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  • 1.
    Andersson, Helene
    et al.
    Sophiahemmet Högskola.
    Andreassen Gleissman, Sissel
    Sophiahemmet Högskola.
    Lindholm, Christina
    Sophiahemmet Högskola.
    Fossum, Bjöörn
    Sophiahemmet Högskola.
    Experiences of nursing staff caring for patients with methicillin-resistant Staphylococcus aureus.2016Ingår i: International Nursing Review, ISSN 0020-8132, E-ISSN 1466-7657, Vol. 63, nr 2, 233-241 s.Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Methicillin-resistant Staphylococcus aureus is a resistant variant of S. aureus and can cause pneumonia, septicaemia and, in some cases, death. Caring for patients with antibiotic resistant bacteria is a challenge for healthcare personnel. There is a risk of spreading the bacteria among patients and of healthcare personnel being infected themselves.

    AIM: To describe nursing staffs' experiences of caring for patients with methicillin-resistant S. aureus in Sweden.

    METHOD: A descriptive qualitative approach was used and 15 nurses from different hospitals and care units, including emergency and geriatric wards and nursing homes in Stockholm, were interviewed. All nurses had been involved in the care of patients with methicillin-resistant S. aureus, but not on a regular basis. The interviews were analysed using qualitative content analysis.

    FINDINGS: Three themes emerged from the data: feeling ignorant, afraid and insecure, feeling competent and secure and feeling stressed and overworked. The more knowledge the nurses acquired about methicillin-resistant S. aureus, the more positive was their attitude to caring for these patients.

    DISCUSSION AND CONCLUSION: Caring for patients with methicillin-resistant S. aureus without adequate knowledge of how to protect oneself and other patients against transmission may provoke anxiety among personnel. Guidelines, memos and adequate information at the right time are of central importance. Healthcare personnel must feel safe in their role as caregivers. All patients have the right to have the same quality of care regardless of the diagnosis and a lack of knowledge influences the level of care given.

    IMPLICATIONS FOR NURSING AND HEALTH POLICY: This study demonstrates the importance of education when caring for patients with infectious diseases. Hopefully, knowledge gained from our study can provide guidance for future health care when new diseases and infections occur.

  • 2.
    Andersson, Helene
    et al.
    Sophiahemmet Högskola.
    Andreassen, Sissel
    Sophiahemmet Högskola.
    Lindholm, Christina
    Sophiahemmet Högskola.
    Fossum, Bjöörn
    Sophiahemmet Högskola.
    Emotional reactions when caring for MRSA-positive patients: ignorance and fear versus knowledge and securityArtikel i tidskrift (Refereegranskat)
  • 3.
    Andersson, Helene
    et al.
    Sophiahemmet Högskola.
    Kalin, Mats
    Fossum, Bjöörn
    Sophiahemmet Högskola.
    Lindholm, Christina
    Ortqvist, Ake
    Är MRSA-patienter olika smittsamma i olika län?2009Ingår i: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 106, nr 7, 412-3 s.Artikel i tidskrift (Övrigt vetenskapligt)
  • 4.
    Andersson, Helene
    et al.
    Sophiahemmet Högskola.
    Lindholm, Christina
    Fossum, Bjöörn
    Sophiahemmet Högskola.
    MRSA - global threat and personal disaster: Patients' experiences2011Ingår i: International Nursing Review, ISSN 0020-8132, E-ISSN 1466-7657, Vol. 58, nr 1, 47-53 s.Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    ANDERSSON H., LINDHOLM C. & FOSSUM B. (2011) MRSA - global threat and personal disaster: patients' experiences. International Nursing Review58, 47-53 Aim:  To ascertain and describe the patients' knowledge, perceptions and experiences of being methicillin-resistant Staphylococcus aureus (MRSA) positive. Background:  Antibiotic resistant bacteria are a serious global threat. MRSA can cause wound infection, pneumonia, septicaemia and mortality. This qualitative study has focused on patients' experiences of living with MRSA. Methods:  Fifteen patients with MRSA-infected wounds were interviewed. All data were transcribed verbatim and analysed according to content analysis. Findings:  Information about the MRSA diagnosis often caused a shock-like reaction. Patients' perception of being MRSA positive was stigmatizing as plague or leprosy; they felt dirty and felt that they were a severe threat to their environment. Fears of infecting someone else and being rejected were commonly expressed. The key findings emerged as a theme: Being exposed to others' shortcomings and being a threat to others' health. Three categories were identified: understanding and emotional reactions, treatment by the healthcare professionals and consequences and expectations. Gaps in both patient and staff knowledge of MRSA led to unnecessary misunderstandings, causing fear, social isolation and suffering. Conclusions:  Living with MRSA can be extremely stressful for the patients. Knowledge and empathy from staff involved in their care is crucial to optimize patients' experiences. Staff education to meet patients' demand for information and prevent contamination is essential.

  • 5.
    Andersson, Helene
    et al.
    Sophiahemmet Högskola.
    Lindholm, Christina
    Sophiahemmet Högskola.
    Iversen, Aina
    Giske, Christian G
    Örtqvist, Åke
    Kalin, Mats
    Fossum, Bjöörn
    Sophiahemmet Högskola.
    Prevalence of antibiotic-resistant bacteria in residents of nursing homes in a Swedish municipality: healthcare staff knowledge of and adherence to principles of basic infection prevention2012Ingår i: Scandinavian journal of infectious diseases, ISSN 1651-1980, Vol. 44, nr 9, 641-649 s.Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Abstract Background: The aims of this study were to investigate the prevalence of methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci (VRE) and extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae in residents living in Swedish nursing homes, and if carriage of resistant bacteria was related to antibiotic treatment, other risk factors, and/or staff's adherence to guidelines for infection control. Methods: Five hundred and sixty residents from 9 nursing homes on a total of 67 wards participated in the study and had microbiological cultures taken. Faecal samples were obtained from 495 residents (88.3%). ESBL-positive residents were followed for 2 y with repeated sampling. Two hundred and ninety-six staff members were interviewed and observed regarding familiarity with and adherence to infection control guidelines. Results: No resident was positive for MRSA or VRE. Fifteen of the residents were found to be ESBL-positive. Residents living on wards where ESBL-positive residents were identified had been treated more frequently with antibiotics (42%), compared to those on wards where no residents with ESBL were found (28%; p = 0.02). ESBL-positive Escherichia coli isolates from residents living in adjacent rooms were found to be closely genetically related when analysed by pulsed-field gel electrophoresis, indicating transmission between residents. Staff adherence to infection control guidelines sometimes revealed shortcomings, but no significant differences regarding compliance to the guidelines could be found. Conclusion: Carriage of resistant bacteria was uncommon and only ESBL-producing Enterobacteriaceae were identified in Swedish nursing homes. Usage of antibiotics was higher on wards where ESBL-positive residents were detected and there was an indication of transmission of ESBL between residents.

  • 6. Butler, Eile
    et al.
    Oien, Rut F
    Lindholm, Christina
    Sophiahemmet Högskola.
    Olofsson, Tobias C
    Nilson, Bo
    Vásquez, Alejandra
    A pilot study investigating lactic acid bacterial symbionts from the honeybee in inhibiting human chronic wound pathogens2016Ingår i: International Wound Journal, ISSN 1742-4801, E-ISSN 1742-481X, Vol. 13, nr 5, 729-37 s.Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Treatment and management of chronic wounds is a large burden on the health sector and causes substantial suffering for the patients. We believe that 13 lactic acid bacteria (LAB) symbionts isolated from the honey crop of the honeybee are important players in the antimicrobial action of honey, by producing antimicrobial substances and can be used in combination with heather honey as an effective treatment in wound management. A total of 22 patients with chronic ulcers were included; culture-dependent and molecular-based (MALDI-MS and 16S rRNA gene sequencing) techniques were used to identify bacteria from chronic wounds. These clinical isolates were used for in vitro antimicrobial testing with standardised viable LAB and sterilised heather honey mixture. Twenty of the patients' wounds were polymicrobial and 42 different species were isolated. Patient isolates that were tested in vitro were inhibited by the LAB and honey combination with inhibitory zones comparable with different antibiotics. LAB and heather honey in combination presents a new topical option in chronic wound management because of the healing properties of honey, antimicrobial metabolite production from the LAB and their bactericidal effect on common chronic wound pathogens. This new treatment may be a stepping stone towards an alternative solution to antibiotics.

  • 7. Ek, Anna-Christina
    et al.
    Lindholm, Christina
    Sophiahemmet Högskola.
    Trycksår. Reviderad 20132013Ingår i: Vårdhandboken / [ed] Annika Ahrnstedt & Monica Andersson, Stockholm: Stockholms läns landsting , 2013Kapitel i bok, del av antologi (Övrigt vetenskapligt)
  • 8.
    Eulau, Louise
    et al.
    Sophiahemmet Högskola.
    Paulander, Ann-Sophie
    Lindholm, Christina
    Sophiahemmet Högskola.
    PC-Music: a cross disciplinary model combining nursing and music therapy as pain management2016Konferensbidrag (Övrigt vetenskapligt)
    Abstract [en]

    While nursing and music therapy have been two important disciplines in analysis of pain management, there has been little research exploring these areas from a cross disciplinary perspective. This paper highlights the importance of acknowledging and beginning to understand the role of scientific and practical cooperation between music therapists and health care professionals.

    In particular, our aim has been to initiate a dialogue about how subject-specific knowledge from both music therapy and nursing – in terms of person-centered care – can strengthen the usage of music as pain management for short-term management of acute pain during painful treatments such as dressing change procedure in wound care. On this basis, a pilot study was conducted regarding wound care. The study has been approved by the ethics committee in Stockholm. The paper is based on the result from this study where the aim was to find a model for pain management as a complementary treatment based on knowledge from nursing and music therapy.

    Philosophical starting points were the “life-world” perspective of Merleau-Ponty as well as Ricoeur’s ethical thoughts. The result has a potential reach beyond wound care that can be used in several treatments that entails acute pain.

  • 9. Gardulf, Ann
    et al.
    Nilsson, Jan
    Florin, Jan
    Leksell, Janeth
    Lepp, Margret
    Lindholm, Christina
    Sophiahemmet Högskola.
    Nordström, Gun
    Theander, Kersti
    Wilde-Larsson, Bodil
    Carlsson, Marianne
    Johansson, Eva
    The Nurse Professional Competence (NPC) Scale: Self-reported competence among nursing students on the point of graduation2016Ingår i: Nurse Education Today, ISSN 0260-6917, E-ISSN 1532-2793, Vol. 36, 165-171 s.Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: International organisations, e.g. WHO, stress the importance of competent registered nurses (RN) for the safety and quality of healthcare systems. Low competence among RNs has been shown to increase the morbidity and mortality of inpatients.

    OBJECTIVES: To investigate self-reported competence among nursing students on the point of graduation (NSPGs), using the Nurse Professional Competence (NPC) Scale, and to relate the findings to background factors.

    METHODS AND PARTICIPANTS: The NPC Scale consists of 88 items within eight competence areas (CAs) and two overarching themes. Questions about socio-economic background and perceived overall quality of the degree programme were added. In total, 1086 NSPGs (mean age, 28.1 [20-56]years, 87.3% women) from 11 universities/university colleges participated.

    RESULTS: NSPGs reported significantly higher scores for Theme I "Patient-Related Nursing" than for Theme II "Organisation and Development of Nursing Care". Younger NSPGs (20-27years) reported significantly higher scores for the CAs "Medical and Technical Care" and "Documentation and Information Technology". Female NSPGs scored significantly higher for "Value-Based Nursing". Those who had taken the nursing care programme at upper secondary school before the Bachelor of Science in Nursing (BSN) programme scored significantly higher on "Nursing Care", "Medical and Technical Care", "Teaching/Learning and Support", "Legislation in Nursing and Safety Planning" and on Theme I. Working extra paid hours in healthcare alongside the BSN programme contributed to significantly higher self-reported scores for four CAs and both themes. Clinical courses within the BSN programme contributed to perceived competence to a significantly higher degree than theoretical courses (93.2% vs 87.5% of NSPGs).

    SUMMARY AND CONCLUSION: Mean scores reported by NSPGs were highest for the four CAs connected with patient-related nursing and lowest for CAs relating to organisation and development of nursing care. We conclude that the NPC Scale can be used to identify and measure aspects of self-reported competence among NSPGs.

  • 10.
    Lindholm, Christina
    Sophiahemmet Högskola.
    Naturens läkekonster - sårläkning i ett naturhistoriskt perspektiv2013Ingår i: Smittskydd Stockholm, Vol. 24, nr 3, 11- s.Artikel i tidskrift (Övrig (populärvetenskap, debatt, mm))
  • 11.
    Lindholm, Christina
    Sophiahemmet Högskola.
    Omvårdnad vid sår2014Ingår i: Omvårdnadens grunder: hälsa och ohälsa / [ed] Anna-Karin Edberg & Helle Wijk, Lund: Studentlitteratur AB, 2014, 2, 495-525 s.Kapitel i bok, del av antologi (Övrigt vetenskapligt)
  • 12.
    Lindholm, Christina
    Sophiahemmet Högskola.
    Sår2012 (uppl. 3)Bok (Övrigt vetenskapligt)
  • 13.
    Lindholm, Christina
    Sophiahemmet Högskola.
    Trycksår i geriatrisk vård: en patient, flera vårdgivare2013Ingår i: Svensk geriatrik : äldrevård och äldremedicin i öppen och sluten vård, ISSN 2001-2047, Vol. 2, nr 4, 9-12 s.Artikel i tidskrift (Övrig (populärvetenskap, debatt, mm))
  • 14.
    Lindholm, Christina
    Sophiahemmet Högskola.
    Trycksår i livets slutskede2014Ingår i: SårMagasinet, ISSN 2001-9920, Vol. 1, nr 1, 46--49 s.Artikel i tidskrift (Övrigt vetenskapligt)
  • 15. Lindholm, Christina
    et al.
    Andersson, Helene
    Sophiahemmet Högskola.
    Fossum, Bjöörn
    Sophiahemmet Högskola.
    Jörbeck, H
    Wounds scrutiny in a Swedish hospital: prevalence, nursing care and bacteriology, including MRSA2005Ingår i: Journal of Wound Care, ISSN 0969-0700, E-ISSN 2052-2916, Vol. 14, nr 7, 313-9 s.Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: To identify all wounds, wound types and wound characteristics; to identify bacteria in all wounds, particularly MRSA, VRE and multi-resistant Gram-negative rods;. METHOD: All patients admitted to or visiting hospital clinics were examined. If the patient had a wound, a questionnaire was filled in by a nurse, and if the wound met the inclusion criteria swabs were taken. RESULTS: A total of 2172 patients were admitted to or visited the hospital; 408 (19%) had a total of 668 wounds. Of this number, 248 were cultured. Thirty-seven patients had pressure ulcers, 83 had leg and foot ulcers and 288 patients had other types of wounds. Nursing care varied according to wound type and ward. Fifty-eight different types of wound dressings were used. Cleansing was performed with saline in 58% of the wounds. The mean number of dressing changes was once daily. Wounds were painful in 37% of the cases, with a predominance of leg and foot ulcers (51%). Many patients did not receive analgesia. MRSA was identified in two patients. No VRE was identified, and there was a low prevalence of multi-resistance in Enterobacteriaceae and Pseudomonas aeruginosa. CONCLUSION: The study provided important information for future improvement of wound care in a university hospital. Fewer resistant bacteria, particularly MRSA, were identified than expected.

  • 16.
    Lindholm, Christina
    et al.
    Sophiahemmet Högskola.
    Cornelius, Maria
    Leo Swenne, Christine
    Sår vid kirurgi och trauma2016Ingår i: Omvårdnad & kirurgi / [ed] Christine Kumlien & Jenny Rystedt, Lund: Studentlitteratur AB, 2016, 1, 133-146 s.Kapitel i bok, del av antologi (Övrigt vetenskapligt)
  • 17.
    Lindholm, Christina
    et al.
    Sophiahemmet Högskola.
    Grauers, Margareta
    Sårbehandling 2013/2014: katalog över sårprodukter2013Samlingsverk (redaktörskap) (Övrig (populärvetenskap, debatt, mm))
  • 18.
    Lindholm, Christina
    et al.
    Sophiahemmet Högskola.
    Grauers, Margareta
    Sårbehandling 2017/2018: katalog över sårprodukter2017Samlingsverk (redaktörskap) (Övrig (populärvetenskap, debatt, mm))
  • 19.
    Lindholm, Christina
    et al.
    Sophiahemmet Högskola.
    Searle, Richard
    Wound management for the 21st century: combining effectiveness and efficiency2016Ingår i: International Wound Journal, ISSN 1742-4801, E-ISSN 1742-481X, Vol. 13, nr Suppl 2, 5-15 s.Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Treatment of wounds of different aetiologies constitutes a major part of the total health care budget. It is estimated that 1·5-2 million people in Europe suffer from acute or chronic wounds. These wounds are managed both in hospitals and in community care. The patients suffering from these wounds report physical, mental and social consequences of their wounds and the care of them. It is often believed that the use of wound dressings per se is the major cost driver in wound management, whereas in fact, nursing time and hospital costs are together responsible for around 80-85% of the total cost. Healing time, frequency of dressing change and complications are three important cost drivers. However, with the use of modern, advanced technology for more rapid wound healing, all these cost drivers can be substantially reduced. A basic understanding of the terminology and principles of Health Economics in relation to wound management might therefore be of interest.

  • 20. Lindholm, Christina
    et al.
    Sterner, Eila
    Sophiahemmet Högskola.
    Romanelli, Marco
    Pina, Elaine
    Torra y Bou, Joan
    Hietanen, Helvi
    Iivanainen, Ansa
    Gunningberg, Lena
    Hommel, Ami
    Klang, Birgitta
    Dealey, Carol
    Hip fracture and pressure ulcers - the Pan-European Pressure Ulcer Study: intrinsic anc extrinsic factors2008Ingår i: International Wound Journal, ISSN 1742-481X, Vol. 5, nr 2, 315-28 s.Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Pressure ulcers (PU) in patients with hip fracture remain a problem. Incidence of between 8.8% and 55% have been reported. There are few studies focusing on the specific patient-, surgery- and care-related risk indicators in this group. The aims of the study were: - to investigate prevalence and incidence of PU upon arrival and at discharge from hospital and to identify potential intrinsic and extrinsic risk factors for development of PU in patients admitted for hip fracture surgery, - to illuminate potential differences in patient logistics, surgery, PU prevalence and incidence and care between Northern and Southern Europe. Consecutive patients with hip fracture in six countries, Sweden, Finland, UK (North) and Spain, Italy and Portugal (South), were included. The patients were followed from Accident and Emergency Department and until discharge or 7 days. Prevalence, PU at discharge and incidence were investigated, and intrinsic and extrinsic risk indicators, including waiting time for surgery and duration of surgery were recorded. Of the 635 patients, 10% had PU upon arrival and 22% at discharge (26% North and 16% South). The majority of ulcers were grade 1 and none was grade 4. Cervical fractures were more common in the North and trochanteric in the South. Waiting time for surgery and duration of surgery were significantly longer in the South. Traction was more common in the South and perioperative warming in the North. Risk factors of statistical significance correlated to PU at discharge were age >or=71 (P = 0.020), dehydration (P = 0.005), moist skin (P = 0.004) and total Braden score (P = 0.050) as well as subscores for friction (P = 0.020), nutrition (P = 0.020) and sensory perception (P = 0.040). Comorbid conditions of statistical significance for development of PU were diabetes (P = 0.005) and pulmonary disease (P = 0.006). Waiting time for surgery, duration of surgery, warming or non warming perioperatively, type of anaesthesia, traction and type of fracture were not significantly correlated with development of PU.

  • 21.
    Lindholm, Christina
    et al.
    Sophiahemmet Högskola.
    Tammelin, Ann
    Häggström, Christer
    Sårbehandling. Reviderad 20132013Ingår i: Vårdhandboken / [ed] Annika Ahrnstedt & Monica Andersson, Stockholm: Stockholms läns landsting , 2013Kapitel i bok, del av antologi (Övrigt vetenskapligt)
  • 22. Nilsson, Jan
    et al.
    Johansson, Eva
    Carlsson, Marianne
    Florin, Jan
    Leksell, Janeth
    Lepp, Margret
    Lindholm, Christina
    Sophiahemmet Högskola.
    Nordström, Gun
    Theander, Kersti
    Wilde-Larsson, Bodil
    Gardulf, Ann
    Disaster nursing: Self-reported competence of nursing students and registered nurses, with focus on their readiness to manage violence, serious events and disasters2015Ingår i: Nurse Education in Practice, ISSN 1471-5953, E-ISSN 1873-5223, Vol. 17, 102-108 s.Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The World Health Organization and the International Council of Nurses recognises the importance of nurses' involvement in disaster preparedness and response. The aim of this study was to describe and compare self-reported disaster nursing competence (DNC) among nursing students (NSs) and among registered nurses (RNs) with professional experience. Further to investigate possible associations between self-reported DNC and background factors. A cross-sectional study was conducted of 569 NSs and 227 RNs. All respondents completed the 88-item Nurse Professional Competence Scale, including three items assessing DNC. Significant differences were found among the NSs depending on which University/University College they had attended. RNs reported significantly higher overall DNC and better ability to handle situations involving violence, and to apply principles of disaster medicine during serious events. RNs working in emergency care reported significantly better DNC ability, compared with RNs working in other areas of healthcare. Multiple linear regression analysis showed that working night shift and working in emergency care were positively associated with high self-reported overall DNC. The results indicate that workplace experience of serious events increase the readiness of registered nurses to handle violence, to act in accordance with safety regulations, and to apply principles of disaster medicine during serious events.

  • 23. Nilsson, Jan
    et al.
    Johansson, Eva
    Egmar, Ann-Charlotte
    Florin, Jan
    Leksell, Janeth
    Lepp, Margret
    Lindholm, Christina
    Sophiahemmet Högskola.
    Nordström, Gun
    Theander, Kersti
    Wilde-Larsson, Bodil
    Carlsson, Marianne
    Gardulf, Ann
    Development and validation of a new tool measuring nurses self-reported professional competence --the nurse professional competence (NPC) Scale2014Ingår i: Nurse Education Today, ISSN 0260-6917, E-ISSN 1532-2793, Vol. 34, nr 4, 574-580 s.Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVES: To develop and validate a new tool intended for measuring self-reported professional competence among both nurse students prior to graduation and among practicing nurses. The new tool is based on formal competence requirements from the Swedish Board of Health and Welfare, which in turn are based on WHO guidelines.

    DESIGN: A methodological study including construction of a new scale and evaluation of its psychometric properties.

    PARTICIPANTS AND SETTINGS: 1086 newly graduated nurse students from 11 universities/university colleges.

    RESULTS: The analyses resulted in a scale named the NPC (Nurse Professional Competence) Scale, consisting of 88 items and covering eight factors: "Nursing care", "Value-based nursing care", "Medical/technical care", "Teaching/learning and support", "Documentation and information technology", "Legislation in nursing and safety planning", "Leadership in and development of nursing care" and "Education and supervision of staff/students". All factors achieved Cronbach's alpha values greater than 0.70. A second-order exploratory analysis resulted in two main themes: "Patient-related nursing" and "Nursing care organisation and development". In addition, evidence of known-group validity for the NPC Scale was obtained.

    CONCLUSIONS: The NPC Scale, which is based on national and international professional competence requirements for nurses, was comprehensively tested and showed satisfactory psychometrical properties. It can e.g. be used to evaluate the outcomes of nursing education programmes, to assess nurses' professional competences in relation to the needs in healthcare organisations, and to tailor introduction programmes for newly employed nurses.

  • 24. Olofsson, Tobias C
    et al.
    Butler, Eile
    Markowicz, Pawel
    Lindholm, Christina
    Sophiahemmet Högskola.
    Larsson, Lennart
    Vásquez, Alejandra
    Lactic acid bacterial symbionts in honeybees - an unknown key to honey's antimicrobial and therapeutic activities2016Ingår i: International Wound Journal, ISSN 1742-4801, E-ISSN 1742-481X, Vol. 13, nr 5, 668-79 s.Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Could honeybees' most valuable contribution to mankind besides pollination services be alternative tools against infections? Today, due to the emerging antibiotic-resistant pathogens, we are facing a new era of searching for alternative tools against infections. Natural products such as honey have been applied against human's infections for millennia without sufficient scientific evidence. A unique lactic acid bacterial (LAB) microbiota was discovered by us, which is in symbiosis with honeybees and present in large amounts in fresh honey across the world. This work investigates if the LAB symbionts are the source to the unknown factors contributing to honey's properties. Hence, we tested the LAB against severe wound pathogens such as methicillin-resistant Staphylococcus aureus (MRSA), Pseudomonas aeruginosa and vancomycin-resistant Enterococcus (VRE) among others. We demonstrate a strong antimicrobial activity from each symbiont and a synergistic effect, which counteracted all the tested pathogens. The mechanisms of action are partly shown by elucidating the production of active compounds such as proteins, fatty acids, anaesthetics, organic acids, volatiles and hydrogen peroxide. We show that the symbionts produce a myriad of active compounds that remain in variable amounts in mature honey. Further studies are now required to investigate if these symbionts have a potential in clinical applications as alternative tools against topical human and animal infections.

  • 25. Olofsson, Tobias C
    et al.
    Butler, Éile
    Lindholm, Christina
    Sophiahemmet Högskola.
    Nilson, Bo
    Michanek, Per
    Vásquez, Alejandra
    Fighting Off Wound Pathogens in Horses with Honeybee Lactic Acid Bacteria.2016Ingår i: Current Microbiology, ISSN 0343-8651, E-ISSN 1432-0991, Vol. 73, nr 4, 463-73 s.Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    In the global perspective of antibiotic resistance, it is urgent to find potent topical antibiotics for the use in human and animal infection. Healing of equine wounds, particularly in the limbs, is difficult due to hydrostatic factors and exposure to environmental contaminants, which can lead to heavy bio-burden/biofilm formation and sometimes to infection. Therefore, antibiotics are often prescribed. Recent studies have shown that honeybee-specific lactic acid bacteria (LAB), involved in honey production, and inhibit human wound pathogens. The aim of this pilot study was to investigate the effects on the healing of hard-to-heal equine wounds after treatment with these LAB symbionts viable in a heather honey formulation. For this, we included ten horses with wound duration of >1 year, investigated the wound microbiota, and treated wounds with the novel honeybee LAB formulation. We identified the microbiota using MALDI-TOF mass spectrometry and DNA sequencing. In addition, the antimicrobial properties of the honeybee LAB formulation were tested against all wound isolates in vitro. Our results indicate a diverse wound microbiota including fifty-three bacterial species that showed 90 % colonization by at least one species of Staphylococcus. Treatment with the formulation promoted wound healing in all cases already after the first application and the wounds were either completely healed (n = 3) in less than 20 days or healing was in progress. Furthermore, the honeybee LAB formulation inhibited all pathogens when tested in vitro. Consequently, this new treatment option presents as a powerful candidate for the topical treatment of hard-to-heal wounds in horses.

  • 26. Pokorná, A
    et al.
    Öien, R. F
    Forssell, H
    Lindholm, Christina
    Sophiahemmet Högskola.
    International Cooperation in Pressure Ulcers Prevalence, Prevention and Treatment is Chal lenged by the Lack of National Registries.2016Ingår i: Česká a Slovenská neurologie a neurochirurgie, ISSN 1210-7859, Vol. 79, nr Suppl. 1, 20-24 s.Artikel i tidskrift (Refereegranskat)
  • 27. Skavberg Roaldsen, Kirsti
    et al.
    Lindholm, Christina
    Sophiahemmet Högskola.
    Fysisk aktivitet och träning vid venös och arteriell insufficiens och bensår2012Ingår i: Äldres hälsa: ett sjukgymnastiskt perspektiv / [ed] Elisabeth Rydwik, Lund: Studentlitteratur, 2012, 1, 259-270 s.Kapitel i bok, del av antologi (Övrigt vetenskapligt)
  • 28.
    Sterner, Eila
    et al.
    Sophiahemmet Högskola.
    Fossum, Bjöörn
    Sophiahemmet Högskola.
    Berg, Elisabeth
    Lindholm, Christina
    Sophiahemmet Högskola.
    Stark, André
    Objective evaluation by reflectance spectrophotometry can be of clinical value for the verification of blanching/nonblanching erythema in the sacral area2014Ingår i: International Wound Journal, ISSN 1742-4801, E-ISSN 1742-481X, Vol. 11, nr 4, 416-423 s.Artikel i tidskrift (Refereegranskat)
  • 29.
    Sterner, Eila
    et al.
    Sophiahemmet Högskola.
    Lindholm, Christina
    Berg, E
    Stark, A
    Fossum, Bjöörn
    Sophiahemmet Högskola.
    Category I pressure ulcers: how reliable is clinical assessment?2011Ingår i: Orthopedic Nursing, ISSN 0744-6020, E-ISSN 1542-538X, Vol. 30, nr 3, 194-205 s.Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    finger-press tests and visual observation alone were not reliable methods to discriminate between blanching and nonblanching erythema. Forty-seven percent of the patients had a risk score 20 or fewer (high risk for pressure ulcers). Forty-four patients (56%) had pressure ulcers at discharge.

  • 30.
    Sterner, Eila
    et al.
    Sophiahemmet Högskola.
    Unbeck, M
    Lindholm, Christina
    Sophiahemmet Högskola.
    Stark, A
    Gordon, M
    Fossum, Bjöörn
    Sophiahemmet Högskola.
    Poor documentation of risk factors and prevention strategies for pressure ulcers in orthopedic inpatientsManuskript (preprint) (Övrigt vetenskapligt)
  • 31. Theander, Kersti
    et al.
    Wilde-Larsson, Bodil
    Carlsson, Marianne
    Florin, Jan
    Gardulf, Ann
    Johansson, Eva
    Lindholm, Christina
    Sophiahemmet Högskola.
    Nordström, Gun
    Nilsson, Jan
    Adjusting to future demands in healthcare: Curriculum changes and nursing students' self-reported professional competence2015Ingår i: Nurse Education Today, ISSN 0260-6917, E-ISSN 1532-2793, Vol. 37, 178-183 s.Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Nursing competence is of significant importance for patient care. Newly graduated nursing students rate their competence as high. However, the impact of different designs of nursing curricula on nursing students' self-reported nursing competence areas is seldom reported.

    OBJECTIVES: To compare newly graduated nursing students' self-reported professional competence before and after the implementation of a new nursing curriculum. The study had a descriptive comparative design. Nursing students, who graduated in 2011, having studied according to an older curriculum, were compared with those who graduated in 2014, after a new nursing curriculum with more focus on person-centered nursing had been implemented.

    SETTING: A higher education nursing program at a Swedish university.

    PARTICIPANTS: In total, 119 (2011 n=69, 2014 n=50) nursing students responded.

    METHODS: Nursing students' self-reported professional competencies were assessed with the Nurse Professional Competence (NPC) scale.

    RESULTS: There were no significant differences between the two groups of nursing students, who graduated in 2011 and 2014, respectively, with regard to age, sex, education, or work experience. Both groups rated their competencies as very high. Competence in value-based nursing was perceived to be significantly higher after the change in curriculum. The lowest competence, both in 2011 and 2014, was reported in education and supervision of staff and students.

    CONCLUSIONS: Our findings indicate that newly graduated nursing students - both those following the old curriculum and the first batch of students following the new one - perceive that their professional competence is high. Competence in value-based nursing, measured with the NPC scale, was reported higher after the implementation of a new curriculum, reflecting curriculum changes with more focus on person-centered nursing.

  • 32. Zubair, Muhammad
    et al.
    Nybom, Hilde
    Lindholm, Christina
    Sophiahemmet Högskola.
    Brandner, Johanna M
    Rumpunen, Kimmo
    Promotion of wound healing by Plantago major L. leaf extracts: Ex-vivo experiments confirm experiences from traditional medicine2016Ingår i: Natural Product Research, ISSN 1478-6419, E-ISSN 1478-6427, Vol. 30, nr 5, 622-624 s.Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The wound-healing properties of Plantago major L. (plantain) were evaluated using an ex-vivo porcine wound-healing model. Ethanol- and water-based extracts were prepared from greenhouse-grown and freeze-dried leaves of P. major. Both types of extracts stimulated wound healing in porcine skin, but the ethanol-based extracts had a somewhat stronger effect. A concentration of 1.0 mg/mL (on dry weight basis) produced the best results for both types of extracts.

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