| 2201. |
- Drevenhorn, Eva, 1954, et al.
(författare)
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Assessment of hypertensive patients' self-care agency after counseling training of nurses
- 2015
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Ingår i: Journal of the American Association of Nurse Practitioners. - : Ovid Technologies (Wolters Kluwer Health). - 2327-6886 .- 2327-6924. ; 27:11, s. 624-630
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Tidskriftsartikel (refereegranskat)abstract
- PurposeThe aim of the study was to assess hypertensive patients' self-care agency and any correlation with the patient's lifestyle changes and the nurse's degree of patient centeredness after counseling training. Data sourcesNurses in the intervention group (IG; n = 19) working at nurse-led clinics at health centers were trained in patient centeredness (motivational interviewing) and the stages of change model and included 137 patients. Nurses in the control group (CG; n = 14) included 51 patients. The Exercise of Self-Care Agency (ESCA) instrument was used. There was a significant difference from baseline to the 2-year follow-up in the ESCA score (IG, p = .0001). An increase in ESCA score was correlated with an increased level of physical activity after 2 years (IG, p = .0001; CG, p = .040). ConclusionsThe counseling training gave an increase in the patients' self-care agency scores, which was significantly correlated with increased physical activity. Implications for practiceIn clinical practice it is important for nurses to be patient centered in their counseling to affect patients' self-care agency in a positive direction.
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| 2202. |
- Drevenhorn, Eva, 1954, et al.
(författare)
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Outcomes following a programme for lifestyle changes with people with hypertension.
- 2007
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Ingår i: Journal of clinical nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 16:7B, s. 144-51
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Tidskriftsartikel (refereegranskat)abstract
- AIM: The purpose of the study was to explore the effects of using a structured nursing intervention programme in hypertension care. BACKGROUND: Counselling on lifestyle changes to address hypertension helps patients reduce risk factors such as smoking, high alcohol consumption, overweight, dyslipidemia, negative stress and physical inactivity. DESIGN: The study was performed as a pre-test-post-test study. METHODS: All 177 patients diagnosed with hypertension visiting a health centre in Southern Sweden were invited to be counselled by a public health nurse about hypertension, cardiovascular risk factors and non-pharmacological treatment with 15 months follow up. RESULTS: One hundred patients participated in the study. Systolic blood pressure decreased overall (p < 0.01), three patients with high alcohol consumption were identified, two smokers stopped smoking, two new diabetics were discovered, physical activity increased (p = 0.035) and one-third of the patients changed their medication. CONCLUSION: The level of exercise increased and a reduction in systolic blood pressure and in women's weight were the most obvious results of this intervention study. The study elucidates the challenge of executing health behaviour changes. RELEVANCE TO CLINICAL PRACTICE: Counselling following a hypertension programme gives hypertensive patients a chance to execute lifestyle changes and have their medication adjusted to achieve goals for blood pressure control. Further prospective studies in this area, with well-defined intervention approaches and several years of follow up, are necessary.
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| 2203. |
- Drevenhorn, Eva, 1954, et al.
(författare)
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To be motivated or only comply - patients' views of hypertension care after consultation training for nurses
- 2015
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Ingår i: Health Education Journal. - : SAGE Publications. - 0017-8969 .- 1748-8176. ; 74:1, s. 28-36
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Tidskriftsartikel (refereegranskat)abstract
- Objective: This paper reports on patients' perspectives on the nurse management of hypertension following consultation training, elicited as part of a randomised controlled study. Method: Telephone interviews were conducted with 16 patients in an intervention group (IG) and eight patients in a control group (CG), 3 years after nurses' consultation training in primary health care. By means of a 3-day course, nurses were educated in patient centredness, Motivational Interviewing, the Stages of Change model, guidelines for cardiovascular prevention, lifestyle changes and pharmacological treatment. In addition, they took part in video-recorded consultation training with simulated patients. A specially designed educational booklet was developed for patients in the IG. Results: Of the 16 patients in the IG, 13 reported that their views and former experiences were taken into account and all eight patients in the CG reported the same. Patients in the IG reported that the nurse listened and they had been guided and motivated to perform lifestyle changes. The booklet in the IG was reported to have been read several times, but a few patients did not remember receiving it. There were more informed thoughts about how to manage lifestyle in the IG. Patients in the CG were less detailed in their descriptions. Conclusion: Patients in both IG and CG reported to have made efforts to change lifestyle, and patients in the IG reported that they had been coached and motivated by their nurses to do so.
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| 2204. |
- Drobyshev, Igor, et al.
(författare)
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Multi-century reconstruction of fire activity in Northern European boreal forest suggests differences in regional fire regimes and their sensitivity to climate
- 2014
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Ingår i: Journal of Ecology. - : Wiley. - 0022-0477 .- 1365-2745. ; 102:3, s. 738-748
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Tidskriftsartikel (refereegranskat)abstract
- Forest fires are one of the main disturbance agents in boreal and temperate ecosystems. To decipher large-scale temporal and spatial patterns of past fire activity in Scandinavia, we analysed the synchronicity of dendrochoronologically reconstructed fire events in a large network of sites (n=62; 3296 samples, 392 individual fire years) covering a wide geographical gradient (56.5-67.0 degrees N and 9.3-20.5 degrees E) over AD 1400-1900. We identified large fire years (LFY) as years with regionally increased forest fire activity and located the geographical centres of climatic anomalies associated with synchronous LFY occurrence across the region, termed LFY centroids. The spatial pattern of LFY centroids indicated the presence of two regions with climatically mediated synchronicity of fire occurrence, located south and north from 60 degrees N. The return intervals of LFYs in Scandinavia followed a Weibull distribution in both regions. Intervals, however, differed: a period of 40years would carry a 0.93 probability of LFY occurrence in the southern region, but only a 0.48 probability of LFY occurrence in the northern region. Over 1420-1759, the northern region was characterized by significantly higher temporal variability in LFY occurrence than the southern region. Temporal correlation of LFYs with reconstructed average summer temperature and total precipitation was evident mainly for the northern region. LFYs in this region were associated with positive temperature and negative precipitation anomalies over Scandinavia and with colder and wetter conditions in more southern parts of the European subcontinent. Synthesis. Historical patterns of the occurrence of large fire years (LFY) in Scandinavia point towards the presence of two well-defined zones with characteristic fire activity, with the geographical division at approximately 60 degrees N. The northern and mid-boreal forests, although exhibiting lower LFY frequencies, appeared to be more sensitive to past summer climate, as compared to the southern boreal forests. This would imply that fire regimes across Scandinavia may show an asynchronous response to future climate changes.
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| 2205. |
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| 2206. |
- Dybjer, E., et al.
(författare)
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Incretin hormones, insulin, glucagon and advanced glycation end products in relation to cognitive function in older people with and without diabetes, a population-based study
- 2020
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Ingår i: Diabetic Medicine. - : Wiley. - 0742-3071 .- 1464-5491. ; 37:7, s. 1157-1166
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Tidskriftsartikel (refereegranskat)abstract
- Aim The aim of this observational study was to investigate relationships between physiological levels of glucometabolic biomarkers and cognitive test results in a population-based setting. Methods Cross-sectional data were obtained from the Swedish population-based Malmo Diet and Cancer Study Re-examination 2007-2012 comprising 3001 older people (mean age 72 years). Through oral glucose tolerance testing (OGTT), fasting and post-load levels of serum insulin, plasma glucagon, serum glucose-dependent insulinotropic peptide (GIP) and plasma glucagon-like peptide-1 (GLP-1) were measured. Insulin resistance and insulin sensitivity levels were calculated. In 454 participants, advanced glycation end products (AGEs) were estimated through skin autofluorescence. Associations between biomarkers and two cognitive tests, the Mini-Mental State Examination (MMSE) and A Quick Test of Cognitive Speed (AQT) respectively, were explored in multiple regression analyses. Results Positive associations following adjustments for known prognostic factors were found between MMSE scores and insulin sensitivity (B = 0.822, P = 0.004), 2-h plasma glucagon (B = 0.596, P = 0.026), 2-h serum GIP (B = 0.581, P = 0.040) and 2-h plasma GLP-1 (B = 0.585, P = 0.038), whereas negative associations were found between MMSE scores and insulin resistance (B = -0.734, P = 0.006), fasting plasma GLP-1 (B = -0.544, P = 0.033) and AGEs (B = -1.459, P = 0.030) were found. Conclusions Higher levels of insulin sensitivity, GIP and GLP-1 were associated with better cognitive outcomes, but AGEs were associated with worse outcomes, supporting evidence from preclinical studies. Glucagon was linked to better outcomes, which could possibly reflect neuroprotective properties similar to the related biomarker GLP-1 which has similar intracellular properties. Longitudinal and interventional studies are needed to further evaluate neuromodulating effects of these biomarkers. presented at the European Association for the Study of Diabetes (EASD) 2019, Barcelona, Spain
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| 2207. |
- Dymitrow, Mirek
(författare)
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Degraded towns in Poland as cultural heritage
- 2013
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Ingår i: International Journal of Heritage Studies. - : Informa UK Limited. - 1470-3610 .- 1352-7258. ; 19:7, s. 613-631
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Tidskriftsartikel (refereegranskat)abstract
- This paper discusses how the concept of cultural heritage is currently used in relation to the so-called degraded towns (i.e. deprived of their urban status) in Poland. It shows the role of heritagisation in the process of restitution of urban status, and addresses the effects of the ongoing revitalisation of degraded towns in order to restore their lost urban glory. I argue that the Polish understanding of urbanity is ambiguous, muddling formality with cultural connotations. I address how such convolution both rewrites history and affects modernity by the imposition of values and foreclosures. I also discuss how alterations to the built environment made in the name of cultural heritage (revitalisation) are often conducted with disregard to identity, authenticity and historical hybridity, and how the introduction of ‘history’ into a modern arena affects the local society. I conclude that considering degraded towns as a special form of cultural heritage is a new construction, where coupling of the disconnected dimensions of the Polish understanding of urbanity becomes even more apparent. I stress that this field is neither sufficiently differentiated nor problematised, and that cultural heritage relating to degraded towns is often taken for granted.
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| 2208. |
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| 2209. |
- Eeg-Olofsson, Katarina, 1968, et al.
(författare)
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Glycemic and risk factor control in type 1 diabetes: results from 13,612 patients in a national diabetes register
- 2007
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Ingår i: Diabetes Care. - : American Diabetes Association. - 1935-5548 .- 0149-5992. ; 30:3, s. 496-502
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: This study was designed to investigate the clinical characteristics of a large type 1 diabetic population and to evaluate the degree of fulfillment of recently updated treatment goals. RESEARCH DESIGN AND METHODS: The Swedish National Diabetes Register was initiated in 1996 as a tool for quality assurance in diabetes care. A1C levels, treatment, and risk factors were analyzed in two cross-sectional samples of 9,424 patients in 1997 and 13,612 patients in 2004 and in a smaller longitudinal sample from 1997 to 2004. RESULTS: Mean A1C decreased from 8.2 +/- 1.3% in 1997 to 8.0 +/- 1.2% in 2004 (P < 0.001). The proportion of patients reaching A1C <7.0% increased from 17.4 to 21.2% in 2004. A slow but significant improvement in blood pressure levels was seen, but only 61.3% reached the blood pressure goal of <130/80 mmHg in 2004. Lipid control improved, and the use of lipid-lowering drugs increased. Among patients treated with lipid-lowering agents, 38% reached the goal of total cholesterol <4.5 mmol/l, and 48% reached the goal of LDL cholesterol <2.5 mmol/l. Successful long-term glycemic and blood pressure control were both independently predicted by low BMI and the absence of microalbuminuria in 1997. CONCLUSIONS: In this large cohort of type 1 diabetic patients, there was a slow improvement in glycemic and risk factor control from 1997 to 2004, although the gap between the clinical results and current Swedish and American treatment goals is still unsatisfactory. It is crucial that additional measures be taken to improve risk factor control in type 1 diabetic patients.
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| 2210. |
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