Här är här och där är där, barnmorskors upplevelser av att arbeta i låginkomstländer

Här är här och där är där - Svenska barnmorskors upplevelser av att arbeta i låginkomstländer Författare: Ylva Bergman & Susanna Olsson Handledare: Margaretha Danerek Magisteruppsats Våren 2013 Abstrakt Syftet var att belysa barnmorskors upplevelser av att arbeta i låginkomstländer. En kvalitativ metod användes och materialet analyserades med innehållsanalys. Tolv barnmorskor med svensk barnmorskeutbildning intervjuades. Intervjuerna transkriberades i sin helhet. Analysen resulterade i fyra kategorier: Att möta kvinnor i en annan verklighet, Att förhålla sig till nya förutsättningar, Motivation och strategier och Utbyte av kunskap och en möjlighet till förändring, med respektive underkategorier. Situationen var ansträngd, ofta med brist på personal och resurser. Detta medförde ett utökat ansvar och att barnmorskan såg som sin främsta uppgift att delge och efterlämna kunskap. Samtidigt som barnmorskorna själva upplevde uppdragen lärorika och fascinerade, var det till ett högt pris. Hemkomsten blev ofta påfrestande och vanligen en lång process av återanpassning till det svenska samhället. Barnmorskornas erfarenheter borde bättre tillvaratas i kliniken samt inom barnmorskeutbildningarna. Avdelningen för omvårdnad Institutionen för hälsa, vård och samhälle Medicinska fakulteten Lunds universitet, Box 157, 221 00 LUN

Weight Loss in Advanced Cancer: Sex Differences in Health-Related Quality of Life and Body Image

Weight maintenance is a priority in cancer care, but weight loss is common and a serious concern. This study explores if there are sex differences in the perception of weight loss and its association to health-related quality of life (HRQoL) and body image. Cancer patients admitted to Advanced Medical Home Care were recruited to answer a questionnaire, including characteristics, the HRQoL-questionnaire RAND-36, and a short form of the Body Image Scale. Linear regression analyses stratified by sex and adjusted for age were performed to examine associations between percent weight loss and separate domains of HRQoL and body image score in men and women separately. In total, 99 participants were enrolled, of which 80 had lost weight since diagnosis. In men, an inverse association between weight loss and the HRQoL-domain physical functioning, β = −1.34 (95%CI: −2.44, −0.24), and a positive association with body image distress, β = 0.22 (95%CI: 0.07, 0.37), were found. In women, weight loss was associated with improvement in the HRQoL-domain role limitations due to physical health, β = 2.02 (95%CI: 0.63, 3.41). Following a cancer diagnosis, men appear to experience weight loss more negatively than women do. Recognizing different perceptions of weight loss may be of importance in clinical practice

Kommentarer till Johan P. Olsen, "Lorenzettis utfordring og demokratiets århundre"

Marcus Agnafors: Lorenzettis utmaning, Pax perspektiv och det normativas platsErik Amnå: När medborgaren står standbyTorbjörn Bergman: Demokratins utmaningar – ett beprövat men svårt temaMagdalena Bexell: Globalt folkstyre?Ylva Stubbergaard: Makt att tala – makt att tolkaElin Wihlborg: Demokratins utmaningar i digitalise-ringens tidevarv – reflektioner kring organiseringenBjörn von Sydow: Norge och Sverige i Lorenzettis ljus</p

Kommentarer till Johan P. Olsen, "Lorenzettis utfordring og demokratiets århundre"

Marcus Agnafors: Lorenzettis utmaning, Pax perspektiv och det normativas platsErik Amnå: När medborgaren står standbyTorbjörn Bergman: Demokratins utmaningar – ett beprövat men svårt temaMagdalena Bexell: Globalt folkstyre?Ylva Stubbergaard: Makt att tala – makt att tolkaElin Wihlborg: Demokratins utmaningar i digitalise-ringens tidevarv – reflektioner kring organiseringenBjörn von Sydow: Norge och Sverige i Lorenzettis ljus</p

Pre-study "Smart and climate conscious retailing for future consumers and society"

Vid sidan om transporter och bostäder så står maten för en av de stora klimatutmaningarna nu och framöver. Matens del av den totala konsumtionsdrivna klimatpåverkan i Sverige är idag cirka 25 %, ca 2 ton CO2-e per person och år. Genom att underlätta för konsumenter att välja mer klimatsmarta val vid livsmedelsinköp finns en möjlighet att minska klimatpåverkan från livsmedel. I ett nudgingförsök på mat.se sänkte medverkande kunder sin klimatpåverkan från livsmedel med 7 procent baserat på genomsnittliga kg CO2-e per order. Under motsvarande period minskade icke-deltagande konsumenter sitt klimatavtryck med 3 procent med samma beräkningsmetod.  Förstudien har undersökt hur information om klimatpåverkan hos olika livsmedel tillsammans med tillgängliggörandet av klimatsmartare alternativ (nudging) kan förändra köpbeteendet hos konsumenten. Målet har varit att minska klimatpåverkan i staden. Förstudien har fokuserat på metoder och parametrar viktiga för att locka fler att medvetet eller omedvetet handla mer miljö-/klimat-smartare mat. Livskraftiga städer som uppmuntrar till hållbara livsstilar kräver innovativa lösningar som underlättar för konsumenten att välja rätt. Projektupplägget har bestått av en kartläggning av nuvarande situation, nudgingförsök samt projektworkshops. Kartläggningen genomfördes för att avgöra vilka produkter som är av specifikt intresse att tillgängliggöra klimatsmartare alternativ. RISE klimatdatabas för livsmedel har varit central i denna del för att identifiera vilka beslutsval som har kapacitet att ge en betydande klimatnytta.  Nudgingförsöket har byggts upp i en två-stegs nudgingmodell där konsumenterna först har aktivt fått välja att medverka i projektet (steg 1). För de som väljer att förbinda sig till detta har klimatsmartare alternativ lyfts upp till det först visade alternativet vid vissa specifika sökord (steg 2).  Projektdeltagare: - Mat.se, en innovativ aktör inom e-handel som vill utveckla lösningar för en minskad klimatpåverkan från livsmedelskonsumtion.- Göteborg Stad deltog som representant för medborgaren och staden, - Handelshögskolan (GU) med forskningsexpertis inom nudging. - RISE, experter inom livsmedels klimatpåverkan och beteendevetenskap. Food consumption is one of our bigger climate challenges. The consumer driven climate effect of food is in Sweden 2 ton CO2-e per person and year, this corresponds to 25 per cent of the total consumption driven effect on the climate. This needs to be lowered. To aid the consumers in making more climate friendly choices present project has focused on how to nudge in an e-food store (mat.se). By simplifying for the participating consumers to do climate friendly choices the preliminary results indicate that CO2-e of the consumers average order was lowered by 7 per cent. At the same time the consumers that decided not to participate lowered their carbon footprint with 3 per cent using the same calculation method.  This pre-study has evaluated how purchase decisions are affected by information on climate change and the influence of food products together with an enabling of climate friendlier choices. The bigger target has been to reduce the climate effect in the city. The study has focused on methods that are important to aid people to buy more climate friendly food. This requires innovative solutions that facilitate the right choices.  Project partners have been: - Mat.se – an innovative e-food market that wants to develop solutions for climate friendly behavior - Göteborg stad – a representative of the citizen and the city of Gothenburg - University of Gothenburg, School of business, economics and law with expertise in nudging- RISE – expertise in the climate effect on food products and behavioral science     Energimyndigheten SLUTRAPPORT. Dnr: 2018-001849. Projektnr: 46047-1.</p

Appetite in Palliative Cancer Patients and Its Association with Albumin, CRP and Quality of Life in Men and Women&mdash;Cross-Sectional Data from the Palliative D-Study

Albumin is an important biochemical marker in palliative cancer care, used for assessment of nutritional status, disease severity and prognosis. Our primary aim was to investigate sex differences in the association between appetite and albumin levels in palliative cancer patients. We also aimed to study associations between appetite and C-reactive protein (CRP), Quality of Life (QoL), pain and fatigue. In the Palliative D-cohort, consisting of 266 men and 264 women, we found a correlation between appetite and albumin; low appetite, measured with the Edmonton Symptom Assessment System, correlated significantly with low albumin in men: (r = &minus;0.33, p &lt; 0.001), but not in women (r = &minus;0.03, p = 0.65). In a regression analysis adjusted for confounding factors, results were similar. Lower appetite was correlated with higher CRP in men (r = 0.27, p &lt; 0.001), but not in women (r = 0.12, p = 0.05). Appetite was correlated with QoL, fatigue and pain in both men and women; those with a low appetite had a low QoL and high fatigue- and pain-scores (p &lt; 0.001). In conclusion, our results indicated possible sex differences in the associations between appetite and albumin, and between appetite and CRP, in palliative care patients. Understanding these associations could provide additional value for clinical practice

Individually tailored Internet-delivered cognitive-behavioral therapy for survivors of intimate partner violence : A randomized controlled pilot trial

Intimate partner violence (IPV) is a serious public health concern worldwide and defined as behavior performed by spouses or other intimate partners that causes physical, sexual, or psychological harm. Internet-delivered cognitive-behavioral therapy (ICBT) may be particularly useful for survivors of IPV for several reasons, including barriers pertaining to limited community recourses and treatment availability, safety concerns, and issues of stigma, guilt and shame, which may prevent members of this population from seeking help via face-to face interactions. However, Internet interventions are lacking. The primary aim of the present randomized controlled pilot trial was to explore the feasibility of ICBT as guided self-help individually tailored to the pre dominant symptomatology of PTSD or depression in survivors of IPV. A second aim was to conduct a preliminary evaluation exploring the short-and long-term effects of the treatment in comparison to a waitlist control con-dition. Results showed that the treatment was feasible. Attrition rate was low (9.4%), and participants were satisfied with treatment. However, treatment adherence was moderate in terms of completed modules (62.5%). Results of the preliminary evaluation of treatment effects showed large and statistically significant between-group effect sizes (Cohens d = 0.86-1.08) on some measures of PTSD and depression at post assessment, fa-voring the treatment condition. However, there were no effects on other measures. At follow-up assessment, when the control condition had received delayed treatment, there were large and statistically significant within-group effect sizes (d = 0.96-1.48) on measures of PTSD, depression and anxiety, and small effects (d = 0.48) on a measure of quality of life. The results of the present pilot study are promising and warrant further research on ICBT for this population.Funding Agencies|National Board of Health and Welfare in Sweden</p

Comparing the results from a Swedish pregnancy cohort using data from three automated placental growth factor immunoassay platforms intended for first-trimester preeclampsia prediction.

INTRODUCTION: Risk evaluation for preeclampsia in early pregnancy allows identification of women at high risk. Prediction models for preeclampsia often include circulating concentrations of placental growth factor (PlGF); however, the models are usually limited to a specific PlGF method of analysis. The aim of this study was to compare three different PlGF methods of analysis in a Swedish cohort to assess their convergent validity and appropriateness for use in preeclampsia risk prediction models in the first trimester of pregnancy. MATERIAL AND METHODS: First-trimester blood samples were collected in gestational week 11+0 to 13+6 from 150 pregnant women at Uppsala University Hospital during November 2018 until November 2020. These samples were analyzed using the different PlGF methods from Perkin Elmer, Roche Diagnostics, and Thermo Fisher Scientific. RESULTS: There were strong correlations between the PlGF results obtained with the three methods, but the slopes of the correlations clearly differed from 1.0: PlGFPerkinElmer  = 0.553 (95% confidence interval [CI] 0.518-0.588) * PlGFRoche -1.112 (95% CI -2.773 to 0.550); r = 0.966, mean difference -24.6 (95% CI -26.4 to -22.8). PlGFPerkinElmer  = 0.673 (95% CI 0.618-0.729) * PlGFThermoFisher -0.199 (95% CI -2.292 to 1.894); r = 0.945, mean difference -13.8 (95% CI -15.1 to -12.6). PlGFRoche  = 1.809 (95% CI 1.694-1.923) * PlGFPerkinElmer +2.010 (95% CI -0.877 to 4.897); r = 0.966, mean difference 24.6 (95% CI 22.8-26.4). PlGFRoche  = 1.237 (95% CI 1.113-1.361) * PlGFThermoFisher +0.840 (95% CI -3.684 to 5.363); r = 0.937, mean difference 10.8 (95% CI 9.4-12.1). PlGFThermoFisher  = 1.485 (95% CI 1.363-1.607) * PlGFPerkinElmer +0.296 (95% CI -2.784 to 3.375); r = 0.945, mean difference 13.8 (95% CI 12.6-15.1). PlGFThermoFisher  = 0.808 (95% CI 0.726-0.891) * PlGFRoche -0.679 (95% CI -4.456 to 3.099); r = 0.937, mean difference -10.8 (95% CI -12.1 to -9.4). CONCLUSION: The three PlGF methods have different calibrations. This is most likely due to the lack of an internationally accepted reference material for PlGF. Despite different calibrations, the Deming regression analysis indicated good agreement between the three methods, which suggests that results from one method may be converted to the others and hence used in first-trimester prediction models for preeclampsia