| 51. |
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| 52. |
- Huus, Karina, et al.
(författare)
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Risk factors in childhood obesity : findings from the All Babies In Southeast Sweden (ABIS) cohort
- 2007
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Ingår i: Acta Paediatrica. - : Wiley. - 0803-5253 .- 1651-2227. ; 96:9, s. 1321-1325
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Tidskriftsartikel (refereegranskat)abstract
- Aim: Our objective was to investigate whether overweight at a very young age predicts overweight at 5 years and to identify risk factors for overweight/obesity at 5 years, thereby making it easier for Child Health Services to focus their prevention strategies on risk groups.Methods: We analysed data from the ABIS study (All Babies In Southeast Sweden), a prospective cohort study. Parents answered questionnaires between childbirth (n = 16,058) and 5 years (n = 7356).Results: High body mass index (BMI; >95th percentile) at 1 year (adjusted odds ratio [AOR]= 6.57; 95% CI = 4.63–9.33; p < 0.001) and age-adjusted BMI > 25 at 2.5 years (AOR = 14.24; 95% CI = 10.52–19.29; p < 0.001) were associated with increased risk of obesity (age-adjusted BMI > 30) at 5 years. Heredity for type 2 diabetes (p = 0.022), high parental BMI and the child's own BMI at birth and at 1 year predicted higher BMI of the child at 5 years (p < 0.001). High parental education was inversely associated with child overweight (p = 0.054 respective p < 0.005).Conclusion: Obesity at age 1 and at 2.5 years predicts obesity at 5 years. Obese parents, especially in families with heredity for type 2 diabetes and low education, should be targeted in early obesity prevention strategies by the Child Health Service.
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| 53. |
- Johansson, Ann-Christin, et al.
(författare)
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Psychosocial stress factors among patients with lumbar disc herniation, scheduled for disc surgery in comparison with patients scheduled for arthroscopic knee surgery
- 2007
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Ingår i: European spine journal. - : Springer Science and Business Media LLC. - 0940-6719 .- 1432-0932. ; 16:7, s. 961-970
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Tidskriftsartikel (refereegranskat)abstract
- Returning to work after disc surgery appears to be more heavily influenced by psychological aspects of work than by MR-identified morphological alterations. It is still not known whether psychosocial factors of importance for outcome after disc surgery are present preoperatively or develop in the postoperative phase. The aim of this study was to investigate the presence of work-related stress, life satisfaction and demanding life events, among patients undergoing first-time surgery for lumbar disc herniation in comparison with patients scheduled for arthroscopic knee surgery. Sixty-nine patients with disc herniation and 162 patients awaiting arthroscopy were included in the study, during the time period March 2003 to May 2005. Sixty-two percent of the disc patients had been on sick leave for an average of 7.8 months and 14 percent of the knee patients had been on sick leave for an average of 4.2 months. The psychosocial factors were investigated preoperatively using a questionnaire, which was a combination of the questionnaire of quality of work competence (QWC), life satisfaction (LiSat9) and life events as a modification of the social readjustment scale. There were no significant differences between the two groups in terms of work-related stress or the occurrence of demanding life events. The disc patients were significantly less satisfied with functions highly inter-related to pain and discomfort, such as present work situation, leisure-time, activities of daily living (ADL) function and sleep. Patients with disc herniation on sick leave were significantly less satisfied with their present work situation than knee patients on sick leave; this sub-group of patients with disc herniation also reported significantly higher expectations in relation to future job satisfaction than knee patients. The results indicate that psychosocial stress is not more pronounced preoperatively in this selected group of disc patients, without co-morbidity waiting for first-time disc surgery, than among knee patients awaiting arthroscopy. It was notable that the disc patients had high expectations in terms of improved job satisfaction after treatment by surgery.
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| 54. |
- Josefsson, Karin, et al.
(författare)
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Registered nurses' education and their views on competence development in municipal elderly care in Sweden : a questionnaire survey
- 2007
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Ingår i: International Journal of Nursing Studies. - : Elsevier BV. - 0020-7489 .- 1873-491X. ; 44:2, s. 245-258
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Tidskriftsartikel (refereegranskat)abstract
- Background: Recent changes of municipal elderly care in Sweden have resulted in that persons 65 years and older, previously nursed in hospital facilities, are now being cared for in the municipality. This change has had a significant impact on the work situation of registered nurses (RNs) and calls for appropriate educational preparation to enable RNs to undertake their new roles effectively. Aim: The main focus was to describe RNs' education and their view of competence development in municipal elderly care. Another aim was to compare RNs working solely in dementia care (DC) with those working in general elder care (GC) of older persons with diverse diagnoses. Design: A non-experimental, descriptive design with a survey research approach was used. Settings: Sixty special housing with subunits including those offering daytime activities in a large city in the middle of Sweden. Participants: The number of participating RNs was a total of 213, with a response rate of 62.3%. Of the 213 RNs, 95 (44.6%) worked in DC, and 118 (55.4%) in GC. Method: A questionnaire survey. Results: The findings showed that RNs possessed a broad range of competence. The majority lacked a bachelor's degree in nursing. Few had adequate specialist competence. RNs' in DC wanted to invest more in competence development whereas RNs in GC were more motivated to attain greater authority in the making of important decisions and to seek another position. Conclusion: An important future prospect is to develop the competence of RNs in elderly care. In order to ensure high quality and security in elderly care, it is also essential to increase the number of RNs with specialist competence. (c) 2005 Elsevier Ltd. All rights reserved.
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| 55. |
- Josefsson, Karin, et al.
(författare)
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Work situation of registered nurses in municipal elderly care in Sweden : a questionnaire survey
- 2007
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Ingår i: International Journal of Nursing Studies. - : Elsevier BV. - 0020-7489 .- 1873-491X. ; 44:1, s. 71-82
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Tidskriftsartikel (refereegranskat)abstract
- Background: Organizational changes have occurred in municipal elderly care in Sweden during the past decades. The 'Adel' reform transferred responsibility for the care of older persons from the county councils to the municipalities. Furthermore, the specialisation in dementia care divided elderly care into two groups: dementia and general care. This change has had a significant impact on the work situation of registered nurses (RNs). Aim: The main focus was to describe RNs' work situation and their characteristics in municipal elderly care. Another aim was to compare RNs working solely in dementia care with those working in general care of older persons with diverse diagnoses. Design: A non-experimental, descriptive design with a survey research approach was used. Settings: Sixty special housing units with underlying units including those offering daytime activities in a large city in the middle of Sweden. Participants: The number of participating RNs was a total of 213, with a response rate of 62.3%. Of the 213 RNs, 95 (44.6%) worked in dementia care, and 118 (55.4%) in general care. Method: A questionnaire survey. Results: The results indicated high levels of time pressure in both groups. Greater knowledge and greater emotional and conflicting demands were found in dementia care. The majority perceived a greater opportunity to plan and perform daily work tasks than to influence the work situation in a wider context. Support at work was perceived as generally high from management and fellow workers and higher in dementia care. Conclusion: It is important to decrease RNs' time pressure and increase their influence on decisions made at work. (c) 2005 Elsevier Ltd. All rights reserved.
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| 56. |
- Kadir, Ahmadul, et al.
(författare)
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Changes in brain 11C-nicotine binding sites in patients with mild Alzheimer's disease following rivastigmine treatment as assessed by PET
- 2007
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Ingår i: Psychopharmacology. - : Springer Science and Business Media LLC. - 0033-3158 .- 1432-2072. ; 191:4, s. 1005-1014
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Tidskriftsartikel (refereegranskat)abstract
- Rationale Marked reduction in the cortical nicotinic acetylcholine receptors is observed in the brain of patients suffering from Alzheimer’s disease (AD). Although cholinesterase inhibitors are used for symptomatic treatment of mild to moderate AD patients, numerous long-term treatment studies indicate that they might stabilize or halt the progression of the disease by restoring the central cholinergic neurotransmission. Thus, we used positron emission tomography (PET) technique as a sensitive approach to assess longitudinal changes in the nicotine binding sites in the brains of patients with AD. Objective To evaluate changes in brain nicotinic binding sites in relation to inhibition level of cholinesterases in cerebrospinal fluid (CSF) and plasma and changes in cognitive performance of the patients in different neuropsychological tests after rivastigmine treatment. Materials and methods Ten mild AD patients received rivastigmine for 12 months. A dual-tracer PET model with administration of 15O–water and (S)(–)11C–nicotine was used to assess 11C–nicotine binding sites in the brain at baseline and after 3 and 12 months of the treatment. Cholinesterase activities in CSF and plasma were assessed colorimetrically. Results The 11C–nicotine binding sites were significantly increased 12–19% in several cortical brain regions after 3 months compared with baseline, while the increase was not significant after 12 months of the treatment. After 3 months treatment, low enzyme inhibition in CSF and plasma was correlated with higher cortical 11C–nicotine binding. The 11C–nicotine binding positively correlated with attentional task at the 12-month follow-up. Conclusion Changes in the 11C–nicotine binding during rivastigmine treatment might represent remodeling of the cholinergic and related neuronal network.
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| 57. |
- Larsen, Joacim, et al.
(författare)
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Factors associated with poor general health after stem-cell transplantation
- 2007
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Ingår i: Supportive Care in Cancer. - Berlin : Springer Berlin/Heidelberg. - 0941-4355 .- 1433-7339. ; 15:7, s. 849-857
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Tidskriftsartikel (refereegranskat)abstract
- Aims: To describe functional status (FS), general health (GH) and symptom distress (SD) from admission to 1 year post-SCT and to identify medical, demographic, and/or patient-reported outcome variables associated with patient-perceived GH. Material and Methods: Forty-one patients (27 women) with a median age of 44 (18-65) years answered three questionnaires (SIP, SWED-QUAL, and SFID-SCT) from admission to 1 year post-SCT. Results: At discharge, 59% of the patients reported poor FS and GH, and 24% reported > 10 simultaneous symptoms. After 1 year post-SCT, 22% still reported poor FS, 32% poor GH, and 12% > 10 simultaneous symptoms. Compared with admission, significantly larger proportions of the patients reported poor GH at discharge (20 vs 59%, p = .001), poor FS at 6 months (24 vs 59%, p = .004), and poor GH [The number of symptoms was found to be significantly associated with poor GH at discharge (OR 1.330, p = .009) and at 1 year post-SCT (OR 2.000, p = .010)]. Patients reporting "poor GH" at discharge and at 1 year post-SCT reported a median of 7 and 10 symptoms, respectively. Patients with "good GH" reported a median of three symptoms both at T1 and T4. "Tiredness", "anxiety", "mouth dryness", "loss of appetite", and "diarrhoea" were reported by a larger proportion of the patients reporting "poor GH". Conclusions: The results confirm that some patients who have undergone a SCT have a negatively affected life situation. The study indicates that actively asking for symptoms and applying the best treatment for symptom alleviation are among the most important measures that SCT teams can take to help the patients perceive better general health and an improved life situation.
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| 58. |
- Lillhök, J E, et al.
(författare)
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Nanodosimetry in a clinical neutron therapy beam using the variance-covariance method and Monte Carlo simulations.
- 2007
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Ingår i: Physics in Medicine and Biology. - : IOP. - 0031-9155 .- 1361-6560. ; 52:16, s. 4953-66
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Nanodosimetric single-event distributions or their mean values may contribute to a better understanding of how radiation induced biological damages are produced. They may also provide means for radiation quality characterization in therapy beams. Experimental nanodosimetry is however technically challenging and Monte Carlo simulations are valuable as a complementary tool for such investigations. The dose-mean lineal energy was determined in a therapeutic p(65)+Be neutron beam and in a Co-60 gamma. beam using low-pressure gas detectors and the variance-covariance method. The neutron beam was simulated using the condensed history Monte Carlo codes MCNPX and SHIELD-HIT. The dose-mean lineal energy was calculated using the simulated dose and fluence spectra together with published data from track-structure simulations. A comparison between simulated and measured results revealed some systematic differences and different dependencies on the simulated object size. The results show that both experimental and theoretical approaches are needed for an accurate dosimetry in the nanometer region. In line with previously reported results, the dose-mean lineal energy determined at 10 nm was shown to be related to clinical RBE values in the neutron beam and in a simulated 175 MeV proton beam as well.
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| 59. |
- Nilsson, Kent W., et al.
(författare)
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Alcohol-related problems among adolescents and the role of a sense of coherence
- 2007
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Ingår i: International Journal of Social Welfare. - Uppsala Univ, Cent Hosp Vasteras, Clin Res Ctr, SE-72189 Vasteras, Sweden. Karlstad Univ, Dept Social Sci, Karlstad, Sweden. Lillehammer Univ Coll, Fac Hlth & Social Studies, Lillehammer, Norway. Karolinska Inst, Div Int Hlth IHCAR, Stockholm, Sweden. : Wiley. - 1369-6866 .- 1468-2397. ; 16:2, s. 159-167
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Tidskriftsartikel (refereegranskat)abstract
- Alcohol abuse is generally regarded as a major risk factor for antisocial problem behaviour among adolescents. On the other hand, personal coping strategies hypothetically can be seen as protective of alcohol-related behaviour problems. The aim of this study was to examine the influence of sense of coherence (SOC) on alcohol-related behavioural problems in an SOC-alcohol intoxication model. The method of study was a cross-sectional, school-based questionnaire study of 4,305, 16- and 19-year-old adolescents. We found that both a SOC and the frequency of alcohol intoxication were independently associated with alcohol-related behavioural problems. Our model shows that the combination of these two independent factors amplifies them considerably, and adolescents with a strong SOC, despite frequent intoxication, were protected to a large degree from experiencing alcohol-related problems.
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| 60. |
- Nordgren, Lena, et al.
(författare)
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An exploration of the phenomenon of formal care from the perspective of middle-aged heart failure patients
- 2007
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Ingår i: European Journal of Cardiovascular Nursing. - : Oxford University Press (OUP). - 1474-5151 .- 1873-1953. ; 6:2, s. 121-129
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Despite a considerable amount of research into heart failure there remains a divergence between the care available and patient's needs. The predominant biomedical perspective is more focused on the disease rather than the patient. In order to deliver formal care appropriate to the needs of middle-aged patients with moderate-severe HF it is imperative to gain the perspective of the individual patient. AIMS: The aim of the current study was to explore and understand the phenomenon: Formal care as experienced from the perspective of middle-aged patients living with HF. METHODS: The study was performed using a lifeworld perspective. Data was collected in seven unstructured interviews with middle-aged people living with moderate-severe HF. Data was analysed using a phenomenological approach. RESULTS: Formal care, as experienced by middle-aged patients living with moderate to severe HF, means hope to once again be able to have access to life. However, the meaning of formal care is ambiguous, which signifies that care means both health and suffering at the same time. The essence's meaning constituents are: dependency of care, surrender to care and unclear participation. CONCLUSION: The experience of formal care means both well-being and suffering at the same time. Patients' suffering in relation to formal care can be reduced if formal carers act from an ethical patient perspective point of view and if carers regard patients' lived experiences.
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