Erkännandets betydelse. Romska kvinnors syn på utbildning som en väg mot inkludering.

Author: Karin Andréasson and Elin Björk Title: The meaning of recognition. –Romani women’s experiences of education as a way to inclusion. Supervisor: Hanna Wittrock Assessor: Elizabeth Martinell Barfoed The aim of this study was to examine the situation of Romani women in Sweden. More specifically, to investigate Romani women’s experiences of and view on education as a way to increase the inclusion of the minority of Romani people into the majority society. Romani people have a history of over 500 years in Sweden and are since year 2000 one of Sweden’s five national minorities protected by the law of minority. Yet it is a minority group with a long history of exclusion and discrimination. This has led to an identified alienation from many different welfare areas. In the process of increasing the minority’s inclusion into the majority society, Romani women have been pointed out as a group at risk of being object for double discrimination. This study was based on interviews with five Romani women who currently are studying to get their basic eligibility and after that, a job. The analysis was made in the light of the theory of recognition, focusing on recognition and its impact on a person’s self-relation alongside with the struggle to achieve recognition. Further the perspective of intersectionality with emphasis on the various of the women’s positions and how those impact their situation. It became clear that the Romani minority group is diverse with a large range of varieties regarding traditions and culture. In conclusion it was clear that education played a huge part in the women’s way of becoming part of the majority society. But they also experienced obstacles originating partly from within the minority group but mainly from the non-recognition surrounding majority society. It also became clear that it exists strategies of how to handle the misrecognition, constituting of that in some contexts hiding the Romani identity or, more or less active, lead a struggle of recognition with the aim to change the view on the Romani people

Breathing Exercises for Patients with Asthma in Specialist Care:A Multicenter Randomized Clinical Trial

RATIONALE: Moderate to severe asthma is associated with impaired asthma control and quality of life (QoL) despite access to specialist care and modern pharmacotherapy. Breathing exercises (BrEX) improve QoL in incompletely controlled mild asthma, but impact in moderate to severe asthma is unknown. OBJECTIVES: To investigate the effectiveness of BrEX as adjuvant treatment on QoL in patients with uncontrolled moderate to severe asthma. METHODS: Adult patients with incompletely controlled asthma attending respiratory specialist clinics were randomized to usual specialist care (UC) or UC and BrEX (UC + BrEX) with three individual physiotherapist-delivered sessions and home exercises. Primary outcome was asthma-related QoL (Mini-Asthma Quality of Life Questionnaire [Mini-AQLQ]) at 6 months on the basis of intention-to-treat analysis. Secondary outcomes: Mini-AQLQ at 12 months, lung function, 6-minute-walk test, physical activity level, Nijmegen Questionnaire, Hospital Anxiety and Depression Scale, and adverse events. Repeated-measures mixed-effects models were used to analyze data. Poisson regression models were used to analyze adverse event incidence rate ratio. RESULTS: A total of 193 participants were allocated to UC + BrEX (n = 94) or UC (n = 99). UC + BrEX was superior in the primary outcome (adjusted mean change difference, 0.35; 95% confidence interval [CI], 0.07 to 0.62). Superiority in Mini-AQLQ was sustained at 12 months (0.38; 95% CI, 0.12 to 0.65). A minor improvement in Hospital Anxiety and Depression Scale depression score at 6 months favoring UC + BrEX (−0.90; 95% CI, −1.67 to −0.14) was observed. Asthma-related adverse events occurred similarly in UC + BrEX and UC participants: 14.9% versus 18.1% (P = 0.38). CONCLUSIONS: BrEX as add-on to usual care improve asthma-related QoL in incompletely controlled asthma regardless of severity and with no evidence of harm. Clinical trial registered with www.clinicaltrials.gov (NCT 03127059)

Murine Polyomavirus Virus-Like Particles Carrying Full-Length Human PSA Protect BALB/c Mice from Outgrowth of a PSA Expressing Tumor

Virus-like particles (VLPs) consist of capsid proteins from viruses and have been shown to be usable as carriers of protein and peptide antigens for immune therapy. In this study, we have produced and assayed murine polyomavirus (MPyV) VLPs carrying the entire human Prostate Specific Antigen (PSA) (PSA-MPyVLPs) for their potential use for immune therapy in a mouse model system. BALB/c mice immunized with PSA-MPyVLPs were only marginally protected against outgrowth of a PSA-expressing tumor. To improve protection, PSA-MPyVLPs were co-injected with adjuvant CpG, either alone or loaded onto murine dendritic cells (DCs). Immunization with PSA-MPyVLPs loaded onto DCs in the presence of CpG was shown to efficiently protect mice from tumor outgrowth. In addition, cellular and humoral immune responses after immunization were examined. PSA-specific CD4+ and CD8+ cells were demonstrated, but no PSA-specific IgG antibodies. Vaccination with DCs loaded with PSA-MPyVLPs induced an eight-fold lower titre of anti-VLP antibodies than vaccination with PSA-MPyVLPs alone. In conclusion, immunization of BALB/c mice with PSA-MPyVLPs, loaded onto DCs and co-injected with CpG, induces an efficient PSA-specific tumor protective immune response, including both CD4+ and CD8+ cells with a low induction of anti-VLP antibodies

CD4+ and CD8+ T Cells Can Act Separately in Tumour Rejection after Immunization with Murine Pneumotropic Virus Chimeric Her2/neu Virus-Like Particles

BACKGROUND: Immunization with murine pneumotropic virus virus-like particles carrying Her2/neu (Her2MPtVLPs) prevents tumour outgrowth in mice when given prophylactically, and therapeutically if combined with the adjuvant CpG. We investigated which components of the immune system are involved in tumour rejection, and whether long-term immunological memory can be obtained. METHODOLOGY AND RESULTS: During the effector phase in BALB/c mice, only depletion of CD4+ and CD8+ in combination, with or without NK cells, completely abrogated tumour protection. Depletion of single CD4+, CD8+ or NK cell populations only had minor effects. During the immunization/induction phase, combined depletion of CD4+ and CD8+ cells abolished protection, while depletion of each individual subset had no or negligible effect. When tumour rejection was studied in knock-out mice with a C57Bl/6 background, protection was lost in CD4-/-CD8-/- and CD4-/-, but not in CD8-/- mice. In contrast, when normal C57Bl/6 mice were depleted of different cell types, protection was lost irrespective of whether only CD4+, only CD8+, or CD4+ and CD8+ cells in combination were eradicated. No anti-Her2/neu antibodies were detected but a Her2/neu-specific IFNgamma response was seen. Studies of long-term memory showed that BALB/c mice could be protected against tumour development when immunized together with CpG as long as ten weeks before challenge. CONCLUSION: Her2MPtVLP immunization is efficient in stimulating several compartments of the immune system, and induces an efficient immune response including long-term memory. In addition, when depleting mice of isolated cellular compartments, tumour protection is not as efficiently abolished as when depleting several immune compartments together

A multi-targeted approach to suppress tumor-promoting inflammation

Cancers harbor significant genetic heterogeneity and patterns of relapse following many therapies are due to evolved resistance to treatment. While efforts have been made to combine targeted therapies, significant levels of toxicity have stymied efforts to effectively treat cancer with multi-drug combinations using currently approved therapeutics. We discuss the relationship between tumor-promoting inflammation and cancer as part of a larger effort to develop a broad-spectrum therapeutic approach aimed at a wide range of targets to address this heterogeneity. Specifically, macrophage migration inhibitory factor, cyclooxygenase-2, transcription factor nuclear factor-κB, tumor necrosis factor alpha, inducible nitric oxide synthase, protein kinase B, and CXC chemokines are reviewed as important antiinflammatory targets while curcumin, resveratrol, epigallocatechin gallate, genistein, lycopene, and anthocyanins are reviewed as low-cost, low toxicity means by which these targets might all be reached simultaneously. Future translational work will need to assess the resulting synergies of rationally designed antiinflammatory mixtures (employing low-toxicity constituents), and then combine this with similar approaches targeting the most important pathways across the range of cancer hallmark phenotypes

Chronic fatigue syndromes: real illnesses that people can recover from

The ‘Oslo Chronic Fatigue Consortium’ consists of researchers and clinicians who question the current narrative that chronic fatigue syndromes, including post-covid conditions, are incurable diseases. Instead, we propose an alternative view, based on research, which offers more hope to patients. Whilst we regard the symptoms of these conditions as real, we propose that they are more likely to reflect the brain's response to a range of biological, psychological, and social factors, rather than a specific disease process. Possible causes include persistent activation of the neurobiological stress response, accompanied by associated changes in immunological, hormonal, cognitive and behavioural domains. We further propose that the symptoms are more likely to persist if they are perceived as threatening, and all activities that are perceived to worsen them are avoided. We also question the idea that the best way to cope with the illness is by prolonged rest, social isolation, and sensory deprivation. Instead, we propose that recovery is often possible if patients are helped to adopt a less threatening understanding of their symptoms and are supported in a gradual return to normal activities. Finally, we call for a much more open and constructive dialogue about these conditions. This dialogue should include a wider range of views, including those of patients who have recovered from them

Anesthesiological Nursing Care of Patient with Obesity

SAMMANFATTNING Bakgrund: Fetma och övervikt är ett hälsoproblem som drabbar mer än var tionde person världen över och antalet individer med BMI >30 ökar ständigt. Som en följd till detta kommer allt fler patienter som genomgår anestesi att ha ett högt BMI. Förändringar i respiration, luftvägsanatomi, läkemedelsmetabolism och ett flertal andra fysiologiska förändringar i kroppen gör generell anestesi för patienter med obesitas till en anestesiologisk utmaning. Syfte: Syftet med denna uppsats är att identifiera den specifika anestesiologiska omvårdnaden av patienten med BMI >30, vid generell anestesi. Metod: En forskningsplan för en fullskalig studie arbetas fram och för att testa dess validitet genomförs en pilotstudie med 15 enkäter på två operationsenheter. Studien har en kvalitativ induktiv design och data insamlas genom semistrukturerade enkätfrågor. Resultatet analyserades med kvalitativ innehållsanalys. Resultat: Resultatet visade ett tydligt fokus på tre huvudkategorier; luftvägshantering, farmaka och positionering av patienten. Nio underkategorier framkom. Majoriteten av respondenterna angav att de inte fått särskild utbildning i omhändertagande av patient med obesitas och att särskilda hänsynstaganden behövs. Diskussion: Resultat överensstämmer till viss del med aktuell forskning. Andra punkter, som forskning framhåller som essentiell, såsom cirkulation, togs inte upp av respondenterna. Resultatet visade på en avsaknad av en tydlig konsensus i den anestesiologiska omvårdnaden av patient med obesitas. Författarna, till denna studie, anser att fler studier behövs för att finna konsensus och utveckla tydliga riktlinjer för optimal anestesiologisk omvårdnad.ABSTRACT Background: Obesity and overweight are health issues that more than every tenth person around the world suffers from and the number of individuals with BMI >30 is every growing. As a result, more patients that are subjects to anesthesia will have an increased BMI. Changes in respiration, airway anatomy, altered drug metabolism and multiple physiological changes in the body makes general anesthesia, of the patient with obesity, an anesthesiological challenge. Purpose: The aim of this study is to identify the specific anesthesiological nursing care of the patient with a BMI >30, undergoing general anesthesia. Method: A research plan is created and to test its credibility, a pilotstudy of 15 surveys in two surgical departments will be conducted. This study has a qualitative inductive design and the data collected through semistructured questionnaires. The result was analyzed using qualitative content analysis. Result: The result showed a clear focus on three main areas; airway management, pharmaceuticals and positioning of the patient. Nine subcategories appeared. The majority of respondents indicated that they had not received special training in the care of patients with obesity and that special considerations are needed. Discussion: The result is to a certain extent consistent with current research. Other areas that current research emphasizes as essential, such as circulation, were not brought up by the respondents. The result showed a lack of a clear consensus in the anesthesiological nursing care of patients with obesity. The authors of this study believe that further research is needed to find consensus and develop clear guidelines for the optimal anesthesiologic nursing care. Keywords Obesity, nursing care, general anesthesi

The responsibility of the nurse? - A literature review of nurses´ promotion and prevention of health in inpatient care.

Bakgrund: Hälsofrämjande och förebyggande arbete är en viktig del av sjuksköterskans arbetsområde. Både kompetensbeskrivningen för legitimerad sjuksköterska och Hälso- och sjukvårdslagen påpekar att sjuksköterskan ska arbeta hälsofrämjande och förebyggande. Det hälsofrämjande och förebyggande arbetet har också fått en allt större uppmärksamhet de senaste åren i form av bland annat riktlinjer, hälsopolitiska mål och styrdokument inom landstingen. Trots detta visar det sig att det är allt mindre förekommande i den praktiska verksamheten. Mycket av forskningen som gjorts berör enbart primärvården och det är också inom primärvården fokus på hälsofrämjande och förebyggande arbete är störst. Syftet: Syftet med studien var att belysa sjuksköterskans hälsofrämjande och förebyggande arbete i mötet med patienter inom slutenvården. Metod: En litteraturstudie genomfördes med utgångspunkt i syftet. Studien består av tio vetenskapliga artiklar publicerade mellan 2005 och 2010 och innehåller kvalitativa och kvantitativa artiklar. Data analyserades enligt Febe Fribergs analysmodell. Resultat: Resultatet visade på olika synsätt bland sjuksköterskor på hälsofrämjande och förebyggande arbete inom slutenvården. Majoriteten av sjuksköterskorna utgick från det biomedicinska synsättet med fokus på diagnos och behandling. Att erhålla utbildning, kompetens och stöd i organisationen var faktorer som sjuksköterskor såg som möjligheter till att arbeta hälsofrämjande och förebyggande. Att mötet med patienten möjliggör information och undervisning sågs också som en möjlighet. Organisation, biomedicinsk tradition och avsaknad av kompetens sågs som hinder för att arbeta hälsofrämjande och förebyggande. Att främja empowerment, jämlikhet, delaktighet och samverkan, motivation samt att göra tillvaron begriplig, hanterbar och meningsfull för patienten identifierades som verktyg sjuksköterskan använder sig av för att arbeta hälsofrämjande och förebyggande inom slutenvården. Slutsats: Sjuksköterskans hälsofrämjande och förebyggande ansvar måste tydliggöras inom slutenvården. En klarhet i innebörden av vad hälsofrämjande och förebyggande arbete betyder behövs så att det kan integreras i större utsträckning i sjuksköterskans arbete inom slutenvården