Långtidssjukskrivna kvinnors erfarenheter av vad som varit betydelsefullt för återgång till arbete

Validerat; 20101217 (root

Membrane protein topogenesis

The membranes of cells are highly complex and heterogeneous structures that fulfill multiple vital tasks. They form thin barriers that seal out the environment, thus defining the cell’s boundaries. They mediate the selective exchange of information and substances between the inside and outside of cells, thus making cellular life and survival possible and allowing fast adaptation to changing conditions. Not least importantly, they harbor key components of many essential processes such as the photosynthesis and respiration. Membranes are composed of a largely apolar lipid matrix densely punctuated with a large number of different proteins. These so-called membrane proteins usually span the lipid matrix and protrude out into the space on either side of the membrane. Over millions of years of evolution, cells have developed an incredible machinery to facilitate the insertion of membrane proteins into the membrane. Our understanding of these machines and the insertion processes they mediate has reached a point where we have a very good picture of membrane protein biogenesis in various types of cells. However, more data still needs to be collected to completely comprehend the complex molecular mechanisms and the physical chemistry that underlies the different insertion processes. The work presented in this thesis contributes to that understanding. More precisely, we have studied how weakly hydrophobic transmembrane elements of membrane proteins, which cannot spontaneously enter the largely apolar membrane matrices, are efficiently incorporated. Indeed, such elements are quite common in membrane proteins and our work has lead to the formulation of a novel mechanism for how they can be integrated into biological membranes. We have also added to the understanding of the physical chemistry that underlies the membrane insertion process by systematically introducing non-proteinogenic amino acids into a membrane-spanning segment of a membrane protein and studying its membrane insertion capability

Sex- och samlevnadsundervisning i Sörmlands skolor

Sexualitet är ett grundläggande behov hos människor och påverkar individens upplevelse av hälsa och välbefinnande. Skolan fungerar som en viktig arena för att främja unga vuxnas sexuella hälsa och sex- och samlevnadsundervisningen i skolan kan ha stor betydelse för unga vuxnas utveckling. Sex- och samlevnadsundervisning har varit obligatorisk i svenska skolor sedan år 1955. Trots det visar en kvalitetsgranskning av sex- och samlevnadsundervisningen i svenska skolor från år 1999 att kvaliteten på undervisningen är ojämn både mellan olika skolor och inom varje enskild skola. Syftet med denna studie var att studera hur sex- och samlevnadsundervisningen bedrivs i Sörmlands högstadie- och gymnasieskolor. En enkätundersökning har skickats ut till samtliga högstadie- och gymnasieskolor i Sörmland för att undersöka sex- och samlevnadsundervisningens omfattning, innehåll samt kvalitet. Resultatet visade att majoriteten av högstadie- och gymnasieskolorna bedriver sex- och samlevnadsundervisning och det vanligaste innehållet i undervisningen är STI, sexualitet, könsroller, relationer, kärlek samt preventivmedelsinformation. Hälften av skolorna samarbetar med en annan verksamhet i undervisningen och en tredjedel av skolorna har fastställda mål för hur sex- och samlevnadsundervisningen ska bedrivas. Slutsatsen är att undervisningen i vissa skolor bör utgå mer från ett främjande perspektiv och fler skolor behöver mål för sex- och samlevnadsundervisningen och utvärdera undervisningen i större utsträckning.Sexuality is a fundamental need for humans and influences the individuals experience of health and well-being. The school serves as an important arena to promote adolescents sexual health and sex education in schools can have significant effects on adolescents` development. Sex education has been mandatory in Swedish schools since the year 1955. A quality review shows inequality in sex education in Swedish schools, both between schools and within each school. The aim of this study was to investigate how sex education is implemented in Sörmlands schools from grade seven to grade twelve. A questionnaire was sent out to all schools from grade seven to grade twelve in Sörmland to investigate sex educations extent, content and quality. The result showed that the majority of the investigated schools have sex education and the most common contents is STI, sexuality, gender roles, relationships, love and birth control information. Half of the schools collaborating with others in sex education and a third of the schools have set targets for the sex education. The conclusion is that sex education in some schools should be more of a promotion prospects and more schools need to set targets for the sex education and evaluate the sex education to a greater extent

Patient- och närståendeutbildning inom strokevård : En litteraturstudie

SAMMANFATTNING Inledning: Att drabbas av stroke kan upplevas som en fruktansvärd och påfrestande händelse, både för patient och närstående. Det är hälso- och sjukvårdens ansvar att utbilda patienter och närstående genom individuellt anpassad information, på ett lyhört, empatiskt och respektfullt sätt. Information och handledning av sjuksköterskan ses därför som mycket viktigt för patient och närstående så att de får kontroll över den nya situationen de befinner sig i. Syfte: Att sammanställa aktuella vetenskapliga artiklar om vilka utbildningar som finns inom strokevård samt hur patienter och närstående upplever och påverkas av dessa. Metod: En litteraturstudie bestående av totalt 16 kvantitativa respektive kvalitativa vetenskapliga artiklar. Databaser som användes är PubMed och CINAHL. Resultat: Studiens resultat visar på att det finns olika metoder för utbildning av patient och närstående bland annat grupputbildning och individuell utbildning med både skriftligt och muntligt innehåll. Patienter och närstående upplever information och utbildning som något viktigt. Studien visar även på att effekterna av utbildning är goda gällande både fysiska och psykiska faktorer, exempelvis ökad livskvalitet samt minskad påfrestning hos närståendevårdgivare. Slutsats: Studien visar på att olika metoder av information och utbildning ger goda effekter och upplevelser hos strokepatienter och deras närstående. Sjuksköterskan bör lägga mer fokus på detta i sitt dagliga arbete. Patient- och närståendeutbildning önskas vara en större del av grundutbildningen för legitimerad sjuksköterska. Vidare forskning kring det aktuella ämnet bör bedrivas.ABSTRACT Introduction: To suffer from a stroke can be perceived as a terrible and stressful incident, both for the patient and family. It is the health care responsibility to educate patients and families through individualized information, in a caring, empathetic and respectful manner. Information and guidance of the nurse is therefore seen as very important for the patient and family so that they can have control over their new life situation. Purpose: To compile current scientific articles about education programs available in stroke care and how patients and families perceive and are affected by them. Method: This literature review included a total of 16 quantitative and qualitative research articles. Used databases were PubMed and CINAHL. Results: Our results demonstrate that there are different methods of education for patients and families including group training and individual training with both written and verbal content. Patients and relatives are experiencing information and training as something important. The study also shows that the effects of education are good regarding both physical and psychological factors, such as increased quality of life and reduced strain of family caregivers. Conclusion: The study shows that different methods of information and education gave good effects and experiences for patients with stroke and their relatives. Nurses should put more focus on this aspect in their daily work. Patient and family education should be a larger part of the basic education of a registered nurse. However, further research should be conducted

Patient- och närståendeutbildning inom strokevård : En litteraturstudie

SAMMANFATTNING Inledning: Att drabbas av stroke kan upplevas som en fruktansvärd och påfrestande händelse, både för patient och närstående. Det är hälso- och sjukvårdens ansvar att utbilda patienter och närstående genom individuellt anpassad information, på ett lyhört, empatiskt och respektfullt sätt. Information och handledning av sjuksköterskan ses därför som mycket viktigt för patient och närstående så att de får kontroll över den nya situationen de befinner sig i. Syfte: Att sammanställa aktuella vetenskapliga artiklar om vilka utbildningar som finns inom strokevård samt hur patienter och närstående upplever och påverkas av dessa. Metod: En litteraturstudie bestående av totalt 16 kvantitativa respektive kvalitativa vetenskapliga artiklar. Databaser som användes är PubMed och CINAHL. Resultat: Studiens resultat visar på att det finns olika metoder för utbildning av patient och närstående bland annat grupputbildning och individuell utbildning med både skriftligt och muntligt innehåll. Patienter och närstående upplever information och utbildning som något viktigt. Studien visar även på att effekterna av utbildning är goda gällande både fysiska och psykiska faktorer, exempelvis ökad livskvalitet samt minskad påfrestning hos närståendevårdgivare. Slutsats: Studien visar på att olika metoder av information och utbildning ger goda effekter och upplevelser hos strokepatienter och deras närstående. Sjuksköterskan bör lägga mer fokus på detta i sitt dagliga arbete. Patient- och närståendeutbildning önskas vara en större del av grundutbildningen för legitimerad sjuksköterska. Vidare forskning kring det aktuella ämnet bör bedrivas.ABSTRACT Introduction: To suffer from a stroke can be perceived as a terrible and stressful incident, both for the patient and family. It is the health care responsibility to educate patients and families through individualized information, in a caring, empathetic and respectful manner. Information and guidance of the nurse is therefore seen as very important for the patient and family so that they can have control over their new life situation. Purpose: To compile current scientific articles about education programs available in stroke care and how patients and families perceive and are affected by them. Method: This literature review included a total of 16 quantitative and qualitative research articles. Used databases were PubMed and CINAHL. Results: Our results demonstrate that there are different methods of education for patients and families including group training and individual training with both written and verbal content. Patients and relatives are experiencing information and training as something important. The study also shows that the effects of education are good regarding both physical and psychological factors, such as increased quality of life and reduced strain of family caregivers. Conclusion: The study shows that different methods of information and education gave good effects and experiences for patients with stroke and their relatives. Nurses should put more focus on this aspect in their daily work. Patient and family education should be a larger part of the basic education of a registered nurse. However, further research should be conducted

Positional editing of transmembrane domains during ion channel assembly

The integration of transmembrane (TM)-spanning regions of many channels and ion transporters is potentially compromised by the presence of polar and charged residues required for biological function. Although the two TMs of the ATP-gated ion channel subunit P2X2 each contain charged/polar amino acids, we found that each TM is efficiently membrane inserted when it is analysed in isolation, and uncovered no evidence for cooperativity between these two TMs during P2X2 integration. However, using minimal N-glycosylation distance mapping, we find that the positioning of TM2 in newly synthesized P2X2 monomers is distinct from that seen in subunits of the high-resolution structures of assembled homologous trimers. We conclude that P2X2 monomers are initially synthesised at the endoplasmic reticulum in a distinct conformation, where the extent of the TM-spanning regions is primarily defined by the thermodynamic cost of their membrane integration at the Sec61 translocon. In this model, TM2 of P2X2 subsequently undergoes a process of positional editing within the membrane that correlates with trimerisation of the monomer, a process requiring specific polar/charged residues in both TM1 and TM2. We postulate that the assembly process offsets any energetic cost of relocating TM2, and find evidence that positional editing of TM2 in the acid-sensing ion channel (ASIC1a) is even more pronounced than that observed for P2X2. Taken together, these data further underline the potential complexities involved in accurately predicting TM domains. We propose that the orchestrated repositioning of TM segments during subunit oligomerisation plays an important role in generating the functional architecture of active ion channels, and suggest that the regulation of this underappreciated biosynthetic step may provide an elegant mechanism for maintaining ER homeostasis

Changed membrane integration and catalytic site conformation are two mechanisms behind the increased Aβ42/Aβ40 ratio by presenilin 1 familial Alzheimer-linked mutations

The enzyme complex γ-secretase generates amyloid β-peptide (Aβ), a 37–43-residue peptide associated with Alzheimer disease (AD). Mutations in presenilin 1 (PS1), the catalytical subunit of γ-secretase, result in familial AD (FAD). A unifying theme among FAD mutations is an alteration in the ratio Aβ species produced (the Aβ42/Aβ40 ratio), but the molecular mechanisms responsible remain elusive. In this report we have studied the impact of several different PS1 FAD mutations on the integration of selected PS1 transmembrane domains and on PS1 active site conformation, and whether any effects translate to a particular amyloid precursor protein (APP) processing phenotype. Most mutations studied caused an increase in the Aβ42/Aβ40 ratio, but via different mechanisms. The mutations that caused a particular large increase in the Aβ42/Aβ40 ratio did also display an impaired APP intracellular domain (AICD) formation and a lower total Aβ production. Interestingly, seven mutations close to the catalytic site caused a severely impaired integration of proximal transmembrane/hydrophobic sequences into the membrane. This structural defect did not correlate to a particular APP processing phenotype. Six selected FAD mutations, all of which exhibited different APP processing profiles and impact on PS1 transmembrane domain integration, were found to display an altered active site conformation. Combined, our data suggest that FAD mutations affect the PS1 structure and active site differently, resulting in several complex APP processing phenotypes, where the most aggressive mutations in terms of increased Aβ42/Aβ40 ratio are associated with a decrease in total γ-secretase activity