| 991. |
- Helgason, Jon, et al.
(author)
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Sophia Elisabet Brenner som Sappho
- 2011
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In: Wår lärda skalde-fru, Sophia Elisabet Brenner och hennes tid. - Lund : Lunds universitet. ; , s. 57-77, s. 56-77
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Book chapter (other academic/artistic)
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| 992. |
- Hellgren, Olof, et al.
(author)
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Circannual variation in blood parasitism in a sub-Saharan migrant passerine bird, the garden warbler
- 2013
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In: Journal of Evolutionary Biology. - : Wiley. - 1010-061X .- 1420-9101. ; 26:5, s. 1047-1059
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Journal article (peer-reviewed)abstract
- Knowing the natural dynamics of pathogens in migratory birds is important, for example, to understand the factors that influence the transport of pathogens to and their transmission in new geographical areas, whereas the transmission of other pathogens might be restricted to a specific area. We studied haemosporidian blood parasites of the genera Plasmodium, Haemoproteus and Leucocytozoon in a migratory bird, the garden warbler Sylvia borin. Birds were sampled in spring, summer and early autumn at breeding grounds in Sweden, on migration at Capri, Italy and on arrival and departure from wintering staging areas in West Africa: mapping recoveries of garden warblers ringed in Fennoscandia and Capri showed that these sites are most probably on the migratory flyway of garden warblers breeding at Kvismaren. Overall, haemosporidian prevalence was 39%, involving 24 different parasite lineages. Prevalence varied significantly over the migratory cycle, with relatively high prevalence of blood parasites in the population on breeding grounds and at the onset of autumn migration, followed by marked declines in prevalence during migration both on spring and autumn passage. Importantly, we found that when examining circannual variation in the different lineages, significantly different prevalence profiles emerged both between and within genera. Our results suggest that differences in prevalence profiles are the result of either different parasite transmission strategies or coevolution between the host and the various parasite lineages. When separating parasites into common vs. rare lineages, we found that two peaks in the prevalence of rare parasites occur; on arrival at Swedish breeding grounds, and after the wintering period in Africa. Our results stress the importance of appropriate taxonomic resolution when examining host-parasite interactions, as variation in prevalence both between and within parasite genera can show markedly different patterns.
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| 993. |
- Hellman, Sofie, et al.
(author)
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Effects of the sampling design and selection of parameter values on pollen-based quantitative reconstructions of regional vegetation: a case study in southern Sweden using the REVEALS model
- 2008
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In: Vegetation History and Archaeobotany. - : Springer Science and Business Media LLC. - 0939-6314 .- 1617-6278. ; 17:5, s. 445-459
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Journal article (peer-reviewed)abstract
- The need for quantification of land cover from pollen data has led to the development of a Landscape Reconstruction Algorithm (LRA). The LRA includes several models of which the REVEALS model estimates regional vegetation abundance using pollen assemblages from large sites (lakes or bogs). In this paper we explore the effects of selection and number of pollen samples, and choice of pollen productivity estimates on the REVEALS results. The effect of the size of vegetation surveys is also tested. The results suggest that the differences between two sizes of vegetation surveys have little effect on the model validation. The "characteristic radius" of regional vegetation in southern Sweden was estimated as 200 km. However, the vegetation composition in a 100 x 100 km(2) square matches well with that estimated by REVEALS. Whether 25, 20 (outliers excluded) or 4 pollen samples are used does not change the REVEALS reconstructions much although the error estimates are larger when outliers are included, and very large when only four samples are used. Therefore validation of the REVEALS model and REVEALS reconstructions of past vegetation can be performed using a limited number of pollen samples, although with caution. The use of many pollen samples from multiple sites is always better whenever possible. REVEALS reconstructions are closer to the actual vegetation when the Danish Pollen Productivity Estimates (PPEs) are used instead of the Swedish PPEs for Cereals, Rumex acetosa/acetosella, Plantago lanceolata and Calluna, indicating that the Danish PPEs are more reliable than the Swedish ones for those taxa. It is recommended to test more than one set of PPEs in validation and applications of the REVEALS model for a better evaluation of the results.
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| 994. |
- Hellman, Sofie, et al.
(author)
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The REVEALS model, a new tool to estimate past regional plant abundance from pollen data in large lakes: validation in southern Sweden
- 2008
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In: Journal of Quaternary Science. - : Wiley. - 1099-1417 .- 0267-8179. ; 23:1, s. 21-42
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Journal article (peer-reviewed)abstract
- The REVEALS model was developed to reconstruct quantitatively regional vegetation abundance (in a 10(4)-10(5) km(2) area) from pollen assemblages in large lakes (>= 100-500 ha). This model corrects for biases in pollen percentages caused by inter-taxonomic differences in pollen productivity and dispersal. This paper presents the first case study to validate REVEALS, using empirical data from southern Sweden. Percentage cover of modern regional vegetation in Skane and Smaland, two contrasting vegetation regions, was predicted with REVEALS for 26 key taxa, using pollen assemblages from surface sediments in 10 large lakes, and compared to the actual vegetation within 10(4) km(2) compiled from satellite data, forestry inventories, crop statistics, aerial photographs, and vegetation inventories. REVEALS works well in predicting the percentage cover of large vegetation units such as total trees (wooded land), total herbs (open land), total conifers and total broad-leaved trees, and it provides reasonable estimates for individual taxa, including Pinus, Picea, Betula, Corylus, Alnus, Tilia, Sahx spp., Juniperus, Poaceae, Cyperaceae, Cerealia and Secale. The results show great potential for REVEALS applications, including (1) quantitative reconstructions of past regional land cover important for palaeoclimatology and nature conservation, and (2) local-scale reconstruction of vegetation (<1 km(2) up to similar to 5 km(2) area) relevant for palaeoecology and archaeology.
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| 995. |
- Hellström, Amanda, et al.
(author)
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Association between Sleep Disturbances and Leisure Activities in the Elderly : A Comparison between Men and Women
- 2014
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In: Sleep Disorders. - : Hindawi Limited. - 2090-3545 .- 2090-3553.
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Journal article (peer-reviewed)abstract
- It has been suggested that physical or social activity is associated with fewer sleep disturbances among elderly people. Women report more sleep disturbances than men, which could indicate a variation in activity patterns between the genders. The aim of this study was to investigate associations between sleep disturbances and leisure activities in men and women (n = 945) aged ≥60 years in a Swedish population. Sleep disturbances were measured using eight dichotomous questions and seventeen variables, covering a wide range of leisure activities. Few leisure activities were found to be associated with sleep disturbances and their importance decreased when the models were adjusted for confounders and gender interactions. After clustering the leisure activities and investigating individual activities, socio-intellectual activities were shown to be significant for sleep. However, following adjustment for confounders and gender interactions, home maintenance was the only activity significant for sleep. Being a female increased the effect of home maintenance. Besides those leisure activities, poor/fair self-rated health (OR 7.50, CI: 4.27-11.81) and being female (OR 4.86, CI: 2.75-8.61) were found to have the highest association with poor sleep. Leisure activities pursued by elderly people should focus on activities of a socio-intellectual nature, especially among women, to promote sleep.
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| 996. |
- Hellström, Amanda, et al.
(author)
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Promoting sleep by nursing interventions in health care settings : A systematic review
- 2011
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In: Worldviews on Evidence-Based Nursing. - : Wiley. - 1545-102X .- 1741-6787. ; 8:3, s. 128-142
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Journal article (peer-reviewed)abstract
- Background: Sleep disturbances are a common problem among individuals in hospitals and institutions. Although several studies have explored this phenomenon, there is still a lack of knowledge about the effectiveness of sleep-promoting nursing interventions. This systematic review aims to describe and evaluate the effectiveness of sleep-promoting nursing interventions in health care settings. Design: A systematic review was performed. Method: In June 2009, a literature search was carried out in the following databases: Academic Search Elite, CINAHL, the Cochrane Library and MedLine/PubMed. Fifty-two references were identified and after critical appraisal nine studies were selected. A compilation of the results and the outcomes of the interventions were carried out. Further, the evidence strength of the interventions was assessed. Findings: Evidence for the nursing interventions sleep hygiene, music, natural sound and vision, stimulation of acupoints, relaxation, massage and aromatherapy, is found to be low or very low. Still large effects of interventions where found when using massage, acupuncture and music, natural sounds or music videos. The use of sleep hygiene and relaxation on the other hand showed only small effects. Conclusion: The paucity of studies implies that the confidence in the effects shown, and the lack of high evidence strength for many nursing interventions, most certain will change if further studies are carried out. The uncertainty about the effects calls for more research before implementing the interventions into clinical practice.
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| 997. |
- Hellström, Amanda, et al.
(author)
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The rhythm of the unit is the pace of life : a study of everyday activities and sleep in Swedish residential care
- 2015
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In: Open Journal of Nursing. - Irvine : Scientific Research Publishing. - 2162-5336 .- 2162-5344. ; 5:8, s. 697-706
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Journal article (peer-reviewed)abstract
- Social and physical activities can improve sleep in older people. However, living in a residential care facility has been associated with a limited potential for activities and increased inactivity, reflected in poor sleep among residents. In turn, poor sleep can impair physical and mental functions. This paper explores sleep habits and everyday activities at three residential care facilities and investigates the link between sleep habits and everyday activities from the perspective of the residents. Data were collected through observations of daily life and interviews with residents.The results showed that fixed times during the day reduced daytime sleep and motivated them to go to the day room, thus enabling social interaction. More impaired residents spent more time in the day room napping or being less active. The residents stated that going outdoors was a desired activity, thought to improve sleep. However, the activity did not occur to the extent the residents wished for. Maintaining mobility and influence over daily activities together with regularity seemed to improve sleep. Awareness among staff of the need for stimulating and enriching activities, as well as access to bright light is requisite. Specific consideration should be given to residents who have difficulties communicating their wishes and/or impaired mobility.
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| 998. |
- Hellström, Lina, 1975-, et al.
(author)
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Clinical implementation of systematic medication reconciliation and review as part of the Lund Integrated Medicines Management model – impact on all cause emergency department revisits
- 2012
-
In: Journal of Clinical Pharmacy and Therapeutics. - : Hindawi Limited. - 0269-4727 .- 1365-2710. ; 37:6, s. 686-692
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Journal article (peer-reviewed)abstract
- What is known and objective: Interventions involving medication reconciliation and review by clinical pharmacists can reduce drug-related problems and improve therapeutic outcomes. The objective of this study was to examine the impact of routine admission medication reconciliation and inpatient medication review on emergency department (ED) revisits after discharge. Secondary outcomes included the combined rate of post-discharge hospital revisits or death.Methods: This prospective, controlled study included all patients hospitalised in three internal medicine wards in a university hospital, between January 1 2006 and May 31 2008. Medication reconciliation on admission and inpatient medication review, conducted by clinical pharmacists in a multiprofessional team, were implemented in these wards at different times during 2007 and 2008 (intervention periods). A discharge medication reconciliation was undertaken in all the study wards, during both control and intervention periods. Patients were included in the intervention group (n=1216) if they attended a ward with medication reconciliation and review, whether they had received the intervention or not. Control patients (n=2758) attended the wards before implementation of the intervention. Results: No impact of medication reconciliation and reviews on ED revisits (hazard ratio [HR], 0.95; 95% confidence interval [CI], 0.86-1.04) or event-free survival (HR, 0.96; 95% CI, 0.88-1.04) was demonstrated. In the intervention group, 594 patients (48.8%) visited the ED, compared to 1416 (51.3%) control patients. In total, 716 intervention (58.9%) and 1688 (61.2%) control patients experienced any event (ED visit, hospitalisation or death). Because the time to a subsequent ED visit was longer for the control as well as the intervention groups in 2007 than in 2006 (p<0.05), we re-examined this cohort of patients; the proportion of patients revisiting the ED was similar in both groups in 2007 (p=0.608).What is new and conclusion: Routine implementation of medication reconciliation and reviews on admission and during the hospital stay did not appear to have any impact on ED revisits, rehospitalisations or mortality over six months' follow-up.
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| 999. |
- Hellström, Lina, 1975-, et al.
(author)
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Errors in medication history at hospital admission: prevalence and predicting factors
- 2012
-
In: BMC Clinical Pharmacology. - : Springer Science and Business Media LLC. - 1472-6904. ; 12, s. Article ID: 9-
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Journal article (peer-reviewed)abstract
- Background: An accurate medication list at hospital admission is essential for the evaluation and further treatment of patients. The objective of this study was to describe the frequency, type and predictors of errors in medication history, and to evaluate the extent to which standard care corrects these errors.Methods:A descriptive study was carried out in two medical wards in a Swedish hospital using Lund Integrated Medicines Management (LIMM)-based medication reconciliation. A clinical pharmacist identified each patient's most accurate pre-admission medication list by conducting a medication reconciliation process shortly after admission. This list was then compared with the patient's medication list in the hospital medical records. Addition or withdrawal of a drug or changes to the dose or dosage form in the hospital medication list were considered medication discrepancies. Medication discrepancies for which no clinical reason could be identified (unintentional changes) were considered medication history errors.Results: The final study population comprised 670 of 818 eligible patients. At least one medication history error was identified by pharmacists conducting medication reconciliations for 313 of these patients (47%; 95% CI 43-51%). The most common medication error was an omitted drug, followed by a wrong dose. Multivariate logistic regression analysis showed that a higher number of drugs at admission (odds ratio [OR] per 1 drug increase = 1.10; 95% CI 1.06 - 1.14; p<0.0001) and the patient living in their own home without any care services (OR1.58; 95% CI 1.02 - 2.45; p = 0.042) were predictors for medication history errors at admission. The results further indicated that standard care by non-pharmacist ward staff had partly corrected the errors in affected patients by four days after admission, but a considerable proportion of the errors made in the initial medication history at admission remained undetected by standard care (OR for medication errors detected by pharmacists' medication reconciliation carried out on days 4 - 11 compared to days 0 - 1 = 0.52; 95% CI 0.30 - 0.91; p = 0.021).Conclusions: Clinical pharmacists conducting LIMM-based medication reconciliations have a high potential for correcting errors in medication history for all patients. In an older Swedish population, those prescribed many drugs seem to benefit most from admission medication reconciliation.
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| 1000. |
- Hellström, Lina, et al.
(author)
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Impact of the Lund Integrated Medicines Management (LIMM) model on medication appropriateness and drug-related hospital revisits.
- 2011
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In: European Journal of Clinical Pharmacology. - : Springer Science and Business Media LLC. - 0031-6970 .- 1432-1041. ; 67:7, s. 741-752
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Journal article (peer-reviewed)abstract
- PurposeTo examine the impact of systematic medication reconciliations when admitted to hospital, and medication review while in hospital, on the number of inappropriate medications and unscheduled drug-related hospital revisits in elderly patients.MethodsA prospective, controlled study in 210 patients, aged 65 years or older, who were admitted to one of three internal medicine wards at a University Hospital in Sweden. Patients received either standard care or care according to the Lund Integrated Medicines Management (LIMM) model. A multi-professional team, including a clinical pharmacist, provided medication reconciliations on admission and medication reviews during the hospital stay for the LIMM group. Blinded reviewers evaluated the appropriateness of the prescribing (using the Medication Appropriateness Index) on admission and discharge, and assessed the probability that a drug-related problem was the reason for any patient readmitted to hospital or visiting the emergency department within three months of discharge (using WHO causality criteria).ResultsThere was a greater decrease in the number of inappropriate drugs in the intervention group than in the control group for both the intention-to-treat population (51% [95% CI 43-58%] versus 39% [95% CI 30-48%], p=0.0446) and the per-protocol population (60% [95% CI 51-67%] versus 44% [95% CI 34-52 %], p=0.0106). There were 6 revisits to hospital in the intervention group which were judged as ‘possibly, probably or certainly drug-related’, compared with 12 in the control group (p=0.0469).ConclusionIn this study, medication reconciliation and reviews provided by a clinical pharmacist in a multi-professional team significantly reduced the number of inappropriate drugs and unscheduled drug-related hospital revisits for elderly patients.
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