Univ, Umeå, Sweden.
    Kallén, Karin
    Ctr Reprod Epidemiol, Lund Univ, Lund, Sweden.
    Lagercrantz, Hugo
    Dept Pediat, Karolinska Inst, Astrid Lindgren Childrens Hosp, Stockholm, Sweden.
    Laurini, Ricardo
    Dept Pathol, Bodø Cent Hosp, Bodø, Norway.
    Lindberg, Eva
    Department of Pediatrics, Örebro University, Örebro, Sweden.
    Lundqvist, Anita
    Dept Hlth Sci, Lund Univ, Lund, Sweden.
    Marsal, Karel
    Dept Obstet & Gynecol, Lund Univ, Lund, Sweden.
    Nilstun, Tore
    Dept Med Eth, Lund Univ, Lund, Sweden.
    Norden-Lindeberg, Solveig
    Dept Obstet & Gynecol, Uppsala Univ, Uppsala, Sweden.
    Norman, Mikael
    Dept Clin Sci Intervent & Technol, Karolinska Inst, Stockholm, Sweden; Dept Pediat, Karolinska Univ Hosp, Stockholm, Sweden.
    Olhager, Elisabeth
    Dept Pediat, Linköping Univ, Linköpinging, Sweden; Dept Obstet & Gynecol, Univ Örebro, Örebro, Sweden .
    Östlund, Ingrid
    Örebro University, School of Health and Medical Sciences.
    Serenius, Fredrik
    Dept Pediat, Umeå Univ Hosp, Umeå, Sweden.
    Simic, Marija
    Dept Obstet & Gynecol, Karolinska Univ Hosp Solna, Stockholm, Sweden.
    Sjors, Gunnar
    Dept Pediat, Uppsala Univ, Uppsala, Sweden.
    Stigson, Lennart
    Dept Pediat, Sahlgrens Univ Hosp, Gothenburg, Sweden.
    Stjernqvist, Karin
    Dept Psychol, Lund Univ, Lund, Sweden.
    Stromberg, Bo
    Dept Pediat, Uppsala Univ, Uppsala, Sweden.
    Tornqvist, Kristina
    Dept Ophthalmol, Lund Univ, Lund, Sweden.
    Wennergren, Margareta
    Dept Obstet & Gynecol, Sahlgrens Univ Hosp, Gothenburg, Sweden.
    Wallin, Agneta
    St Erik Eye Hosp, Karolinska Univ, Stockholm, Sweden.
    Westgren, Magnus
    Dept Obstet & Gynecol, Karolinska Univ Hosp Huddinge, Stockholm, Sweden.
    Incidence of and risk factors for neonatal morbidity after active perinatal care: extremely preterm infants study in Sweden (EXPRESS)2010In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 99, no 7, p. 978-992Article in journal (Refereed)
    Abstract [en]

    Aims: The aim of this study was to determine the incidence of neonatal morbidity in extremely preterm infants and to identify associated risk factors. Methods: Population based study of infants born before 27 gestational weeks and admitted for neonatal intensive care in Sweden during 2004-2007. Results: Of 638 admitted infants, 141 died. Among these, life support was withdrawn in 55 infants because of anticipation of poor long-term outcome. Of 497 surviving infants, 10% developed severe intraventricular haemorrhage (IVH), 5.7% cystic periventricular leucomalacia (cPVL), 41% septicaemia and 5.8% necrotizing enterocolitis (NEC); 61% had patent ductus arteriosus (PDA) and 34% developed retinopathy of prematurity (ROP) stage >= 3. Eighty-five per cent needed mechanical ventilation and 25% developed severe bronchopulmonary dysplasia (BPD). Forty-seven per cent survived to one year of age without any severe IVH, cPVL, severe ROP, severe BPD or NEC. Tocolysis increased and prolonged mechanical ventilation decreased the chances of survival without these morbidities. Maternal smoking and higher gestational duration were associated with lower risk of severe ROP, whereas PDA and poor growth increased this risk. Conclusion: Half of the infants surviving extremely preterm birth suffered from severe neonatal morbidities. Studies on how to reduce these morbidities and on the long-term health of survivors are warranted.

  • 236.
    Autio, Eila
    Örebro University, School of Health and Medical Sciences.
    Anestesisjuksköterskans upplevelser av att vara resurs vid primär- och sekundäruppdrag prehospitalt2011Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
  • 237.
    Avraam, Sofia
    et al.
    Örebro University, School of Health and Medical Sciences.
    Lindén, Madeleiné
    Örebro University, School of Health and Medical Sciences.
    Patienters erfarenheter av att leva med KOL2011Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 238.
    Awdi, Mona
    Örebro University, School of Health and Medical Sciences.
    Arabiska kvinnors upplevelser av bristande språkförståelse i möte med den svenska vården2010Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
  • 239.
    Axell, Anna
    et al.
    Örebro University, School of Health and Medical Sciences.
    Dahlberg, Svitlana
    Örebro University, School of Health and Medical Sciences.
    Anhörigas upplevelser av Parkinsons sjukdom - en litteraturstudie2009Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
  • 240.
    Axelsson, Anna
    Örebro University. Örebro University, School of Health and Medical Sciences.
    Localization of the HIV-1 subtype C p24 protein within transgenic plant tissues using IHC in combination with light microscopy.2009Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
  • 241.
    Axelsson, Anna
    Örebro University, School of Health and Medical Sciences.
    Targeting HIV-p24 Protein within Transgenic Plant tissues Using Confocal and Transmission Electron Microscopy2011Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
  • 242.
    Axelsson, Arvid
    et al.
    Örebro University, School of Health and Medical Sciences.
    Hammar, Magnus
    Örebro University, School of Health and Medical Sciences.
    Träning av frekvensdiskriminering - är det meningsfullt?2009Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Denna experimentella studie syftar till att undersöka huruvida en eventuell träningseffekt i 

    frekvensdiskrimination kvarstår efter en tids träningsuppehåll. Tidigare forskning har visat 

    tydliga samband mellan frekvensdiskriminering och talutveckling, kortikal signalbehandling 

    och dyslexi. Det har klargjorts genom tidigare studier att förmågan att diskriminera frekvenser 

    är möjligt att träna upp. Därmed är träning i frekvensdiskrimination en lämplig del i en 

    behandlingsmetod med syfte att utveckla den auditiva perceptionen. Denna studie undersöker 

    de praktiska förutsättningarna till denna behandlingsmetod genom att utreda varaktigheten av 

    den eventuella träningseffekten 14 dagar efter träningen. 24 normalhörande personer deltog i 

    studien där försökspersonernas förmåga att frekvensdiskriminera undersöktes med hjälp av ett 

    egenutvecklat mjukvaruprogram. Först uppmättes försökspersonernas förmåga när de var 

    otränade (mätning 1). Sedan genomfördes ett träningspass som följdes av en mätning 

    (mätning 2). Efter 14 dagar genomfördes ytterligare en mätning för att undersöka den 

    bestående effekten (mätning 3). 

    Resultatet visade (när tre outliers exkluderats) en signifikant skillnad mellan mätning 1 och 2 

    (p=0,034) vilket innebär att en omedelbar träningseffekt erhölls. Ingen signifikant skillnad 

    kunde påvisas mellan mätning 2 och 3 (p=0,952) men en signifikant skillnad erhölls mellan 

    mätning 1 och 3 (p=0,031) vilket påvisar att den omedelbara träningseffekten kvarstod efter 

    de gångna 14 dagarna. 

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  • 243.
    Axelsson, Elisabet
    et al.
    Örebro University, School of Health and Medical Sciences.
    Haglund, Sofi
    Örebro University, School of Health and Medical Sciences.
    Musik som omvårdnadsåtgärd - Patienters upplevelser och fysiskt mätbara effekter2009Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
  • 244. Axelsson, Johan
    et al.
    Elmståhl, Sölve
    Akner, Gunnar
    Örebro University, School of Health and Medical Sciences.
    Geriatrik är ett försummat ämne i svensk läkarutbildning [Geriatrics neglected in Swedish medical education.]: "äldreparadoxen" kräver rejäl satsning ["The elderly paradox" requires a substantial effort]2006In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 103, no 44, p. 3361-3365Article in journal (Refereed)
  • 245.
    Axelsson, Kjell
    et al.
    Örebro University, School of Health and Medical Sciences.
    Gupta, Anil
    Örebro University, School of Health and Medical Sciences.
    Johanzon, Eva
    Berg, Elisabeth
    Ekbäck, Gustav
    Rawal, Narinder
    Enström, Peter
    Nordensson, Ulf
    Intraarticular administration of ketorolac, morphine, and ropivacaine combined with intraarticular patient-controlled regional analgesia for pain relief after shoulder surgery: a randomized, double-blind study2008In: Anesthesia and Analgesia, ISSN 0003-2999, E-ISSN 1526-7598, Vol. 106, no 1, p. 328-333Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: In this study we assessed the efficacy of intraarticular regional analgesia on postoperative pain and analgesic requirements. METHODS: Fifty-one patients undergoing shoulder surgery (Bankart) were recruited into this double-blind study. At the end of the operation, patients were randomized to three groups to receive intraarticularly via a catheter: Group 1: ropivacaine 90 mg (9 mL), morphine 4 mg (10 mL), and ketorolac 30 mg (1 mL) (total volume 20 mL); Groups 2 and 3: saline (20 mL). In addition, Groups 1 and 3 received 1 mL saline IV while Group 2 received ketorolac 30 mg (1 mL) IV. Postoperatively, Group 1 received pain relief using 10 mL 0.5% ropivacaine on demand via the intraarticular catheter while Groups 2 and 3 received 10 mL of saline intraarticularly. Group 3 was the Control group. RESULTS: Postoperative pain at rest and on movement were lower in Group 1 than in Groups 2 and 3 during the first 30 and 120 min, respectively. The time to first request for local anesthetic infusion was longer in Group 1 than in Groups 2 and 3 (P < 0.001). The median morphine consumption during the first 24 postoperative hours was less in Groups 1 and 2 than in Group 3 (P < 0.001). There was no significant difference in analgesic consumption between Group 1 and Group 2. The median satisfaction score was higher in Group 1 compared with Groups 2 (P < 0.05) and 3 (P < 0.001). CONCLUSIONS: A combination of intraarticular ropivacaine, morphine, and ketorolac followed by intermittent injections of ropivacaine as needed provided better pain relief, less morphine consumption, and improved patient satisfaction compared with the control group. The group that received IV ketorolac consumed less morphine and was more satisfied with treatment than patients in the control group.

  • 246. Axelsson, Roland
    et al.
    Jansson, Charlotte
    Järliden, Eva
    Westblad, Johan
    Jendteg, Stefan
    Sedelius, Thomas
    Sandberg, Andreas
    Eriksson, Charli
    Örebro University, School of Health and Medical Sciences.
    Indikatorer för hållbar välfärdsutveckling på stadsdelsnivå2010In: Partnerskap för hållbar välfärdsutveckling: utveckling och forskning under sex år i fyra städer / [ed] Charli Eriksson, Eva Järliden, Annika Larsson, Solveig Sandberg, Örebro: Örebro universitet , 2010, p. 219-240Chapter in book (Other academic)
  • 247.
    Axelsson, Sofie-Linnéa
    et al.
    Örebro University, School of Health and Medical Sciences.
    Falk, Susanne
    Örebro University, School of Health and Medical Sciences.
    Personers upplevelser av att bli diagnostiserade med Multipel skleros2008Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
  • 248.
    Axelsson, Susanna
    et al.
    Örebro University, School of Health and Medical Sciences.
    Zabrdac, Ivona
    Örebro University, School of Health and Medical Sciences.
    Vårdpersonalens attityder till patienter med övervikt och fetma2008Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
  • 249.
    Axelsson, Susanne
    Örebro University, School of Health and Medical Sciences.
    Flödescytometrisk sortering av cellpopulationer med olika cytostatikakänslighet: metodutvärdering på leukemi- och brösttumörceller2008Independent thesis Advanced level (professional degree), 20 credits / 30 HE creditsStudent thesis
    Abstract [sv]

    Flödescytometrisk cellsortering möjliggör att ur ett större cellmaterial separera en subpopulation celler för vidare analyser. Uppkomst av cytostatikaresistens beror på olika faktorer men där överuttryck av P-gp spelar stor roll. P-gp transporterar aktivt ut cytostatika ur cellen. I studier på AML-celler har man flödescytometriskt påvisat att JC-1 ackumulering speglar P-gp aktivitet. Därmed kan cytostatikaresistenta celler identifieras och sorteras.

    Bröstcancer är den svenska kvinnans vanligaste cancerform där cytostatika ofta ingår i den postoperativa behandlingen. Trots att många patienter svarar på första behandlingen drabbas många ändå av återfall. Problematik med cytostatikaresistens är då vanligt förekommande.

    Syftet med denna studie var att sätta upp en metod för att flödescytometrisk cellsortera avseende olika JC-1 ackumulering och därmed olika cytostatikakänslighet.

    I studien användes färskt brösttumörmaterial och två subcellinjer av leukemicellinjen HL-60. HL-60 S som är känslig för cytostatika och HL-60 R5 som är resistent vid odling med 5 µM doxorubicin.

    Resultaten visade att starkare fluorescensintensitet erhölls vid inkubation och förvaring i JC-1 jämfört med att efter JC-1 inkubation förvara cellerna i D-PBS. Det var möjligt att inkubera ett större antal celler med JC-1 i cellodlingsflaska. Resultaten visar dock att flödescytometrisk sortering kraftigt påverkade viabiliteten hos HL-60 S + R5 där endast två tredjedelar av cellerna var viabla efter sorteringen. Preparering av brösttumörmaterial med Medicon medförde att en betydande andel celler dog och materialet i studien var inte tillräckligt för cellsortering. Att cellsortera kräver kunskap och erfarenhet och det är av vikt att prepareringsmetoden och sorteringsinställningarna optimeras på det material som ska användas i studien.

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  • 250. Ayala, Marcelo
    et al.
    Strid, Hilja
    Örebro University, School of Health and Medical Sciences.
    Jacobsson, Ulrika
    Söderberg, Per G.
    p53 expression and apoptosis in the lens after ultraviolet radiation exposure2007In: Investigative Ophthalmology and Visual Science, ISSN 0146-0404, E-ISSN 1552-5783, Vol. 48, no 9, p. 4187-4191Article in journal (Refereed)
    Abstract [en]

    PURPOSE: To localize p53 protein and active caspase-3 in the albino rat lens and to compare p53 mRNA and active caspase-3 expression in ultraviolet radiation (UVR) 300 nm exposed lenses and their contralateral nonexposed controls. METHODS: Ten Sprague-Dawley albino rats were unilaterally exposed to 8 kJ/m(2) UVR, and the contralateral eyes were left nonexposed. In total, four exposed lenses and their respective contralateral nonexposed lenses were analyzed by immunohistochemistry to localize p53 and active caspase-3. In addition, six exposed and contralateral nonexposed lenses were analyzed by real-time RT-PCR. Quantified p53 and caspase-3 expression were compared between the in vivo UVR 300 nm exposed lenses and the contralateral nonexposed lenses. RESULTS: All lenses exposed to UVR developed cataract. Immunohistochemistry showed that p53 and active caspase-3 were localized in the lens epithelial cells. Quantified p53 and caspase-3 expression were significantly higher in lenses exposed to UVR than in nonexposed lenses. CONCLUSIONS: p53 and caspase-3 expression increase in lens epithelial cells after UVR exposure. In the lens, apoptosis induced by UVR may be associated with increased p53 expression.

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