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Sökning: LAR1:rkh > (2005-2009)

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1.
  • Abdelmassih Waller, Peter, et al. (författare)
  • The Extended Television : Using tangible computing to meet the needs of older persons at a nursing home
  • 2008
  • Ingår i: Gerontechnology. - : International Society for Gerontechnology (ISG). - 1569-1101 .- 1569-111X. ; 7:1, s. 36-47
  • Tidskriftsartikel (refereegranskat)abstract
    • This paper presents a person-centred model and a tangible computing approach to better adapt television media to meet two important needs of older people: social inclusion in their immediate surroundings and better support for one’s own reflections. Method The research project was carried out as a part of the construction, planning and implementation of a new nursing home. The implemented infrastructure enabled television watching at three levels: the regular (broadcast programmes), the internal and the personal. The internal level consisted of an in-house broadcast television channel and two media centres placed in common areas. The personal level had individualised functions. The entire concept is referred to as ‘extended television’. This paper describes the early implementation phase of the internal television channel and the personal television photo album. It also examines the consequences of a person-centred model and a tangible computing approach. Participation in the use of the ‘extended television’ together with older people, relatives and care workers, semistructured dialogues with these people, and observations of the television usage were conducted. Furthermore, the care workers were invited to comment on the prototypes very early in the process. Results Both the internal channel and the personal television photo album were used by older residents and iteratively adapted. However, too many factors and routines varied to get statistically sound results. On the other hand, the research shows that the person-centred study design utilised provided positive results in a setting with constantly changing conditions. Discussion This design encourages further investigations regarding how new conceptual television design can enrich the everyday lives of older people. The results also indicate the plausibility of television photo albums providing new opportunities for reminiscence compared to traditional ones, and that the internal channel resulted in possibilities for social inclusion in the nursing home examined.
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2.
  • Aguero-Torres, H, et al. (författare)
  • Rethinking the dementia diagnoses in a population-based study : What is Alzheimer's disease and what is vascular dementia? A study from the Kungsholmen Project
  • 2006
  • Ingår i: Dementia and Geriatric Cognitive Disorders. - Basel : Karger. - 1420-8008 .- 1421-9824. ; 22:3, s. 244-249
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective: To explore the hypothesis that older adults often are affected by more than one disease, making the differential diagnosis between Alzheimer’s disease (AD) and vascular dementia (VaD) difficult. Methods: Incident dementia cases (n = 308) from a population-based longitudinal study of people 75+ years were investigated. The DSM-III-R criteria were used for the clinical diagnosis of dementia. Data on vascular disorders (hypertension, cerebrovascular and ischemic heart diseases, heart failure, atrial fibrillation, diabetes) as well as type of onset/course of dementia were used retrospectively to reclassify dementias. Results: Only 47% of the AD cases were reclassified as pure AD without any vascular disorder. Among subjects with AD and with a vascular component, cerebrovascular disease was the most common (41%). Only 25% of VaD were reclassified as pure VaD. Further, 26% of the pure AD subjects developed a vascular disorder in the following 3 years. Conclusions: Both vascular and degenerative mechanisms may often contribute to the expression of dementia among the elderly. Most of the AD cases have vascular involvements, and pure dementia types in very old subjects constitute only a minority of dementia cases.
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3.
  • Ahlin, Catharina, et al. (författare)
  • Implementation of a written protocol for management of central venous access devices : a theoretical and practical education, including bedside examinations.
  • 2006
  • Ingår i: Journal of Infusion Nursing. - : Lippincott Williams & Wilkins. - 1533-1458 .- 1539-0667. ; 29:5, s. 253/294 quiz-259/296
  • Tidskriftsartikel (refereegranskat)abstract
    • The objectives of this study were to evaluate registered nurses' (RN) compliance with a local clinical central venous access device (CVAD) protocol after completing an educational program and to determine RNs' perception of the program. Seventy-five RNs working in hematology participated in the educational part of the program. Sixty-eight RNs were examined while changing CVAD dressings or placing a Huber needle into a port on actual patients. Sixty percent of the RNs passed the examination and reported that the program increased their knowledge. The results indicated that the educational program could be recommended for use when implementing a new clinical protocol.
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5.
  • Arman, M., et al. (författare)
  • Women's Perceptions and Beliefs About the Genesis of Their Breast Cancer
  • 2006
  • Ingår i: Cancer Nursing. - : Ovid Technologies (Wolters Kluwer Health). - 0162-220X .- 1538-9804. ; 29:2, s. 142-148
  • Tidskriftsartikel (refereegranskat)abstract
    • A person's belief is seen as a set of assumptions, depending on perceptions, and formed with the influence of experiences and social culture. With the aim of understanding the beliefs about the genesis of their illness, 118 (59 + 59) women with different stages of breast cancer were interviewed. Half of the sample had chosen complementary care in an anthroposophical hospital, and the other half was a matched group. Qualitative content analysis was used. Three themes emerged: (1) belief in a link to life lived (71%), (2) heredity as the sole genesis (4%), and (3) rejection of the question (25%). Under beliefs in a link to life lived, external aspects to the patient's own life (eg, diet and lifestyle) were cited, as well as inner aspects such as psychosocial problems and stress. The findings show that women are well informed about medical facts, although their beliefs reveal a holistic approach. The women's beliefs, where inner psychosocial factors are uppermost, point to a reverse of the causal ranking of medical advisors. The difference between the groups was that the matching sample was more likely to reject the influence of possible causes from life lived. In a caring perspective, women's perceptions of the genesis of their illness are in some cases turned to creative health activities that may increase well-being.
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6.
  • Backman, Sara, et al. (författare)
  • Material Wear of Polymeric Tracheostomy Tubes : A Six-Month Study
  • 2009
  • Ingår i: The Laryngoscope. - : Wiley. - 0023-852X .- 1531-4995. ; 119:4, s. 657-664
  • Tidskriftsartikel (refereegranskat)abstract
    • Objectives: The objectives were to study long-term material wear of tracheostomy tubes made of silicone (Si), polyvinyl chloride (PVC), and polyurethane (PU) after 3 and 6 months of clinical use. Study Design: The study has a prospective and comparative design. Methods: Nineteen patients with long-term tracheostomy, attending the National Respiratory Center in Sweden, were included, n = 6 with Si tubes, n = 8 with PVC tubes, and n = 5 with PU tubes. The tubes were exposed to the local environment, in the trachea for 3 and 6 months and analyzed by scanning electron microscopy, attenuated total reflectance Fourier transform infrared spectroscopy, and differential scanning calorimetry. Results: All tubes revealed severe surface changes. No significant differences were established after 3 or 6 months of exposure between the various materials. The changes had progressed significantly after this period, compared to previously reported changes after 30 days of exposure. The results from all analyzing techniques correlated well. Conclusions: All tubes, exposed in the trachea for 3-6 months, revealed major degradation and changes in the surface of the material. Polymeric tracheostomy tubes should be changed before the end of 3 months of clinical use.
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7.
  • Bassil, A K, et al. (författare)
  • Little or no ability of obestatin to interact with ghrelin or modify motility in the rat gastrointestinal tract.
  • 2007
  • Ingår i: British Journal of Pharmacology. - : Wiley. - 0007-1188 .- 1476-5381. ; 150:1, s. 58-64
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND AND PURPOSE: Obestatin, encoded by the ghrelin gene may inhibit gastrointestinal (GI) motility. This activity was re-investigated.EXPERIMENTAL APPROACH: Rat GI motility was studied in vitro (jejunum contractility and cholinergically-mediated contractions of forestomach evoked by electrical field stimulation; EFS) and in vivo (gastric emptying and intestinal myoelectrical activity). Ghrelin receptor function was studied using a GTPgammaS assay and transfected cells.KEY RESULTS: Contractions of the jejunum or forestomach were unaffected by obestatin 100 nM or 0.01-1000 nM, respectively (P>0.05 each; n=4-18). Obestatin (0.1-1 nM) reduced the ability of ghrelin 1 microM to facilitate EFS-evoked contractions of the stomach (increases were 42.7+/-7.8% and 21.2+/-5.0 % in the absence and presence of obestatin 1 nM; P<0.05; n=12); higher concentrations (10-1000 nM) tended to reduce the response to ghrelin but changes were not statistically significant. Similar concentrations of obestatin did not significantly reduce a facilitation of contractions caused by the 5-HT(4) receptor agonist prucalopride, although an inhibitory trend occurred at the higher concentrations (increases were 69.3+/-14.0% and 42.6+/-8.7% in the absence and presence of 1000 nM obestatin; n=10). Obestatin (up to 10 microM) did not modulate recombinant ghrelin receptor function. Ghrelin increased gastric emptying and reduced MMC cycle time; obestatin (1000 and 30,000 pmol kg(-1) min(-1)) had no effects. Obestatin (2500 pmol kg(-1) min(-1), starting 10 min before ghrelin) did not prevent the ability of ghrelin (500 pmol kg(-1) min(-1)) to shorten MMC cycle time.CONCLUSIONS AND IMPLICATIONS: Obestatin has little ability to modulate rat GI motility.
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8.
  • Bennet, Louise, et al. (författare)
  • Clinical appearance of erythema migrans caused by Borrelia afzelii and Borrelia garinii : effect of the patient´s sex
  • 2006
  • Ingår i: Wiener Klinische Wochenschrift. - : SPRINGER WIEN. - 0043-5325 .- 1613-7671. ; 118:17-18, s. 531-537
  • Tidskriftsartikel (refereegranskat)abstract
    • Aim: The aim in this survey was to study the clinical characteristics of infections caused by Borrelia genospecies in patients with erythema migrans where Borrelial origin was confirmed by polymerase chain reaction. The aim was also to study factors influencing the clinical appearance of erythema migrans. Methods: The study was conducted in southern Sweden from May 2001 to December 2003 on patients 18 years and older attending with erythema migrans at outpatient clinics. All erythema migrans were verified by polymerase chain reaction, photographed and categorized into “annular” or “non-annular” lesions. A logistic regression model was used to analyze relations between the appearance of the erythema migrans (i.e., annular or non-annular) and factors that influenced its clinical appearances. Results: A total of 118 patients, 54 women (45.8%) and 64 men (54.2%), fulfilled the inclusion criteria. Of these patients, 74% were infected by B. afzelii, 26% by B. garinii ( p < 0.001). A total of 45% (38/85) of the erythema migrans were annular, 46% (39/85) were non-annular and 9.4% (8/85) were atypical. For men infected by B. afzelii the odds ratio of developing non-annular erythema migrans was 0.09 (95% CI: 0.03 - 0.33) in comparison with women with the same infection. Conclusions: In this prospective study of a large series of erythema migrans, where infecting genospecies were confirmed by polymerase chain reaction, the sex of patients infected with B. afzelii had a strong influence on the appearance of the rash. Patients infected by B. garinii more often had non-annular erythema migrans and a more virulent infection with more individuals presenting with fever, raised levels of C-reactive protein and seroreactivity in the convalescence sera.
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9.
  • Bennet, Louise, et al. (författare)
  • Effect of Gender on Clinical and Epidemiologic Features of Lyme Borreliosis
  • 2007
  • Ingår i: Vector Borne and Zoonotic Diseases. - : Vector-borne and zoonotic diseases. - 1530-3667 .- 1557-7759. ; 7:1, s. 34-41
  • Tidskriftsartikel (refereegranskat)abstract
    • The aim is to highlight the influence of patients’ gender on Lyme borreliosis and especially erythema migrans (EM), focusing on exposure to tick bites, epidemiology, and the clinical picture. All studies were conducted in the county of Blekinge, located in southeastern Sweden. A prospective study was conducted in 235 individuals (women, n=110; men, n=125) engaged in recreational or occupational activities focusing on exposure to tick bites. A retrospective epidemiological study evaluating 123,495 electronic patients´ records (women, n=61,712; men, n=61,783) and a prospective clinical study including 118 patients (women, n=54; men, n=64) 18 years or older seeking care for EM > 5 cm in diameter with genospecies verified by polymerase chain reaction were conducted. Results: Women 40 years or older had a 48% higher risk than men 40 years or older and 42% higher risk than women younger than 40 years of attracting tick bites (0.0188 versus 0.0127 and 0.0188 versus 0.0132 tick bites respectively per hour). Additionally they had a 96% higher risk than men younger than 40 years of attracting tick bites (0.0188 versus 0.0096). The annual incidence rate of EM in women was 506 and in men 423 cases per 100,000 inhabitants (p<0.001). Significant differences in incidence rates occurred in those 40 years or older. Odds ratios for males infected with Borrelia afzelii developing nonannular EM were 0.09 (95% confidence interval [CI] 0.03 to 0.33) in comparison with females infected by Borrelia afzelii. Conclusions: Significant gender differences in the risk of contracting tick bites, incidence rates, and clinical picture of EM have been observed. Exposure to tick bites alone may not explain these observations and further studies need to be done to clarify the biologic, immunologic, and sociological mechanisms causing these differences.
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10.
  • Björling, Gunilla, Docent, et al. (författare)
  • A retrospective survey of outpatients with long-term tracheostomy
  • 2006
  • Ingår i: Acta Anaesthesiologica Scandinavica. - : Wiley-Blackwell. - 0001-5172 .- 1399-6576. ; 50:4, s. 399-406
  • Tidskriftsartikel (refereegranskat)abstract
    • Background:  The Respiratory Unit (RU) at Danderyd University Hospital opened in 1982, with the expressed goal of supporting outpatients with long-term tracheostomy. The primary aim of this retrospective study in tracheostomized patients was to compare the need for hospital care in the 2-year period before and after the tracheostomy.Methods:  Data were collected from patient medical records at the RU, from the National Board of Health and Welfare, Sweden and from the Official Statistics of Sweden. The subjects were RU patients in 1982 (Group 1, n = 27) and in 1997 (Group 2, n = 106) with long-term tracheostomy surviving at least 4 years after the tracheostomy.Results:  Both groups had few and unchanged needs for hospital care after tracheostomy. They spent ≥ 96% of their time out of hospital. In 1997, (group 2) the number of patients, diagnoses and need for home mechanical ventilation had increased. Life expectancy was assessed for patients in Group 1. Data showed that they lived as long as an age-matched and gender-adjusted control cohort.Conclusions:  Long-term tracheostomy may not increase the need for hospital care and does not reduce life expectancy. These clinical observations were made in a setting where patients had regular access to a dedicated outpatient unit.
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